Many countries do not provide adequate or age-appropriate sexuality education in schools or out-of-school settings. This means young people are more likely to believe myths and misinformation about sex and HIV.
HIV and young people
- Of all new HIV infections in 2021, 27% were among young people.
- In sub-Saharan Africa, young women are twice as likely to have HIV than young men.
- Outside sub-Saharan Africa, most infections among young people are in those who are also in other high-risk groups.
UNAIDS defines young people as between the ages of 15-24. Within this, adolescents are those aged 10-19.
Only one in three young people have the correct knowledge of how to prevent HIV.
Requirements for young people to get their parents to provide consent for them to access sexual health and HIV services is one of the biggest barriers to young people accessing these services and protecting themselves from HIV.
Why are young people at higher risk of HIV?
Lack of sexuality education for young people
Parental consent requirements
Some countries require people under a certain age (often 18) to provide parental consent before they can access sexual health, contraception, HIV testing or harm reduction services. Young people are often afraid to speak with their parents about these subjects, and so do not access the services.
Low or inconsistent condom use
Some young people don’t know about the benefits of condoms, where to get them, or how to use them correctly. Other young people find it hard to negotiate condom use if they are in a relationship with an older partner.
Young people from other high-risk groups are ignored
Young people who are also part of the other high-risk groups are often ignored from services that target that group. For example, young sex workers or young people who inject drugs struggle to access services designed for these groups. They face official resistance, legal impediments, and high levels of stigma and discrimination.
Intergenerational relationships
Young people who have relationships with older people are more likely to get HIV because of the greater likelihood that the older person has HIV.
Having sex for the first time at a young age
Having sex at a young age before acquiring knowledge about HIV means young people are less likely to know how to protect themselves from HIV. Reasons for having sex at a young age can include child marriage, sexual violence or coercion, and a lack of empowerment to say no.
How can HIV services meet the needs of young people?
Involve young people
Involve young people in the design and delivery of HIV services. This way the service is more likely to meet their needs. For example, youth spaces in HIV clinics make the service more friendly.
Open services outside of school hours
Lots of young people report not going to HIV services because they are not open outside of school hours. Later opening clinics would enable more young people to attend.
Integrate HIV services with other services
Young people fear stigma if they ask for HIV services. By integrating HIV services into other services, young people are more likely to attend. Other services should include sexual and reproductive health and post-violence care where young people can get PEP, PrEP and emotional support.
Provide community outreach services
Bring HIV services closer to where young people are by training community healthcare workers who can go to where young people are, rather than expecting young people to go to clinics.
Train young peer educators
Young people are more likely to open up to other young people of a similar age than adults. Young peer educators can make HIV services more accessible for young people.
Work with schools
Schools and out-of-school clubs are good places to provide young people with correct information on HIV. Speak with local schools and clubs to see if your service can provide local young people with sex and HIV information.
Make condoms available
Make condoms available to young people at the places they meet up or via peer educators in the community.
Make transitioning to adult HIV services easy
Young people with HIV who turn 18 must move to adult clinics. They are more likely to have disruption in their treatment or stop taking their treatment altogether during this time. Make sure that young people are supported during this transition time which is unsettling for many.
Provide health information digitally
Digital technologies such as website, apps, chatbots and messaging services allow young people to learn on their own and ask questions without feeling embarrassed to talk about sexual health in real life. It’s also a way for young people to share correct information digitally with their peers.
Reach young people who can’t access digital technology
Many young people cannot afford or access digital technology, so other spaces must be used to share information with them: mass media campaigns, radio talk shows, theatre shows, community talks, and talks by local leaders or religious leaders.
What systemic changes could reduce the risk of HIV for young people?
Remove age of consent laws for services
Young people have sex and are at risk of HIV. Laws that prohibit young people from accessing services without parental consent must be overturned. This particularly affects those who are orphaned and have no option for parental consent.
Improve provider attitudes towards young people
Providing services that are youth-friendly is essential to reaching this community group. Health care workers must be sensitised on the needs and rights of young people in order to improve provider attitudes and reduce stigma.
Include comprehensive sexuality education in the curriculum
Students that have the correct knowledge about sexual and reproductive health and rights including HIV are more empowered to use their knowledge to protect themselves and their peers from HIV.
Keep young people in school
Countries should make greater effort to keep young people in school, particularly girls and young women. Evidence shows that this greatly reduces their risk of HIV.
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