Transitioning to a healthy adulthood: Lessons learned from adolescent girls living with HIV in urban Zambia.

Nearly six percent of Zambian girls aged 15-19 are living with HIV. Many were infected at birth when antiretroviral therapy (ART) was not widely available for pregnant women. Others have acquired HIV through sexual relationships or abuse. Adolescent girls continue to be at high risk for acquiring HIV due to social factors like harmful gender norms and structural factors such as a lack of youth-friendly health services. Previous research in Zambia found that adolescents living with HIV often had difficulty adhering to treatment disclosing their HIV status to family and friends and coping with stigma. They also had limited access to information about sexual and reproductive health. Despite these challenges having been identified very few community-based or clinic-based programs are designed to support healthy transitions to adulthood for adolescent girls living with HIV. The International Center for Research on Women (ICRW) and Zambart conducted formative research between January and April 2015 to generate evidence-based ideas for services and programmatic interventions that support healthy transitions to adulthood among adolescent girls living with HIV in Zambia. A range of findings emerged from the research including examples of resilience support and creative mechanisms for coping with HIV. In this brief we focus mainly on the challenges that emerged and the types of interventions that could be implemented to remove these hurdles to ensure a healthy transition to adulthood for adolescent girls living with HIV. We have organized the findings based on the following socio-ecological levels to inform the development of a multi-level intervention: the individual-level (adolescent girls) the interpersonal level (families friends and social networks) and the organizational level (social institutions such as schools and clinics). (Excerpts)