Fighting for Our Future: Taking on HIV Disparities Among Young People

By Ilyana Sithole

What came out at the just-ended Regional Consultation Meeting on Scaling Peer Provider Services, led by Dr. A.J.V. Maunganidze in Harare, is an issue that is of greater urgency and needs our immediate attention-that is, the dire disparities in children’s and adolescents’ access to HIV treatment. As we celebrate progress in the fight against HIV/AIDS, we have come to face some uncomfortable truths: our young people continue to be plagued by barriers to care.

What was most alarming were the revelations by Dr. Maunganidze of the inequalities within access to ART between adults and adolescents. While 76% of adults living with HIV are on ART, only 55% of adolescents benefit from this life-saving treatment. Most worrying, though, is that only 48% of adolescents on ART manage to achieve viral suppression, compared to 79% of adults. This is not a statistic; these are lives, and a system that is failing young people.

The cause of this disparity is multi-layered, underpinned by societal stigma, a lack of tailored healthcare services, and insufficient outreach to younger populations. It is our shared responsibility to tear down these barriers and ensure that every young person living with HIV has access to the treatment they deserve.

One of the most hopeful notes in Dr. Maunganidze’s speech was his emphasis on how peer-led the services were. The Zvandiri model is a great example of bottom-up change: young mentors are enabled to offer their peers support and mentorship. Young people often understand the battle of a friend in ways adults can never know. By leveraging this knowledge, we will be able to provide support that would enhance health outcomes and build community and a sense of belonging.

Investing in peer-led programs is not only innovative; it is imperative. Young people are not passive recipients of care but active contributors in their health journey. By engaging them in the development and delivery of health services, we empower them and strengthen the effectiveness of our health systems.

This is one of those moments that defines our journey together in the creation of the Global Alliance to End AIDS in Children by 2030. It is a commitment from the stakeholders at all levels for comprehensive testing, treatment, and care for children and adolescents. Zimbabwe’s commitment to this alliance is strong, and a model for other nations.

But commitment is not enough; concrete strategies focusing on the specific needs of this young generation must now be made from these promises. This requires collaboration among governments, healthcare providers, and the youth themselves in formulating policies that hear their voices, understand their struggles, and include them in decision-making.

We are facing some hard truths as we go forward: the journey towards zero AIDS among children and adolescents requires absolute commitment and a multi-pronged approach. It is not just providing the medication, but it has to be within an enabling environment where young people feel safe, supported, and empowered toward accessing the help they need.

The message from Harare is loud and clear: we have the tools, we know what to do, and we care. Let us now act. Together, we can build a future where no child and adolescent are left behind in the HIV/AIDS response. Together we will make this happen, and by the year 2030 we shall celebrate ending AIDS among our adolescents. It is something in which the health and future of an entire generation of human beings are at stake, dependent on our joint efforts.