Transcript Reaching MARA Experiences from England Challenges for Eastern

Evidence and good practices on HIV
prevention for young people
From evidence to action:
experience from Ukraine
Olena Sakovych
UNICEF Ukraine
2011
Ukraine
Street Children, 10-19 years old (UNICEF baseline
study, 2007)
• 47% of street children reported condom use at the last sex
• 57% of girls living on the street are involved in transactional
sex
• Only 8% of girls living on the street and involved in
transactional sex always use condom with clients
Most At Risk Adolescents (MARA), 14-19 years old
(BSS, 2009). Reported condom use at the last sex:
• 70% boys-IDUs
• 55% girls-IDUs
• 65% boys-MSM
MARA: Ukrainian context
HIV Prevalence exceeds:
Adolescents comprise:
19% among A-FSWs
29% among A-IDUs
26% of FSWs
24% of IDUs
32% of MSM
A lower knowledge of HIV/AIDS and lower use of
prevention services than among adults at risk
Generalized PSE – 1,602 out of 100,000 adolescents
UNICEF, 2010
Interventions
• integrated HIV/STI prevention programmes for girls
engaging in sex work or transactional sex
• Multidisciplinary outreach team approach for children living
or working on the streets
• peer education approach for adolescent injecting drug users
• one-stop shop approach for rehabilitation and HIV/STI
prevention for girls exploited for sex or experienced sexual
violence
• ‘MARA-Friendly’ Youth Friendly Clinic
• psycho-social rehabilitation and HIV/STI prevention
programme for in-patient adolescent drug users
‘
32% coverage of MARA to
date (UNICEF/UISR, 2010)
Pirozzi/2010
UKRAINE: school-aged children*
• Only 17% correctly identify the ways of HIV transmission
• 15% and 42% had the sexual debut at the age of 13-14 and
15-17 respectively
• 25% aged 13-14 and 20% aged 15-17 did not use a condom
at the last sex, but almost one in three consumed alcohols or
took drugs
• More girls than boys practice unsafe sex. One in four girls
did not use condom at the last sex; among those aged 17
years old – 1/3.
• 25% did not use a condom during their first sex. More girls
reported having unsafe first sex (some 40%). Boys, however,
had more sexual partners during last 12 months than
girls.
* HBSC, 2010&ESPAD, 2009*
Way Forward for Systemic Inclusion
• Integration of interventions into the system of
existing services
• Scaling up and strengthening inter-sectoral
linkages
• Intensification through ‘equity lens’
• Finding practical solutions to problems inherent
in systems & sectors
• Maintaining political commitment and increasing
accountability
Thank you
www.unicef.org.ua