Adolescents living with HIV in India - the clock is ticking.

The term "Adolescence" literally means "to emerge" or "to attain identity" and is essentially the period of rapid physical and psychological development starting from the onset of puberty to complete growth. All adolescents go through a myriad of physical, psychological, neurobehavioural, hormonal and social developmental changes. Given the social taboos often surrounding puberty, the lives of millions of adolescents worldwide are at risk because they do not have the information, skills, health services and support they need to go through the enormous, rapid changes that adolescence brings. A HIV infected adolescent particularly presents enormous challenges in the current cultural and social context of India. The distinct groups of adolescents in the context of HIV are those who were infected at birth and survived and those who became infected during adolescence. Risk factors and situations for adolescents contracting HIV infection are life on streets, lack of adult love/care and support, extreme poverty, child trafficking, migrant population, exploitation in terms of sex and labor. HIV-infected adolescents with long standing HIV infection often face considerable physical challenges - delayed growth and development, late puberty, stunting/wasting, malnutrition, etc. Added to this are many other challenges related mainly to disclosure of HIV status, developmental delay, and transition from pediatric to adult care, including the choice of appropriate treatment regimens and adherence. Psychological and social factors deeply impact the ability to deal with the illness and must be addressed at all levels to encourage and support this vulnerable group.