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Around 2,100 young people and adolescents are infected with HIV every day.1 In 2013, four million
young people aged 15-24 were living with HIV, with 29% aged under 19.2 AIDS remains the
number-one killer of adolescents in Africa and the second-leading cause of death among
adolescents worldwide.3
The majority of young people living with HIV are in low- and middle-income countries, with 85% in
sub-Saharan Africa. Countries in this region already have youthful populations, and this trend is
expected to increase until 2050.4 For example, 51% of the population of South Sudan are under the
age of 18.5 For countries like South Sudan that already have a high burden of HIV infections, this
will inevitably lead to more HIV transmissions among young people.6
The number of AIDS-related deaths among adolescents rose by 50% between 2005 and 2012. This
is in comparison to a 30% fall among people of all ages living with HIV.7
HIV treatment needs and new responsibility for their own health. These explain why some young
people stop adhering to antiretroviral treatment (ART) correctly during their adolescent years.10
Data issues
HIV-related data for young people is often divided between adolescents (aged 10-19) and young
people (aged 15-24), with less data available for adolescents. However, these age groups are not
well defined internationally and even vary within countries, making data collection and its
reliability very complex.15
Ethical and legal issues make it difficult to conduct studies and research on people under 18,
limiting what data is available about how HIV affects young people.16
The age of sexual debut is rising, showing a positive change in attitudes among young people with
regards to sexual behaviour.17 However, it is still relatively low in many South and East African
countries, and lower among adolescent girls than boys in low- and middle-income countries.18 19
Condom use among young people and adolescents is usually low, with only 34% of young women
and 45% of young men in South and East Africa using them.20
Multiple partners
The number of sexual partners young people have is falling, although it remains high in countries
most affected by the HIV epidemic.21 More than a quarter of young men in Lesotho, Madagascar
and Swaziland are thought to be in multiple relationships.22
Older partners
Inter-generational sex (when young people have relationships with older people) is thought to be a
driver of the HIV epidemic in sub-Saharan Africa.
Older partners are more likely to be living with HIV, therefore risking exposure to young people.
Young women also find it harder to negotiate condom use with older partners who have greater
power in the relationship and may use gifts or money to encourage girls to have unprotected sex.23
Young women
60% of new HIV infections among young people occur in young women, equating to 380,000 every
year. In sub-Saharan Africa, women are likely to become HIV-positive five to seven years earlier
than men and girls account for seven in 10 new infections among those aged 1519. More than
5,000 young women and girls, the vast majority of them in southern Africa, acquire HIV every week.
26 27
A number of reasons for this are reported, including gender-based violence and a lack of access to
education and healthcare services. In some places, up to 45% of women report that their first
There are often age restrictions on accessing harm reduction services, forcing young people away
from services and being denied help to overcome their addiction.39 If someone starts injecting
drugs in their youth, they should be prioritised for harm reduction services, not denied them.
In many countries, the age of consent is high at around 18-21, leaving people younger than this
having to obtain parental consent. This is much more likely to result in a young person not getting
an HIV test when discussions with parents around sexual relations and HIV are necessary.
For many orphaned young people, parental consent is not an option and so they are denied access.
50 Age of consent laws to HIV testing should be removed.
Age-appropriate HTC
Services must be open at appropriate times (after school/college), and be at appropriate venues
where young people feel safe enough to go alone.51
Legal protection
In the case of sexual violence, it is important that a young person is supported and referred to child
protection services.52
Young people need extra support to transfer to treatment if they test positive, as they may
otherwise get lost in the treatment cascade.53
Due to common low ages of sexual debut and age of first childbirth, it is important that young
people are supported to protect the health of their partner(s) through disclosure.54
15 million girls between 15 and 19 give birth every year.72 In certain countries, the average age of
parenthood is even lower - 41% of girls in Sierra Leone have their first pregnancy between 12 and
14 years of age.73
As a result, young women are more likely to learn their HIV status before their partner does via
antenatal clinic tests. This generates a culture of blame on the woman because she found out first,
reducing her willingness to seek future healthcare services.74
