Ending AIDS Means Empowering Young People

Integrating Family Planning and HIV Services

Marielle Hart

International HIV/AIDS Alliance (Alliance) | Policy Manager
© 2010 Basri Marzuki, Courtesy of Photoshare

© 2010 Basri Marzuki, Courtesy of Photoshare.

Today’s young people are the first generation that has never known a world without HIV, and they account for 40% of all new HIV infections. Each day, more than 2,400 young people become infected with HIV—and some 5 million young people ages 15 to 24 are living with HIV. Young women and girls living with HIV, young people who engage in sex work, young men who have sex with men, young transgender people, and young people who use drugs are among the most marginalized youth in the world. They experience extreme difficulties accessing services due to high levels of stigma, discrimination, violence, and, in some cases, fear of arrest. This makes them highly vulnerable to HIV, sexually transmitted infections, unwanted pregnancies, and severe human rights violations.

The Link Up project that my organization is part of works in Bangladesh, Burundi, Ethiopia, Myanmar and Uganda, to improve the sexual and reproductive health of young people most affected by HIV and to help them realize their sexual and reproductive rights. The project is implemented based on the principle that young people themselves have the power, through their own leadership, to bring an end to AIDS.

How do you get safe sex messages to young people in Ethiopia, where cultural attitudes make discussing sex taboo? By forming a dance group! A group of young people between 15 and 20 year old in Addis Ababa decided to use their combined talents for music and dance to get messages about HIV prevention across to their peers. Supported by Link Up, they founded Addis Beza, which means “to live for others.” They perform regularly in public places around the city, while handing out leaflets and encouraging young people and others to get tested for HIV free of charge.

At a youth centre in Burundi, all the action takes place at the football table. While playing or watching a table football match with their peers, young people, including those who sell sex, LGBT people, and people living with HIV, receive information, training, HIV counseling and testing, contraception advice, and condoms. The centre is one of a kind in Bujumbura with an entirely non-judgmental philosophy. It provides and equips young people with the information they need to make their own decisions and plays a crucial role in a country where half of the population are under age 17. Young people attending the centre all have their own personal story to tell, from being abused at home due to being homosexual to having children at an early age as a result of a lack of proper family planning advice.

In addition to the personal struggles and challenges these young people face, there are overarching structural barriers in all five project countries. Each of them criminalizes HIV transmission, drug use, same sex-relations, and sex work. As a result, neither national policies nor the programmes and services that stem from them can fully address the needs of young people most affected by HIV. In addition, in all of the countries, a lack of sufficient data on young people most affected by HIV and lack of age-disaggregated data on relevant service outreach activities leaves decision makers without the evidence base to guide the development of appropriate services. 

Finally, young people in these countries face multiple obstacles to contributing to HIV and SRHR policy and programme development processes. While their governments are making efforts to involve young people and to make services more youth-friendly, there do not appear to be specific forums for young people most affected by HIV that are consulted by government, with the notable exception of Bangladesh. There, the government intends to establish groups of most-at-risk adolescents and already supports peer-led HIV interventions with these populations.

Link Up has demonstrated that building the capacity of, and providing participation and leadership space for, young people most affected by HIV to engage in health policy and programme development is crucial. This both empowers young people to challenge their marginalised status and increases the likelihood that policies and programmes will be tailored to respond to young people’s needs. Without it, bringing an end to AIDS will remain a very distant reality.   

Visit K4Health’s new page on Integrating Family Planning and HIV Services to learn more about integration approaches for young people and other populations.