Sexual and reproductive health needs of adolescents living with HIV © Nigerian Journal of Health Sciences The Underserved Sexual and Reproductive Health Needs of Adolescents Living with HIV in Nigeria Folayan MO, 1 Odetoyinbo M, 2 Brown B, 3 Harrison A. 4 1 Institute of Public Health and Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife, Nigeria, 2 Positive Action for Treatment Access, First floor, Holy Trinity Hospital Plaza, Adesina Street, Off Obafemi Awolowo Way, Ikeja, Lagos, Nigeria, 3 Programme in Public Health, University of California, Irvine, Irvine, CA, USA, 4 Population Studies and Training Center, and Department of Behavioral and Social Sciences, Public Health Programme, Brown University, Providence, RI 02912, USA INTRODUCTION The number of African children living with HIV continues to escalate despite the advances made in prevention of mother to child transmission. It is estimated that globally, 90% of HIV positive adolescents acquire infection perinatally. 1,2 There is a preponderance of risks for HIV infection through vaginal and anal sex among the adolescents. A proportion of cases may also be attributable to rape. 3 In Nigeria, mother to child transmission is the second most common route of HIV transmission, second only to sexual intercourse. 4 The current rate of mother to child transmission of HIV infection is 27.3%. 5 In the past, it would have been unthinkable for infants born with HIV to have the opportunity to develop into adulthood. The roll-out of treatment programmemes has made this possible, albeit for a small but growing proportion. However, the contribution of perinatal infection, unprotected vaginal and anal sex, and rape, to the incidence of HIV infection in adolescents in Nigeria remain unknown. Corresponding author: Morenike Oluwatoyin Folayan, Institute of Public Health and Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife, Nigeria, 22005; toyinukpong@yahoo.co.uk; +234706 2920 394 Preliminary Data on Adolescents living with HIV in Nigeria Extrapolation of data reported in the 2010 HIV sentinel surveillance survey provides an estimate of 267,081 adolescents, aged 10 to 19 years old, living with HIV in Nigeria. This figure constitutes about 0.71% of the 37,674,800 adolescents, aged 10 to 19 years old in Nigeria. 6 However, the proportion of those who were infected perinatally or postnatally remains unknown. Data from the national African National Congress (ANC) sentinel surveillance show a decline in perinatal and postnatal HIV acquisition. The prevalence of HIV infection among adolescents and youths aged 15 to 24 years has steadily declined from 6% in 2001, to 4.3% in 2005, and 4.2% in 2008, and 4.1% in 2010. 7 The sentinel surveillance report also showed the number of new HIV infections is increasing; new infections in 2011 were estimated to be 127,430 in adults and 157,790 in children, compared with 126,260 in adults and 154,920 in children in 2010. 7 In 2012, the estimates of the number of new infection was 210,000 for those aged 15 years and above; while it was 60,000 for those who were 14 years of age and below. 8 Also, the 2012 National HIV and AIDS Reproductive Health Survey Abstract Children born with and infected with HIV are living into adolescence due to improved management of the infection. Based on extrapolated data, the number of adolescents living with HIV in Nigeria is well over 200,000: a sizeable but manageable number. Unfortunately, planning for ALHIV care is still rudimentary in many ways. There is still little known about their sexual and reproductive health needs, and how to effectively provide HIV treatment, care and support needs. This paper takes a look at and discusses the gaps in addressing the sexual and reproductive health needs, including the contraceptive needs of adolescents living with HIV in Nigeria. It suggests that need to develop service models that can provide prevention-treatment-care services in a supportive environment for adolescents living with HIV. It also recognises the need for development of appropriate policies that support funding of adolescent friendly HIV and SRH services in both urban and rural settings. Finally, it recommends the establishment of core indicators for adolescent health which would promote the development of data collection systems and the evaluation of policy initiatives. Further studies are needed to understand the sexual and reproductive health needs of adolescents living with HIV and how these could be integrated into existing HIV/AIDS treatment, care and support programmemes. Key words: Adolescents, HIV, Nigeria, Policy, treatment, sexual, reproductive, health Citation: Nigerian Journal of Health Sciences 2014; 14: 00