Adolescents with HIV Infection

  • Lee FairlieEmail author


Adolescence is a challenging time characterised by physical, sexual, emotional and psychosocial changes. These challenges are often enhanced in HIV-positive adolescents but may also affect HIV prevention. In this chapter, we discuss HIV prevention and HIV treatment within an adolescent friendly framework, sexual and reproductive health, as well as pregnancy in adolescents. Additionally, psychosocial issues and support are discussed.


HIV treatment HIV prevention Sexual and reproductive health Transition Mental health 


  1. 1.
    World Health Organization. Health for the world’s adolescents. In: A second chance in the second decade. Geneva: WHO; 2014.Google Scholar
  2. 2.
    Department of Justice SA. Children’s act 38 of 2005. 2005.Google Scholar
  3. 3.
    Fick C, Fairlie L, Moultrie H, Woollett N, Pahad S, Thomson K, et al. Working with adolescents living with HIV: a handbook for healthcare providers. Johannesburg: Wits RHI and Southern African HIV Clinicians Society; 2015.Google Scholar
  4. 4.
    UNICEF. Turning the tide against AIDS will require more concentrated focus on adolescents and young people. Newyork: UNICEF; 2017.Google Scholar
  5. 5.
    Human Sciences Research Council (HSRC). The fifth south african national HIV prevalence, incidence, behaviour and communication survey, 2017: HIV impact assessment summary report. Cape Town: HSRC Press; 2018. p. 2017.Google Scholar
  6. 6.
    Cohen MS, Chen YQ, McCauley M, Gamble T, Hosseinipour MC, Kumarasamy N, et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011;365(6):493–505.CrossRefGoogle Scholar
  7. 7.
    Hosek S, Celum C, Wilson CM, Kapogiannis B, Delany-Moretlwe S, Bekker LG. Preventing HIV among adolescents with oral PrEP: observations and challenges in the United States and South Africa. J Int AIDS Soc. 2016;19(7):21107.PubMedPubMedCentralGoogle Scholar
  8. 8.
    World Health Organization. Guideline on when to start antiretroviral therapy and on pre-exposure prophylaxis for HIV september 2015. Geneva: WHO; 2015.Google Scholar
  9. 9.
    Idele P, Gillespie A, Porth T, Suzuki C, Mahy M, Kasedde S, et al. Epidemiology of HIV and AIDS among adolescents: current status, inequities and data groups. J Acquir Immune Defic Syndr. 2014;66(Suppl 2):S144–53.CrossRefGoogle Scholar
  10. 10.
    Kariminia A, Law M, Davies MA, Vinikoor M, Wools-Kaloustian K, Leroy V, et al. Mortality and losses to follow-up among adolescents living with HIV in the IeDEA global cohort collaboration. J Int AIDS Soc. 2018;21(12):e25215.CrossRefGoogle Scholar
  11. 11.
    Kim SH, Gerver SM, Fidler S, Ward H. Adherence to antiretroviral therapy in adolescents living with HIV: systematic review and meta-analysis. AIDS. 2014;28(13):1945–56.CrossRefGoogle Scholar
  12. 12.
    Nachega JB, Sam-Agudu NA, Mofenson LM, Schechter M, Mellors JW. Achieving viral suppression in 90% of people living with human immunodeficiency virus on antiretroviral therapy in low- and middle-income countries: progress, challenges, and opportunities. Clin Infect Dis. 2018;66(10):1487–91.CrossRefGoogle Scholar
  13. 13.
    South African National Department of Health. 2019 ART clinical guidelines for the management of HIV in adults, pregnancy, adolescents, children, infants and neonates. South Africa: National Department of Health; 2019.Google Scholar
  14. 14.
    South African National Department of Health. Guideline for the prevention of mother to child transmission of communicable infections. South Africa: National Department of Health; 2019.Google Scholar
  15. 15.
    Agwu AL, Fairlie L. Antiretroviral treatment, management challenges and outcomes in perinatally HIV-infected adolescents. J Int AIDS Soc. 2013;16:18579.CrossRefGoogle Scholar
  16. 16.
    World Health Organisation. Mental health: a state of wellbeing [online]. 2014. Available from:
  17. 17.
    Pyra M, Anderson P, Mugwanya K, Haberer JE, Heffron R, Asimwe S, et al., editors. Concentrations of TFV-DP during pregnancy among women using PrEP conference on retroviruses and opportunistic infections. Boston; 2018.Google Scholar
  18. 18.
    World Health Organisation. WHO technical brief: preventing HIV during pregnancy and breastfeeding in the context of pre-exposure prophylaxis (PrEP). Geneva: World Health Organization; 2017. Licence: CC BY-NC-SA 30 IGO.Google Scholar
  19. 19.
    Southern African HIV Clinicians Society. Guidelines for adherence to antiretroviral therapy in adolescents and young adults. Houghton: Southern African HIV Clinicians Society; 2017.Google Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Maternal and Child HealthWITS RHIJohannesburgSouth Africa

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