Lessons Learned From a Review of Interventions for Adolescent and Young Key Populations in Asia Pacific and Opportunities for Programming

Schunter, Bettina T.; Cheng, Wing-Sie; Kendall, Megan; Marais, Hein

doi:10.1097/qai.0000000000000185

Cited by 21 publications

(20 citation statements)

References 38 publications

(49 reference statements)

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“…Unprotected sex is an important risk factor for negative health outcomes among young people, accounting for 4% of disability-adjusted life years (DALYs) in those aged 10–24 [ 12 ]. Several studies have shown younger age is associated with more frequent unprotected sex among KP [ 13 ], often due to lower levels of education, knowledge, and risk perception [ 13 – 15 ]. Young key populations (YKP) may also be unaware of where to access condoms and other contraception.…”

Section: Resultsmentioning

confidence: 99%

“…In one study of young MSM aged 16–20, considering a relationship to be serious was associated with an eight-fold increase in the rate of unprotected sex [ 24 ]. For TG women, condom negotiation may be more difficult given their female gender identity and socially constructed role, and young TG people may be more likely to have unprotected sex to validate their gender identity [ 13 ]. Among young PWID, low rates of condom use are often associated with other high-risk practices such as needle sharing or smoking drugs together [ 23 ].…”

Section: Resultsmentioning

confidence: 99%

“…Low levels of education and HIV knowledge or risk perception are associated with low uptake of HIV services [ 13 ]. YKP with less formal education and/or less sex education may be less familiar with what constitute safe sex or safe injection practices.…”

Section: Resultsmentioning

confidence: 99%

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Providing comprehensive health services for young key populations: needs, barriers and gaps

Delany‐Moretlwe

Cowan

Busza

et al. 2015

Journal of the International AIDS Society

173

186

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IntroductionAdolescence is a time of physical, emotional and social transitions that have implications for health. In addition to being at high risk for HIV, young key populations (YKP) may experience other health problems attributable to high-risk behaviour or their developmental stage, or a combination of both.DiscussionWe reviewed the needs, barriers and gaps for other non-HIV health services for YKP. We searched PubMed and Google Scholar for articles that provided specific age-related data on sexual and reproductive health; mental health; violence; and substance use problems for adolescent, youth or young sex workers, men who have sex with men, transgender people, and people who inject drugs.ResultsYKP experience more unprotected sex, sexually transmitted infections including HIV, unintended pregnancy, violence, mental health disorders and substance use compared to older members of key populations and youth among the general population. YKP experience significant barriers to accessing care; coverage of services is low, largely because of stigma and discrimination experienced at both the health system and policy levels.DiscussionYKP require comprehensive, integrated services that respond to their specific developmental needs, including health, educational and social services within the context of a human rights-based approach. The recent WHO Consolidated Guidelines on HIV Prevention, Diagnosis, Treatment and Care for Key Populations are an important first step for a more comprehensive approach to HIV programming for YKP, but there are limited data on the effective delivery of combined interventions for YKP. Significant investments in research and implementation will be required to ensure adequate provision and coverage of services for YKP. In addition, greater commitments to harm reduction and rights-based approaches are needed to address structural barriers to access to care.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Providing comprehensive health services for young key populations: needs, barriers and gaps

Delany‐Moretlwe

Cowan

Busza

et al. 2015

Journal of the International AIDS Society

173

186

View full text Add to dashboard Cite

show abstract

“…This finding may reflect that youth are vulnerable to STIs, possibility due to lower levels of education, risk perception, and the higher prevalence of risky sexual behaviors (23,24). Because HIV transmission among youth MSM in China has become a rapidly emerging public health problem (25,26), interventions including education on safer sexual behaviors, improving the coverage and pertinence voluntary counseling, and testing work and STI treatments are imperative to prevent STIs infections in MSM.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Determinants of Herpes Simplex Virus Type 2 (HSV-2)/Syphilis Co-Infection and HSV-2 Mono-Infection among Human Immunodeficiency Virus Positive Men Who Have Sex with Men: a Cross-Sectional Study in Northeast China

Chu

et al. 2017

Jpn J Infect Dis

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“…Of the 2.1 million adolescents (11-19 years) who are infected with HIV, about 1.3 million (62%) live in Eastern and Southern Africa [6,7]. It is estimated that 95% of new infections among adolescents in Asia are among key populations such as people who inject drugs (PWID), men having sex with men (MSM) and sex workers [8] and 70% of all individuals who inject drugs are under the age of 25 [9]. This can be supported by empirical evidence that key populations and their sexual partners account for a high proportion of new HIV infections in countries such as Dominican Republic 47%, Kenya 33%, Morocco 80%, Mozambique 27.5%, Nigeria 51%, Peru 65% [10].…”

Section: Introductionmentioning

confidence: 99%

Review of HIV Interventions among Young and Adolescent Key Populations in Low to Middle Income Countries

Mehra¹,

Khanna²,

Behera³

et al. 2017

J AIDS Clin Res

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Background: Globally, Young key populations (age 10-24) (YKPs) are more at risk to HIV infection and are disproportionately infected by HIV. There is a pressing need for evidence on how best to implement effective interventions for young key populations.Objective: The overall aim was to conduct a systematic review of interventions to summarize the data on effectiveness of interventions in low and middle income countries among young key populations. Method:We conducted a review of the evidence on interventions designed to increase adolescents and young people's access to services for reducing their HIV risk. We focused specifically on the young key populations from low to middle income countries. We searched PubMed, Medline and Cochrane databases using MesH terms to identify peer-reviewed articles. We included studies with designs such as randomized control trails (RCT), clustered randomized trails, quasi experimental, prospective observational and studies that measured outcomes pre and post an intervention. We identified a total of 10 studies that were included in the review based on certain inclusion and exclusion criteria.Results: Among the interventions designed for young people, community based interventions driven by peer led approach and mobile based interventions were effective in engaging with these hard to reach populations. Structural interventions focusing on stigma and psychosocial component can positively impact important HIV-related outcomes. HIV screening needs to be integrated in programs and policy with intimate partner violence. The evidence on PreP is mixed and needs more systematic investigation. Conclusion:Combinations of prevention packages that include behavioural, structural and biological interventions are needed for young key populations to prevent new HIV infections. These interventions with proven effectiveness should be included in all HIV prevention programming for young people.

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Lessons Learned From a Review of Interventions for Adolescent and Young Key Populations in Asia Pacific and Opportunities for Programming

Abstract: Although structural factors play a key role in access and uptake of HIV prevention services for adolescent and YKP, further qualitative research is needed to understand and mitigate the drivers of vulnerability and constructed perceptions of risk.

Cited by 21 publications

References 38 publications

Providing comprehensive health services for young key populations: needs, barriers and gaps

Providing comprehensive health services for young key populations: needs, barriers and gaps

Prevalence and Determinants of Herpes Simplex Virus Type 2 (HSV-2)/Syphilis Co-Infection and HSV-2 Mono-Infection among Human Immunodeficiency Virus Positive Men Who Have Sex with Men: a Cross-Sectional Study in Northeast China

Review of HIV Interventions among Young and Adolescent Key Populations in Low to Middle Income Countries

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