ADOLESCENTS AND HIV: THE TICKING TIME BOMB IN KENYA

The pomp and fanfare that marked World AIDS Day celebrations in the past has gradually dissipated in the last few years. This year, all world over, it was a fairly quiet affair that could be easily missed. HIV experts have been quick to warn that we are not out of the woods yet and the attention given to the scourge needs to be amplified appropriately, or else we risk negating the marked progress we have made.  

One of the most powerful tools for HIV prevention has been the mass appeal to every person to know their HIV status. Today, I wish to direct this appeal to the adolescents and their parents.  

Current HIV statistics among the adolescents do not paint a pretty picture. As of 2012, 2.1 million adolescents (10-19 years) worldwide were HIV positive, with 82% of them being in sub-saharan Africa. 58% of these adolescents are female. Closer home, 29% of all new HIV infections are occuring among the youth (15 to 24 years), with 9,720 of them succumbing to AIDS in 2014 alone. Currently almost half a million youth in Kenya are living with HIV. 60% of the HIV positive youth do not know their status.  

As devastating as these statistics are, most Kenyans are seemingly detached from this reality. In a country where the average working day starts at 5.00am and ends well after 8.00pm, most parents hardly ever see their children for more than three hours a day. School hours have gotten longer as teachers and sports coaches have taken over the position of most working class parents. Therefore, if one randomly asked a parent what the HIV status of their 15 year old child is, they are likely to draw offence borne out of a feeling of parental inadequacy.  

It is 11 years since Kenya recorded the height of the HIV scourge, in 2004. The advent of highly active anti-retroviral therapies brought down the scourge and a lot of opportunistic infections that were felling Kenyans living with HIV have since mostly disappeared. The introduction of the prevention of mother to child transmission programmes and the treatment of infants born with HIV has resulted in children who have grown with HIV and are living a full and productive life. Some are in their twenties and are even starting families of their own. In this respect, we can count our victories in keeping HIV at bay.  

The question we wish to see answered though is, have we done enough to reduce the stigma of the disease among the adolescents? Do these heroes, who have put the virus in its place and lived their lives, have the courage to tell their agemates of their status before they start to date? We have treated them for years but did we remember to prepare them psychologically for this phase of their lives?  

One in five adolescents in Sub-Saharan Africa, reports early sexual debut (first sexual contact below the age of 15), according to UNICEF. With sexual intercourse being the commonest mode of HIV transmission, one can understand why this is a greatly disconcerting factor. The adolescent at the highest risk of contracting HIV has always been stereotyped as the child from a poor soci-economic background,  exposed to social vices such as prostitution from an early age in a bid to survive. These vulnerable children are forced to sell their bodies for food, whether male or female, so that their families may avoid starvation. In other communities, the girls wil be married off young, to old men with a bit of money and several other wives, with no one to fight for their rights.  

This stereotype has blinded many from the risk that children from priviledged backgrounds may be exposed to. Most of these children are raised by caregivers as parents are away for work for long hours or altogether away from home on business trips. Some of these caregivers have been reported to prey on these children, through violent means or through emotional exploitation by provididng a false sense of caring that the children so crave from their parents. These children have been molested, introduced to dangerous recreation drugs and to the dark world of pornography. They are in as much risk as their poor counterpart.  

It is devastating for a parent to find out that their child has contracted HIV from a shared sex toy that a friend has been loaning out at a fee in a boarding school. We can ask the million dollar question of why an adolescent would be in possession of such an item but the real issue here is, where was the parent when their child had unrestricted free access to the internet. A quick google search on where to buy a sex toy in Kenya reveals at least six different suppliers on the first page only, willing to deliver to the doorstep.  

One of the well-known modes of HIV transmission is though unsafe needles. Most secondary level schools in Kenya are now battling drug use within their establishments, to the point where some schools demand a mandatory drug screen for new students wishing to enroll. With injectable drugs being pretty expensive for most adolescents, it then infers that those able to access them have fairly fat wallets lined by absentee parents who expect money to fill in the gap. It does not take a genius to connect the dots and see the risk index shooting up in this population. By 2012, according to the Kenya Aids Indicator Survey (KAIS) Report, 1.4% of adolescents aged 10-14 years were on recreation drugs while 4.8% were using alcohol. It is a well documentated fact that alcohol use leads to disinhibition and greatly increases the risk of unprotected sex. For adolescents with raging hormones and lack or guidance, alcohol serves as a lighter to a highly combustible fuel. The saddest bit is that, the most likely beneficiary of the sexual favors will be an adult who bought the alcohol to begin with.  

With this reality, it is therefore paramount that we all roll up our sleeves and get very serious with addressing the issue of adolescent HIV. Top on the list is provision of accessible age-appropriate, adolescent friendly HIV care centers that will address counselling, testing and treatment. These can still be crafted within the already established comprehensive care centers.

In the words of the adolescents themselves, how do they wish to be regarded?
They should be supported without judgement, and be accepted and loved despite their status
They should be given information about their HIV status and any other co-mobid illnesses they may have
They should have access to treatment despite their background
Their opinion in their medical care plan should matter, not just what the parents want
They should be supported to disclose their status when, and how they deem fit
They should be allowed access to condoms without judgement
They should be protected from discrimination within institutions and their community
They should be given an equal chance with their peers in all spheres of their lives  

The adolescents of today are the future of our country. We as parents, caregivers, policy makers and service providers must play our role in ensuring a healthy generation, poised to take over nation-building from us. It is therefore our duty and responsibility to carry out this mandate with due dilligence. Let us not sacrifice our children at the alter of irresponsible parenting, seven-figure paychecks and self-gratification. We give rise to these children, we must account for the adults they grow into.