Stories

Children, Youth and Community-led Responses to HIV

Photo Credit: Wonai Haruperi

Description: Musasa

Location: Zimbabwe

About 43% of children living with HIV were not receiving treatment in 2023, while treatment coverage among adults was 77%. Only 48% of children compared to 73% of adults attained viral suppression. As a result of the failure by HIV decisionmakers and funders to adequately meet the needs of children and adolescents living with HIV, approximately 90,000 children and adolescents died from AIDS-related causes in 2023. 

These inexcusable inequities are front and centre on the agenda at the 2025 FCAA Global Philanthropy Summit in Washington, D.C. (January 2728, 2025). At a workshop titled “Smart Funding for Children, Adolescents and Caregivers Affected by HIV” organized by the Coalition for Children Affected by AIDS, Stephen Lewis Foundation Executive Director Meg French will highlight the ways our community-led partners are implementing focused, wrap-around programming that addresses the diverse needs of children, adolescents and their caregivers.  

Community-led organizations and their holistic approaches and expertise 

From many years of doing this work, community-led organizations (CLOs) have learned that to be most effective, HIV prevention, treatment and care services need to be provided as part of holistic programming. They know that effective HIV interventions for children, adolescents and their caregivers include both reaching people with targeted medical and public health services and strengthening the support systems that enable people to stay in care. 

“By addressing health and well-being in a comprehensive way — considering the interconnectedness of physical health, mental health, nutrition and social support — we were able to provide more effective, sustainable care.”

— Centre for Alternatives for Victimized Women and Children, an SLF partner in Malawi

Programs to eliminate perinatal transmission need to meet pregnant people where they are and provide meaningful support before, during and after birth. Initiatives for children affected by HIV must start early in life and support children as whole persons with services like pediatric care, early childhood development, play therapy and nutrition support.  

Through a multifaceted approach, CLOs ensure caregivers often grandmothers  are equipped with parenting skills, psychosocial support, child protection awareness, and income-generating skills to strengthen their capacity to support children under their care.    


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Youth-centred programming

As a child enters adolescence, their needs and priorities change. CLOs work with caregivers and families to ensure their program support evolves alongside these natural changes. Adolescence is a time when adherence to treatment can be very challenging for young people. SLF partners remain committed to providing youth-led services that retain young people in a continuum of age-appropriate care.  

To support adolescent girls and young women, CLOs address gender inequalities and unequal gender norms in their programming, because these factors significantly elevate their risk of acquiring HIV. In Eastern and Southern Africa, where the SLF’s partners are located, adolescent girls and young women aged 1524 years are three times more likely to acquire HIV than their male counterparts (UNAIDS report, 2024). CLOs invest in the agency of girls and young women through access to education, financial literacy and economic opportunities, family planning, and peer support groups. 


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Other youth-led services, often championed by young people as peer educators, include comprehensive sexual and reproductive health and rights (SRHR) services, mental health support, and youth-friendly spaces that are inclusive and shaped by young people’s priorities.  

CLOs understand that meaningful youth engagement and involvement is required to move toward better health outcomes for young people. The documentary Youth Championing Youth featuring past and current SLF partners, shows the impact of youth-led programming, mentorship, and holistic support in cultivating young people’s agency, leadership skills, and advocacy.  


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Young people’s priorities

In 2023, the SLF hosted a roundtable comprised of eight young people and five staff from five participating CLOs to share lessons and reflect on their programming for children and young people. The reports below captures young people’s priorities, and the plans CLOs collectively discussed to strengthen the HIV response for children and young people.
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Resourcing community-led organizations

A 2024 Report from the Coalition for Children Affected by AIDS found that there is a 35% funding gap across low- and middle-income countries when it comes to total spending needed to meet the HIV targets for children and adolescents. The report explained, “Half of this gap (US$505 million) is in the 21 sub-Saharan African countries that together account for 80% of all child and adolescent HIV.”    

Because of this funding gap, many CLOs serving children and adolescents affected by HIV remain underfunded and underrecognized. As a result, they are only able to offer their programming to a small percentage of the young people who would benefit from it.  

Increasing access to unrestricted, flexible funding for CLOs will sustain the gains they have already made and allow them to close the gap when it comes to HIV treatment and adherence for children and adolescents.