Introduction
The worldwide incidence of human immunodeficiency virus (HIV) is high, and almost three million new cases were reported as per the 2008 census. The most heavily affected country in the world is Southern Africa, with a high prevalence rate of more than 15 percent. Over the past few years, the prevalence of HIV has increased, and it is higher, mostly in pregnant women, which results in a larger number of infants getting exposed to human immunodeficiency virus transmission. This untreated infection in children leads to rapid progression of the disease, and death occurs usually at the age of two years. The incidence is high, and the increasing evidence of one-third of the infants infected with infection are slowly progressing with survival of ten years and above children. The survival is median even in the absence of diagnostics and care for HIV.
As per the increasing number of infants infected with HIV, it is considered that the adolescents in Southern Africa in the coming decades will increase the number of infected survivors. There is an increase in several adolescents who are showing characteristics of HIV infection that are long-standing. The mortality rate is extremely high, and many cases were admitted with HIV infection. The diagnosis of the disease was made early in the presentation of the disease.
What Are the Challenges of HIV Testing for Adolescents?
Many critical issues should be considered while implementing planning for HIV testing and also the strategies of counseling. Primary care of adolescents has the lowest rate. Many adolescents are suffering from asymptomatic human immunodeficiency virus or sexually transmitted disease. The symptoms are not present and do not seek any treatment. The patients who are supposed to go for screening do not opt for the testing or get diagnosed. There are issues that adolescents face living in sub-Saharan Africa because of a lack of care and adolescents-friendly services that conflict with school timings and attendance. The impact that parents and caregivers have on HIV testing is not underestimated. The patient's fear of HIV has an adverse effect, and the adolescents lack parental support. Parents usually have emotional reactions and consider adolescents at lower risk of developing HIV.
What Are the Approaches for HIV Testing?
Many strategies may help reach children and also adolescents to address the unique requirements to reduce the chances of undisclosed HIV infections in today’s population. There should be a community-based approach for up-taking tests among adolescents. Among those, one of the most common strategies is family-based testing, in which all the family members are offered to test for HIV. This strategy has proven to be successful in conditions such as tuberculosis and STDs. Community health campaigns should be utilized to incorporate HIV testing. This strategy has also shown promising results. School education and health programs should be used to issue consent from parents and confidentiality in cases of positive children. Models driven by peers are also used to motivate adolescents. There are programs in which powers are used to support adherence to treatment provided to HIV-positive adolescents.
Another strategy is providing self-test kits for HIV at home at community centers, which young adolescents highly accept. Extending clinic hours after school and on weekends also allows adolescents to accept the testing or screening.
What Are the Risk Factors for Undiagnosed HIV Infections?
Studies show that HIV-positive patients have a higher source of income, have both their parents living, have never hospitalized for tuberculosis, and have never faced skin problems that were recurring. The poor patient, one or both of the parents who had died, had reduced chances of undisclosed HIV.
Patients suffering from HIV were associated with being mostly orphans or having a caregiver, had low grades in school academics, had hospital admission, and usually were above 13 years of age. The family of the HIV-positive child reported being comfortable sharing food with the HIV-positive adolescent.
The burden of undiagnosed HIV patients is different for different groups. Africans account for less than half of all the adolescents infected with HIV. Every racial community has a greater percentage of undiagnosed, with blacks and Africans having the highest percentage of overall infections. Race is not a risk factor, but there is a difference in HIV burden across the groups that include risk behavior.
Sexual contact is the main behavioral risk factor for both men and women. The risk factor of male-to-male sex is almost half of the total undiagnosed individuals. Almost three percent of the undiagnosed individuals include males with male partners.
People suffering from HIV because of injection drug use have a significantly lower rate of undiagnosed infections. They are likely to acknowledge being at risk of developing HIV and do not deny it when offered to be tested.
What Is the Impact of Provider-Initiated HIV Testing and Counseling?
Studies show that children between 8 to 18 years of age lived with HIV infection, and 37 percent of the population was undiagnosed. Out of almost 450 children who were infected with PITC (provider-initiated testing and counseling) at public health centers were diagnosed positive, only ten were already diagnosed, and the rest were undiagnosed. The undiagnosed children after PITC were significantly reduced.
Conclusion
This HIV epidemic is now in its third decade. There are better treatments that allow the sufferer to live long, but there is still no cure for the disease. Development of an effective and safe vaccine against HIV is still elusive. Prevention is the main component to cure the disease. More public health programs should be initiated to increase awareness of the human immunodeficiency virus.
