How can we better serve adolescent key populations? Strategies to encourage and inform future data collection, analysis, and use

Abstract

Young key populations (ages 10-24) (YKPs) are uniquely vulnerable to HIV infection. Yet they are often underserved, due in part to a limited understanding of their needs. Many successful approaches to understanding YKPs exist but are not widely used. To identify the most useful approaches and encourage their uptake, we reviewed strategic information on YKPs and experiences collecting, analysing, and utilising it from countries in Africa, Asia, and Central and Eastern Europe. As a result, we recommend one central guiding principle - any effort to understand and serve YKPs should include a specific focus on adolescent key populations (AKPs) (ages 10-19) - and three strategies to inform data collection, analysis, and use: tailor recruitment practices to ensure young people's representation, select indicators and research methods based on their ability to inform responsive programming for and give a voice to YKPs, and thoroughly disaggregate data. We demonstrate the utility of each strategy in YKP research and programmes, and in doing so note the particular importance for AKPs. We hope that this paper encourages additional research on YKPs and helps bridge the gap between research and effective programmes to serve the youngest and most vulnerable members of key populations.

Ensuring Inclusion of Adolescent Key Populations at Higher Risk of HIV Exposure: Recommendations for Conducting Biological Behavioral Surveillance Surveys

“…This was the third such meeting (2004 in Addis Ababa, Ethiopia; 2009 and 2015 in Bangkok, Thailand) but the first to include a focus on AKP, reflecting recent concerns about their absence in HIV BBSS [ 49 ]. Data from surveys conducted among AKP thus far have provided essential information to respond to the specific needs of AKP, including overlapping risks (ie, adolescents who inject drugs and sell sex), sexual behaviors, barriers to service uptake, violence, as well as HIV- and non-HIV-related (ie, reproductive and mental) health needs [ 14 , 48 , 50 ].…”

“…Given that survey designs need to be tailored to reach AKP, they comprise a small part of the key populations and may be more hidden than their adult counterparts. Many surveys of adult key populations include adolescents as young as 15 years [ 11 , 12 ]; however, disaggregated analysis that might inform donors and governments about 15-19 year olds, including disaggregation by sex, is rarely presented [ 14 ]. Other important information including the age of initiation of drug use or sexual behavior from surveys of adult key populations have been useful for advocating new policies to benefit AKP.…”

“…Unfortunately, many of these surveillance activities do not collect data from persons under the age of 18 years. Some surveys have managed to collect data from participants as young as 15 years [ 11 , 12 ]; however, these data are not disaggregated (by age and sex), and the sample sizes comprising 15 to 19 year olds are often not sufficient for meaningful analysis [ 13 , 14 ]. To fill this gap, some countries have conducted separate studies on younger cohorts; however, many studies use non-probability sampling methods from which inferences about the population cannot be made [ 15 , 16 ].…”

<p>Revisiting public health programming in Nigeria: challenges and solutions</p>

“…Today, the emphasis is different, being focused primarily on targets and data monitoring. Nothing significant is done about other vital components of public health programming 7. As program management professionals, we must try to remind ourselves of what is meaningful in public health programming.…”

“…Documentation with monitoring is the last component of public health programming and is critical to ensuring that the right things are done, the right results are obtained and the right structures are ultimately established 15. Documentation with monitoring should be a way of providing proof to the funders and to the world that the right investments were made and appropriate results, outcomes and benefits have been obtained 7. Documentation should be done, because a programme that is not documented is a programme that never happened 16,17.…”