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YouthPower Action funded and supported a special AIDS supplement entitled:
Achieving 902: Young People, HIV Testing Services and Linkage to Treatment Guest Editors: Sten H. Vermund, MD, PhD Donna R. McCarraher, PhD, MPH B. Ryan Phelps, MD, MPH, FAAP Open Access online version: Funding: U.S. President's Emergency Plan for AIDS Relief (PEPFAR) through the United States Agency for International Development (USAID) under YouthPower Action, Contract number AID-OAA-TO /AID-OAA-I This journal supplement will be available freely online as it is open access:
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Overview Challenges: Adolescents and youth (AY) ages have low rates of HIV diagnosis and treatment initiation Approximately 1/3 of all new infections worldwide occur in AY 15–24 years old HIV mortality is increasing among AY, while mortality for other age groups is declining Despite this, few interventions have been tailored to and tested among AY Goal of this journal supplement: To provide new evidence and insight to enable funders, program planners, researchers and policy makers to improve or develop HIV programs, policies and approaches for adolescents and youth AIDS has published a special issue about HIV testing and linkage to care among adolescents and youth. This provides information from sub-Saharan Africa and the United States. It highlights innovative approaches for increasing adolescents and youth testing for HIV and linking them to care. It also highlights the importance of involving adolescents and young people in the design of research and programs that aim to meet their needs. The goal of this supplement is to inform program planners, researchers, policymakers, and funding agencies about the development and design of effective adolescent and youth programs, policies, and strategies for improving the critical first two “90s” among adolescents and youth: HIV testing and diagnosis, and linkage to care and treatment. The articles in the supplement were written by experts in the field and reviewed by youth to solicit their inputs on the saliency of the findings for youth in the countries in which they live.
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Research summary Youth must be involved in the design of programs and research that aim to meet their needs (Denison et al.). HIV+ youth participated in the Project SOAR (Supporting Operational AIDS Research) meeting and influenced the development of an implementation science agenda. HIV self-testing (Indravudh et al.) is acceptable to young people in Malawi and Zimbabwe, especially if kits were provided for free or at low-cost and provided by lay community distributors. Voluntary Male Circumcision Services (VMMC) (Kaufman et al.) in South Africa, Tanzania, and Zimbabwe represent a missed opportunity for counseling adolescents and young men on HIV prevention and care. Delivering a community-level door-to-door combination HIV prevention package (Shanaube et al.) is acceptable to adolescents and feasible in Zambia. Continuous Quality Improvement (CQI) interventions (Wagner et al.) in Kenya resulted in changes in knowledge of HIV transmission, HIV prevention, and intention to re-test for HIV. CQI interventions may improve adolescent-friendly HIV testing services. [
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Research summary Youth value the support of caregivers and health care workers (Wilson et al.) in deciding to seek HIV testing and linking to care in Kenya. Strengthening HCW and caregiver capacities to support adolescents while respecting autonomy may facilitate attaining ’90-90’90’ targets for young people. Improving services for adolescents at health centers and establishing linkages between schools and health centers (Ruria et al.) in Kenya are feasible to address the needs of adolescents and support timely linkage to care and retention. In the U.S., Centers for Disease Control-funded non-healthcare facilities provide HIV tests to adolescent MSM (Marano et al.). A greater proportion of adolescent MSM were newly diagnosed in non-healthcare facilities compared to total tested in those facilities, and linkage to care was lower for black and Latino adolescents. The Metropolitan Atlanta Community Adolescent Rapid Testing Initiative (MACARTI) (Camacho-Gonzalez et al.) combined venue-based testing, motivational interviewing, and case management to improve linkage to care and timing to linkage to care.
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