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HIV prevalence ↑ from ages 10-15 on

HIV prevalence ↑ from ages 10-15 on. ?. ?. YMSM Incidence: Bangkok MSM Cohort Study ( 4762 MSM attending HIV VCT during 2005-2011). Cumulative probability of HIV infection (%). N=4762. Estimated number of AIDS-related deaths among adolescents (ages 10-19 ), Asia-Pacific, 2001-2012.

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HIV prevalence ↑ from ages 10-15 on

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  1. HIV prevalence ↑ from ages 10-15 on ? ?

  2. YMSM Incidence: Bangkok MSM Cohort Study (4762 MSM attending HIV VCT during 2005-2011) Cumulative probability of HIV infection (%) N=4762

  3. Estimated number of AIDS-related deaths among adolescents (ages 10-19), Asia-Pacific, 2001-2012 6513 (2012) AIDS-related deaths among adolescents in Asia-Pacific are growing

  4. Children under 18 at higher HIV risk • Epidemiological definition of children/adolescents as key population is not clearly established – by age and by risk behaviours (classified as “other populations”) - Often excluded from surveillance • Legal age of consent to test • Face cumulative risks • Extremely vulnerable to sexual abuse and violence • Excluded from HTC/STI/SRH/OST services • Diagnosed and treated too late

  5. Legal age to consent independently to an HIV test Source: Young people and the law in Asia and the Pacific: A review of laws and policies affecting young people’s access to sexual and reproductive health and HIV services- UNESCO 2013

  6. Not leaving adolescents behind… Routine programme data Time to revive routine data/reporting data monitoring, disaggregated by age and gender (currently requires additional abstraction from health facility registers for analyses) Surveillance/surveys Current surveys are not designed for adolescents – most population surveys (MICS, DHS) start from age 15; not 10-14 Time to redesign survey questions by testing knowledge of services instead of knowledge on correct route of HIV transmission. “Do you know where to obtain HIV test? Where to get condoms? Where to get HIV treatment?” Programme response Time for open dialogue on ethical, policy and programmatic issues - to improve adolescents’ access to information and services A multi-sectoral approach – collaboration between NAP, SRH, child/social welfare, juvenile justice, law enforcement and civil society

  7. THANK YOU Wing-Sie Cheng Regional Adviser, HIV and AIDS UNICEF East Asia and Pacific Regional Office

  8. Emerging research • 33% of boys working on beaches reported adults sexual touching them; 56% first sexual experiences qualify as abuse; 66% forced; • Help seeking: 82% feel guilty, 40% numb compared to 12% of boys not abused • Feelings: Shame, guilt, self blame. • Boys who were sexually touched are 4 times more likely to feel suicidal • 33%of boys working on beaches reported adults sexual touching them; 56% first sexual experiences qualify as abuse; 66%forced; • Help seeking: 82%feel guilty, 40% numb compared to 12%of boys not abused • Feelings: Shame, guilt, self blame. • Boys who were sexually touched 4 times more likely to feel suicidal ‘I Want to be Brave’ Davis, J. and Miles, G. 2014 *Source: UNICEF EAPRO (2012), Systematic Review of Child Maltreatment

  9. The LingaBoys of Siem Reap (Davis, J. 2013) • 25% report never having used a condom • 58% report never having received sexual health services • Almost half –47% report being forced to have sex • Trans-gender individuals face high degree of discrimination and marginalisation (‘Listening to the Demand’ ,Havey, J. 2014)

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