HIV / AIDS

Introduction

Strategic Result

Vulnerability of children, adolescents and women to HIV infection is mitigated, and the care and treatment needs of those living with HIV are met

Commitment

Benchmarks

HIV prevention services are available and used, including information on post-rape care, HIV post-exposure prophylaxis and sexually transmitted infection (STI) treatment
Confidential and voluntary HIV testing is available and used

1: Prevention and testing

Children, adolescents and women have access to information and services for HIV prevention, including HIV testing

HIV and AIDS care and treatment services, including antiretroviral treatment, are available and accessed by 90% of children, adolescents and women living with HIV, both newly identified and those previously known to be living with HIV
Services for prevention of mother-to-child transmission of HIV (PMTCT) are available and used by pregnant and lactating women, including 90% accessing HIV testing and 90% of those found to be positive accessing lifelong antiretroviral treatment
At least 90% of children, adolescents and women who start treatment access continuous treatment and are retained in care

2: Access to HIV treatment

Children, adolescents and women living with HIV access sustained care and treatment services

Children, their caregivers and communities are aware of how and where to access services for HIV prevention, care and treatment
Children, their caregivers and communities are engaged through participatory behaviour change interventions on HIV prevention, care and treatment

3: Community engagement for behaviour and social change

At-risk and affected populations have timely access to culturally appropriate, gender- and age-sensitive information and interventions, to improve prevention practices, care and treatment

Key Considerations

Advocacy

Ensure testing is offered in all contexts. Testing must always be confidential, voluntary and linked to provision of counselling, prevention and treatment services.
Promote HIV testing as an entry point for both prevention and treatment, and link to GBV prevention, risk mitigation and response.
Promote understanding that HIV prevention, testing and treatment are cross-cutting interventions: GBV, including sexual assault and transactional sex, which is exacerbated during emergencies, increases exposure and vulnerability to HIV infection.

Coordination and Partnerships

Ensure the roles, responsibilities and complementarities of partners around HIV prevention and treatment are clearly defined. For example, agencies providing sexual reproductive health (SRH) services and sexually transmitted infection (STI) information and treatment should incorporate HIV prevention messaging alongside violence prevention messaging into their work.
Ensure there are focal points with expertise in HIV and related STI prevention and treatment in children, adolescents and women amongst partners.
Train frontline health workers, social workers and volunteers on the normative guidance and clinical recommendations for care for survivors of sexual assault, including sexually transmitted infection (STI) treatment and post-exposure HIV prophylaxis.

Quality Programming and Standards

Foster an integrated multisectoral response. Prevention of mother-to-child transmission of HIV (PMTCT) and paediatric HIV care and treatment should form part of the overall maternal and young child response. Infants and children with severe acute malnutrition (SAM) should be prioritised for HIV testing, especially if they are not responsive to nutritional treatments. HIV prevention should be joined with Protection, Education, Community Engagement for Behaviour and Social Change and other sectors that reach adolescents and address violence.
Ensure access to mental health and psychosocial support services (MHPSS), including community-based adherence support, for people living with HIV and survivors of sexual assault who are living with HIV or at risk of HIV infection.
Emergency cash or in-kind transfers should be HIV-sensitive by targeting vulnerable girls and young women or people living with HIV and linking those recipients to other emergency support services.
Design and implement HIV interventions according to the quality standards described in the IASC Guidelines for HIV/AIDS.
Design HIV interventions based on the context and the background of HIV prevalence. In a generalized HIV epidemic where prevalence is greater than 1%, the full set of HIV prevention and treatment interventions should be prioritised. Where prevalence is lower, the numbers of people living with HIV may be small, but HIV prevention may still be an important forward-thinking intervention.
Protect the integrity of family structures and ensure that children who are orphans and/or living in child-headed households receive adequate support and achieve equitable outcomes.
Create context-specific HIV prevention and treatment information showing where people can access services.
Introduce gender- and age-responsive programming, including GBV risk mitigation, taking into account the unique needs of adolescents and girls.
Involve existing community networks to identify the most appropriate content and strategies.