Integrating Psychological Support with HIV Treatment for Adolescents Vital for Better Outcomes

New York – This World AIDS Day, we reflect on the progress made in the HIV epidemic over four decades, especially the advances in anti-retroviral treatment (ART) that have successfully suppressed HIV transmission. While funding remains essential for continued progress, there is a growing recognition of the need to address disparities in treatment outcomes, particularly among adolescents living with HIV (ALHIV).

According to World Economic Forum, The gap in HIV outcomes for ALHIV indicates that more than just clinical treatment is required. Access to effective ART has significantly improved, but ALHIV often face challenges in adhering to their treatment regimen. A solution lies in providing psychological support alongside medical treatment, empowering adolescents to engage actively in their care.

The Zvandiri program, established in Zimbabwe 20 years ago, exemplifies this approach. It trains ALHIV as peer counselors, fostering a support network that enhances health, happiness, and hope. This program, which complements clinical care, has demonstrated effectiveness in early intervention for deteriorating mental health and supporting those with mental health conditions.

Qualitative research has shown that Zvandiri’s peer support model builds a connected community, improves HIV knowledge, and inspires hope and purpose among adolescents. It nurtures character strengths such as connectedness, self-acceptance, and hope, as highlighted in a film created by young participants.

A randomized controlled trial of Zvandiri showed a 42% lower prevalence of virological failure or death compared to standard care. This success has influenced global policy, with WHO updating its guidelines in 2020 to recommend integrating psychosocial support into HIV care for adolescents.

Despite advancements in ART, like the rollout of Dolutegravir, supporting mental health remains crucial for treatment adherence. Maintaining mental health is essential for the effectiveness of these treatments, especially as adolescents need to adhere to their regimen lifelong.

There is a growing emphasis on biomedical approaches to HIV prevention, such as pre-exposure prophylaxis (PrEP). However, for the 1.4 million ALHIV in Africa, psychological support is a more viable and necessary option than pharmaceutical treatments.

Investing in psychological treatment through peer-delivered psychosocial support is an efficient use of resources. The Zvandiri model, now adopted in 12 African countries, has reached 160,000 ALHIV. It has significantly reduced symptoms of depression and anxiety among participants.

As HIV care becomes more efficient, allowing individuals to focus on living full lives, adolescents still require dedicated time and space for psychosocial support. Peer support models like Zvandiri are effective in meeting adolescents’ needs and driving positive outcomes.

The challenge is not the lack of effective solutions but the underappreciation of the value of psychological support in HIV care. Evidence shows that this support is central to improving HIV outcomes and enabling adolescents to thrive, not just survive. The time is now to invest intentionally in what works, providing foundational support for adolescents living with HIV.