1. UNAIDS (2014) The MAC AIDS Fund, Rihanna and UNAIDS team up to reach nearly 2
million young people in need of lifesaving HIV treatment
2. UNAIDS (2014) 'The Gap Report'
3. UNICEF (2015) Annual Report
4. Idele, P., et al (2014) 'Epidemiology of HIV and AIDS Among Adolescents: Current Status,
Inequities, and Data Gaps'
5. UNAIDS (2013) 'President of South Sudan commits to strengthening the countrys response to
HIV'
6. UNAIDS & UNESCO (2013) 'YOUNG PEOPLE TODAY - Time to Act Now'
7. UNICEF (2013) 'Towards an AIDS-free generation: Children and AIDS Sixth Stocktaking report,
2013'
8. Idele, P. et al (2014) 'Epidemiology of HIV and AIDS Among Adolescents: Current Status,
Inequities, and Data Gaps'
9. UNAIDS (2014) 'The Gap Report'
10. UNICEF (2013) 'Towards an AIDS-free generation: Children and AIDS Sixth Stocktaking
report, 2013'
11. Idele, P., et al (2014) 'Epidemiology of HIV and AIDS Among Adolescents: Current Status,
Inequities, and Data Gaps'
12. WHO (2013, November) 'HIV And Adolescents: Guidance For HIV Testing And Counselling
And Care For Adolescents Living With HIV'
13. UNAIDS (2013) 'Global Report: UNAIDS Report on the Global AIDS Epidemic 2013'
14. UNESCO (2014) 'In or Out? Asia-Pacific Regional Review of the Inclusion of Young Key
Populations in National AIDS Strategic Plans'
15. AIDSTAR-One (2013) 'MAPPING HIV SERVICES AND POLICIES FOR ADOLESCENTS'
16. UNICEF (2013) 'Lost in Transitions: Current issues faced by adolescents living with HIV in
Asia Pacific'
17. UNICEF (2013) 'Towards an AIDS-free generation: Children and AIDS Sixth Stocktaking
report, 2013'
18. UNAIDS & UNESCO (2013) 'YOUNG PEOPLE TODAY - Time to Act Now'
19. Idele, P. et al (2014) 'Epidemiology of HIV and AIDS Among Adolescents: Current Status,
Inequities, and Data Gaps'
20. UNAIDS & UNESCO (2013) 'YOUNG PEOPLE TODAY - Time to Act Now'
21. UNICEF (2013) 'Towards an AIDS-free generation: Children and AIDS Sixth Stocktaking
report, 2013'
22. UNAIDS & UNESCO (2013) 'YOUNG PEOPLE TODAY - Time to Act Now'
23. UNAIDS & UNESCO (2013) 'YOUNG PEOPLE TODAY - Time to Act Now'
24. UNESCO (2014) 'In or Out? Asia-Pacific Regional Review of the Inclusion of Young Key
Populations in National AIDS Strategic Plans'
25. UNESCO (2014) 'In or Out? Asia-Pacific Regional Review of the Inclusion of Young Key
Populations in National AIDS Strategic Plans'
26. UNAIDS (2014) 'The Gap Report'
27. UNICEF (2015) Annual Report
28. UNAIDS (2014) 'The Gap Report'
29. UNICEF (2013) 'Towards an AIDS-free generation: Children and AIDS Sixth Stocktaking
report, 2013'
30. UNESCO (2014) 'In or Out? Asia-Pacific Regional Review of the Inclusion of Young Key
Populations in National AIDS Strategic Plans'
31. UNESCO (2014) 'In or Out? Asia-Pacific Regional Review of the Inclusion of Young Key
Populations in National AIDS Strategic Plans'
32. UNICEF (2013, November) 'Lost in Transitions: Current issues faced by adolescents living
with HIV in Asia Pacific'
33. Van Devanter, N., et al (2011) 'Continued Sexual Risk Behaviour in African American and
Latino Male-to-Female Transgender Adolescents Living with HIV/AIDS: A Case Study', Journal of
AIDS and Clinical Research, Dec 20, Supp 2, Page 002
34. UNAIDS (2014) 'The Gap Report'
35. UNICEF (2013, November) 'Lost in Transitions: Current issues faced by adolescents living
with HIV in Asia Pacific'
36. UNAIDS (2014) 'The Gap Report'
37. UNICEF (2013, November) 'Lost in Transitions: Current issues faced by adolescents living
with HIV in Asia Pacific'
38. International Harm Reduction Association (IHRA) (2013, December) 'Injecting Drug Use
Among Under-18s A Snapshot of Available Data'
39. UNESCO (2013) 'Young people and the Law in Asia and the Pacific: review of laws and
policies affecting young peoples access to sexual and reproductive health and HIV services'
40. UNICEF (2013, November) 'Lost in Transitions: Current issues faced by adolescents living
with HIV in Asia Pacific'
41. UNAIDS (2013) 'Global Report: UNAIDS Report on the Global AIDS Epidemic 2013'
42. Emmanuel Njeuhmeli et al (2014) 'Lessons Learned From Scale-Up of Voluntary Medical Male
Circumcision Focusing on Adolescents: Benefits, Challenges, and Potential Opportunities for
Linkages With Adolescent HIV, Sexual, and Reproductive Health Services', JAIDS, Vol 66
Supplement 2
43. UNICEF (2013) 'Towards an AIDS-free generation: Children and AIDS Sixth Stocktaking
report, 2013'
44. UNICEF (2013) 'Towards an AIDS-free generation: Children and AIDS Sixth Stocktaking
report, 2013'
45. Cluver, L. D., et al (2014) Cash plus care: social protection cumulatively mitigates HIV-risk
behaviour among adolescents in South Africa', AIDS Journal, Vol 28 Supplement 3
46. WHO (2013, November) 'HIV And Adolescents: Guidance For HIV Testing And Counselling
And Care For Adolescents Living With HIV'
47. UNICEF (2013) 'Towards an AIDS-free generation: Children and AIDS Sixth Stocktaking
report, 2013'
48. UNAIDS & UNESCO (2013) 'YOUNG PEOPLE TODAY - Time to Act Now'
49. Rosenberg, N. E., et al (2013) 'Assessing the effect of HIV counselling and testing on HIV
acquisition among South African youth', AIDS Journal Vol 27, pages 2765-2773
50. WHO (2013, November) 'HIV And Adolescents: Guidance For HIV Testing And Counselling