This year’s Women Deliver conference made a strong call for investing in the health and development of adolescents and young people. It highlighted the unique problems faced by adolescent girls and young women–some of the most vulnerable and neglected individuals in the world–and stressed the importance of addressing their needs and rights, not only for their individual benefit, but also to achieve global goals such as reducing maternal mortality and HIV infection.In response to an invitation from the editors of Reproductive Health, we-the sixteen coauthors of this commentary–put together key themes that reverberated throughout the conference, on the health and development needs of adolescents and young people, and promising solutions to meet them.1. Investing in adolescents and young people is crucial for ensuring health, creating prosperity and fulfilling human rights.2. Gender inequality contributes to many health and social problems. Adolescent girls and boys, and their families and communities, should be challenged and supported to change inequitable gender norms.– Child marriage utterly disempowers girls. It is one of the most devastating manifestations of gender discrimination.– Negative social and cultural attitudes towards menstruation constrain the lives of millions of girls. This may well establish the foundation for lifelong discomfort felt by girls about their bodies and reticence in seeking help when problems arise.3. Adolescents need comprehensive, accurate and developmentally appropriate sexuality education. This will provide the bedrock for attitude formation and decision making.4. Adolescent-centered health services can prevent sexual and reproductive health problems and detect and treat them if and when they occur.5. National governments have the authority and the responsibility to address social and cultural barriers to the provision of sexual and reproductive health education and services for adolescents and young people.6. Adolescents should be involved more meaningfully in national and local actions intended to meet their needs and respond to their problems.7. The time to act is now. We know more now than ever before about the health and development needs of adolescents and young people, as well as the solutions to meeting those needs.
Combining intensive group learning and provision of on-site reproductive health services through an existing alternative basic education program increased use of contraception and HIV testing and counseling among young out-of-school Liberians.
This review provides a synthesis of the experiences of organisations providing psychosocial support for young people living with HIV (YPLHIV) from throughout the world. Little research exists on psychosocial support for YPLHIV, with many providers uncertain about how to address their complex needs. Eighty-six organisations were sent a survey containing 15 semi-structured, open-ended questions. Sixty-eight organisations from the United States, Europe, Africa, Asia, Latin America and the Middle East responded. The survey asked what challenges the organisation's patient group face; what the organisational aims are; how, where and by whom psychosocial support is delivered; what types of psychosocial support have been effective and which have not; and what recommendations the organisation has for service provision and policy. Data were stratified by age of population, region of the world and whether youth were infected at birth or in adolescence. The problems and needs across groups were more consistent than disparate. Adherence to medication, disclosure of HIV status, issues relating to sex and lack of support networks are problems faced by all YPLHIV. Most organisations use a multi-disciplinary team of individuals to meet these needs, with particular emphasis on individual and group therapy, educational support, and skills-building programmes. The review stresses the importance of youth-centered and youth-led approaches that engage young people in the planning, implementation and evaluation of programmes. Organisations underlined the need for increased funding, capacity building and trained staff. They suggest that policy makers put more effort into understanding the distinctiveness of adolescence, particularly in the context of HIV, and challenge them to make longer-term commitments to funding and programme support. In order for organisations to provide better services, they need further evidence of effective solutions, programme guidance and support tools, and increased collaboration and communication with one another, and with policy-makers and donors.
Young people living with HIV in the US have the potential to live long and healthy lives. However, the psychosocial impact of an HIV diagnosis, complicated by poverty, inequality, stigma and marginalization, create structural and behavioral challenges for young people that can overwhelm them and their health care providers. This narrative provides a reflective analysis of insights and discussions captured through participant observation at a five-day conference for young people living with HIV. The manuscript provides practitioners with an additional interpretive lens, highlighting participant observation as a valuable methodology to better understand and design programs for young people living with HIV. The article calls for youth-led, peer-based approaches that focus on support for disclosure of HIV status, self-esteem in relationships and adherence to medication.
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