Lack of access to HIV services
Many young people report that healthcare workers have negative attitudes towards young people seeking healthcare services, particularly those having sex under the national age of consent, engaging in homosexual relationships or using drugs. This deters them from seeking contraception, sexually transmitted infection (STI) check-ups and HIV testing.
Some young people are also fearful of stigma from their partners, families and communities, making them unwilling to come forward for HIV testing in case their families find out that they are sexually active or living with HIV. Other sexual and reproductive health services deny access to people who are not married.
Gender inequality and HIV vulnerability
Of all adolescents aged 15-19 who were diagnosed as HIV-positive during 2012, two-thirds were girls. Globally, young girls are more vulnerable to HIV for a number of reasons, but universally the level of HIV knowledge among girls is less than among boys because girls are less likely to attend and finish secondary school.
In order to address these gender differences, a systematic review of HIV programming for adolescents noted a number of interventions that are needed for programs to be effective for girls:
- an enabling environment, including keeping girls in school, promoting gender equity, strengthening protective legal norms, and reducing gender-based violence
- Information and service needs, including provision of age-appropriate comprehensive sex education, increasing knowledge about and access to information and services, and expanding harm reduction programs for adolescent girls who inject drugs
- social support, including promoting caring relationships with adults and providing support for adolescent female orphans and vulnerable children.
Young parenthood and HIV
15 million girls between 15 and 19 give birth every year. 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.
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.
The future of HIV among young people
Among young people, the age of sexual debut is rising, the number of sexual partners is falling and the uptake of voluntary medical male circumcision is most popular among people younger than 25.
Still, young people are routinely forgotten in national strategic plans to tackle the HIV epidemic, especially those that also fall under other key affected populations. They are not targeted with age-appropriate HIV prevention programs and data about their vulnerability is not collected.
As a result, young people are often forgotten and excluded from the international HIV response. Engaging young people is key to protecting their health and addressing the HIV epidemic as a whole.