Adolescent HIV care and treatment: A training curriculum for health workers (Trainer Manual)
This training package was developed with health workers in mind and aims to support them in meeting the evolving needs of adolescents with HIV infection. The materials cover a broad range of subjects, including youth-friendly services, HIV clinical care, counseling, psychosocial support, mental health, adherence and disclosure support, sexual and reproductive health, the transition to adult care, and monitoring and evaluation.
With the success of the global scale-up of HIV prevention and treatment services, a new paradigm for pediatric HIV is emerging, representing a slow shift from a fatal infection threatening the lives of infants and young children to a manageable, chronic disease affecting adolescents and young adults.
As the number of adolescents (defined as those aged 10-19 years) with HIV increases, doctors, nurses, program managers, parents, caregivers, and communities are beginning to recognize the distinct health, psychological, and social needs of this population. Adolescents living with HIV face considerable challenges and have unique needs and vulnerabilities, as compared with both young children and adults. As a result, questions are rapidly emerging as to how best to address these needs while also ensuring successful treatment, long-term retention, and optimal outcomes during the complex and often difficult transition from childhood to adulthood. Programs are responding by incorporating attributes of youth-friendly services into HIV care, including reproductive and sexual health care, peer-based activities, mental health and psychosocial support services, and other features appealing to young people, such as flexible clinic hours, specific clinic times for adolescents, and the availability of drop-in services. At the same time, health workers — who often play critical roles in the lives of young people — are anxious to enhance their skills to ensure that they are well-equipped to provide optimal health care services to the growing population of adolescents living with HIV.
This curriculum was built with the understanding that services for adolescents must be youth-friendly, comprehensive (including biomedical and psychosocial care and support), multidisciplinary, and integrated to include as many different services and providers under one roof as possible. Adolescent HIV care services should aim to become the medical home for adolescents living with HIV, and health workers should be able to attend to the broad set of needs that are likely to emerge when providing services to this population. Central to the philosophy of this curriculum is the premise that health workers need to interact with adolescents, both as individuals with unique needs, wants, and hopes for the future, and as parts of families, peer groups, and communities. (ICAP, Columbia University, 2012)