Achieving 902: Young People, HIV Testing Services, and Linkage to Treatment

1. YouthPower Action funded and supported a special AIDS supplement entitled: Achieving 902: Young People, HIV Testing Services and Linkage to Treatment Guest Editors: • Sten H. Vermund, MD, PhD • Donna R. McCarraher, PhD, MPH • B. Ryan Phelps, MD, MPH, FAAP Open Access online version: http://journals.lww.com/aidsonline/toc/2017/07013 Funding: U.S. President's Emergency Plan for AIDS Relief (PEPFAR) through the United States Agency for International Development (USAID) under YouthPower Action, Contract number AID-OAA-TO-15-00003/AID-OAA-I-15-00009

2. Overview Challenges: • Adolescents and youth (AY) ages 15-24 have low rates of HIV diagnosis and treatment initiation • Approximately 1/3 of all new infections worldwide occur in AY 15–24 years old • HIV mortality is increasing among AY, while mortality for other age groups is declining • Despite this, few interventions have been tailored to and tested among AY Goal of this journal supplement: • To provide new evidence and insight to enable funders, program planners, researchers and policy makers to improve or develop HIV programs, policies and approaches for adolescents and youth

3. Research summary • Youth must be involved in the design of programs and research that aim to meet their needs (Denison et al.). HIV+ youth participated in the Project SOAR (Supporting Operational AIDS Research) meeting and influenced the development of an implementation science agenda. • HIV self-testing (Indravudh et al.) is acceptable to young people in Malawi and Zimbabwe, especially if kits were provided for free or at low-cost and provided by lay community distributors. • Voluntary Male Circumcision Services (VMMC) (Kaufman et al.) in South Africa, Tanzania, and Zimbabwe represent a missed opportunity for counseling adolescents and young men on HIV prevention and care. • Delivering a community-level door-to-door combination HIV prevention package (Shanaube et al.) is acceptable to adolescents and feasible in Zambia. • Continuous Quality Improvement (CQI) interventions (Wagner et al.) in Kenya resulted in changes in knowledge of HIV transmission, HIV prevention, and intention to re-test for HIV. CQI interventions may improve adolescent-friendly HIV testing services.

4. Research summary • Youth value the support of caregivers and health care workers (Wilson et al.) in deciding to seek HIV testing and linking to care in Kenya. Strengthening HCW and caregiver capacities to support adolescents while respecting autonomy may facilitate attaining ’90-90’90’ targets for young people. • Improving services for adolescents at health centers and establishing linkages between schools and health centers (Ruria et al.) in Kenya are feasible to address the needs of adolescents and support timely linkage to care and retention. • In the U.S., Centers for Disease Control-funded non-healthcare facilities provide HIV tests to adolescent MSM (Marano et al.). A greater proportion of adolescent MSM were newly diagnosed in non-healthcare facilities compared to total tested in those facilities, and linkage to care was lower for black and Latino adolescents. • The Metropolitan Atlanta Community Adolescent Rapid Testing Initiative (MACARTI) (Camacho-Gonzalez et al.) combined venue-based testing, motivational interviewing, and case management to improve linkage to care and timing to linkage to care.

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