Transcript Powerpoint

The realities of
young key populations
What is the evidence?
Martin Choo
Centre of Excellence for Research in AIDS (CERiA)
University of Malaya, Kuala Lumpur
© UNFPA Morocco - Youth participants-Rabat -Morocco 2012
Who are young key populations?
• Young people
– 10 – 24 years
– One quarter of world’s population
• Key populations = groups at increased risk for
HIV due to specific high risk behaviour, includes:
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People who inject drugs
People who sell sex
Young men who have sex with men
Transgender people
Why young key populations matter?
• Vulnerabilities of youth
– Adolescence increases pleasure seeking and risktaking, peer pressures, wanting to adopt “adult”
behaviours.
• Cascade of risk
– Multiple overlapping risk factors, and where any risk
behaviour often compounds further risk.
• Social marginalisation
– Increased risk of social isolation for key populations.
Among most affected by HIV
• Over 5 million aged 10-24
living with HIV in 2013.
• Each day more than 2,400
young people become
infected with HIV.
• 35% of new HIV infections
worldwide are aged 15-24.
Image available at http://youthrise.org/blog/youth-rise-and-rumah-cemara-6-months
Methodology (1)
• Review of literature on available epidemiological
evidence guided by experts in the field.
• Global community consultations (2013):
– UN Population Fund
– Youth RISE – global youth-led harm reduction
network
– Youth Voices Count – policy brief on self-stigma
among young MSM and transgender
– Youth LEAD – Youth Leadership,
Education, Advocacy and Development Project
– HIV Young Leaders Fund
What are the
realities
for young
people?
Image available at http://youth-lead.org
Young people who inject drugs
• Injecting drugs in groups is common and sharing
equipment more likely – young people often last in line to
use injecting equipment.
• Drug use compounds rapid changes during
adolescence, increasing risk for unprotected sex.
• Experimentation with drugs as part of adolescence can
lead to dependence/addiction.
• Socially marginalized (including race and gender)
young people more likely to inject drugs.
• Lack of resources and information on drugs can lead to
exchanging sex for drugs.
• Criminalization, enforcement and incarceration of drug
use disproportionately affect young people.
Young people who sell sex
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Economic necessity often drives selling sex.
Poor negotiation of condom use is common.
Seek protection from adults in exchange for sex.
More prone to violence particularly from law
enforcement.
• Criminalization of sex work disproportionately burdens
youth – vulnerable to police action.
• Denied access to SRH/comprehensive services without
parental guidance/consent – increases chances of poorly
conducted self-administered abortions.
• No access to sex education and protection from
HIV/STI especially among street-based youth often have
Young men who have sex with men
• Prone to violence and relationship dynamics mean
inability to negotiate condom use.
• Homophobia/criminalization increases chances of
social marginalization and isolation among youth –
increases risk of suicide.
• Homophobic bullying more common at school than in
other social venues.
• Misconception of risk from lack of information.
• Risk of drugs/alcohol use increases with need to fit in to
social scene among adult MSM.
• Criminalization and social inhibitions further restricts
access to services.
Young transgender people
• Normalizing gender identity is poor.
• Unprotected anal sex common among transgender
women.
• Intersection of drug use with unprotected/selling sex.
• Criminalization/marginalization of sexual differences
increases chances youth will be isolated – risk of
homelessness, unemployment.
• Social marginalization keeps them from schools, and
in accessing services (especially SRH).
• Selling sex to survive is an increasing reality for many.
• Sexual exploitation and violence are common –
increased risk of police extortion.
Current gaps in research
• Implementation research
– Insufficient data on what works and what doesn’t
– Need more validation of programmes
• Qualitative research
– Hearing the voices of young people
– Case studies and community consultations.
• Consent restrictions for under 18s impede
research.
• Results often not disaggregated by age even when
young people have been included in studies.
Conclusions
• Social and structural conditions which usually
compound HIV risk among key populations are
even more acute among the young people, and
place them disproportionately at risk for HIV.
• Due to their vulnerabilities young people are
more likely to face a cascade of risk that further
increases their vulnerability to other risks.
• Young people need dedicated services that
cater specifically to their needs.
• More research is needed to augment existing
data.
Thank you!
Image available at http://youth-lead.org
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