5 Life-Cycle Approach to Youth (15-24) HIV prevention

HIV global overview

HIV (Human Immunodeficiency Virus), which causes AIDS (Acquired Immunodeficiency Syndrome) remains the most challenging public health pandemic since the first case diagnosed in 1981. Even though substantial efforts have gone towards the fight against the virus, it is estimated that 79 million people have been infected and 36 million have died from AIDS-related illnesses. Today, approximately 38 million people are living with HIV, globally. In 2020, there were 1.5 million new infections. Young people aged 15 to 24 years accounted for a third of all the new infections. AIDS is the second leading cause of death among the youth after unintentional accidents.

To a nation, the youth represents the future and its stronghold. They have the creativity, innovation, and energy to shape the world. So, you can imagine the devastating effect of HIV infection and its impact on future generations. HIV crashes the hope of the youth, blends self-resentment and more so it pushes the youth to self-hate and isolation. If the change is not recognized early enough to seek health care, it becomes difficult to salvage the youth. 

We must, then, strive to shield our youth from factors that increase their vulnerability to HIV infection, identify barriers to HIV prevention, and look at a life-cycle model of care. It is evident that with appropriate care, the virus can be completely suppressed allowing the person to live a ‘normal’ life that reduces the chance of infecting others. 

1. Risks factors that increase youth vulnerability to HIV infection

The age between 15 and 24 years is characterized by rapid physiological and psychological changes pitting the youth to a period of self-awareness of body image and sexual maturity. The addition of HIV infection can complicate this matrix. Below are some risk behaviors that drive HIV infections among the youth;

Substance abuse

Substance intoxication can alter the mental capacity for judgment. This contributes to risky behavior such as impulsive and unsafe sex. Poor mental capacity limits the effective use of protective measures raising the risks of HIV infection.

In addition, drug abuse can lead to HIV infection when people exchange sex for drugs or money.

Low rate of condom use

Appropriate use of condoms reduced risks of HIV infection, other sexually transmitted diseases, and pregnancy. Yet, evidence shows that condom use among the youth is still low.

Multiple sex partners

Having more than one sexual partner increases the risks of HIV/ AIDS and other sexually transmitted diseases. The choice of a partner increases the risks of acquiring the infection. Sex with a commercial sex worker or an older partner who is likely to have many sexual partners increases the risk of getting infected.

Anal sex

Anal sex is associated with higher risks of HIV transmission. This is because the anal canal has a thin lining that allows the infection to easily gain access, infecting the HIV-negative partner in the process.

Injection drug use

The high prevalence of drug use among the youth poses a great danger to HIV infection. Common practices like sharing needles are key in the transmission of the disease. And, even where harm reduction strategies to injection drug users have occurred, accessibility to these services remains a challenge further increasing the risks.

2. Barriers that hinder the youth access to HIV prevention

There are multiple strategies to prevent HIV infection, yet, we constantly have new infections that do not seem to go away among young people. Understanding barriers to effective HIV prevention is a great way to start addressing this need. Outlined are the most common barriers that hinder the youth from accessing HIV prevention opportunities;

Stigma, Rejection, and Bullying. 

Despite HIV being with us for close to 40 years, HIV stigma presents a real barrier to HIV prevention and impacts the health-seeking habits of youth who get infected. Stigma is defined as negative beliefs, feelings, and attitudes towards people living with HIV leading to the social exclusion of the infected individual and their families. People with HIV still face discrimination. For example, people may refuse to associate with them, refuse to share food, handshake, or even sit in the same area. These attitudes lead to self-isolation and may prevent HIV disclosure to protect themselves. When there is no full disclosure, HIV infection will continue to spread rampantly within the community because the infected person does not take precautions. If stigma is not dealt with, it can continue to fuel new infections.

Inadequate sex education

Health education has been recognized as a major HIV prevention strategy. Education on HIV increases understanding of the disease, mode of transmission, and precautions to prevent its spread. Inadequate knowledge on HIV drives misinformation, stigma, and beliefs that hinder appropriate health-seeking for counseling, testing, and treatment.

This is more profound among the youth, some who barely understand what HIV is and how it is acquired. It is through health education that we can start to tackle some of the cultural gender norms that have continuously predisposed the youth to HIV infection.

Older sex partners

When young people engage in sexual behavior with older adults, they are likely to get infected. First, they are not likely to negotiate for safer sex, and second, the older person may have several sexual partners increasing their risk of HIV infection. The power imbalance is at the core of youth HIV infection.

Low rate of pre-Exposure Prophylaxis (PrEP) use

PrEP is a course of HIV drugs that are taken by HIV-negative people to protect them from getting infected. PrEp is recommended for people who engage in risky HIV exposure activities. Evidence indicates that when PrEP is used appropriately it can significantly reduce the risk of HIV infection by up to 99%.

Other Sexually Transmitted Diseases (STD)

STD and HIV have a symbiotic relation. Behaviors that put someone at risk of STD are the same behaviors that increase the risk of HIV infection; not using a condom, having multiple partners, or having anonymous partners.

3. Life-Cycle Approach to youth HIV prevention  

Life-cycle approach advocates examining the biological, social, and behavioral factors that act together or independently to increase the risk of HIV infection in a population. To influence HIV prevention among the youth, a life-cycle approach can yield a better result. Some key life-cycle strategies are;

1. Scaling up youth-friendly health services for HIV care

The youth live in a rapidly transitioning environment, the physical, psychological, and sexual maturation all impact a single individual. To harness the emotions and provide appropriate care for the youth, youth-friendly health services that provide the unique health needs of the youth can have a significant impact on youth HIV care and prevention. A non-judgmental attitude of the caregiver can greatly influence youth health services uptake.

• Including parents and guardians in youth HIV infection prevention

Parents, guardians, and the wider community have the power, influence, and control over the youth and can be resourceful in HIV care and prevention. Setting up a strong social support system where the youth can grow and is protected from such infections.

• Including schools in the HIV prevention response

School-based HIV/AIDS education programs have a huge impact on HIV prevention. It is in the formative years that the youth can be educated on HIV, how it is transmitted, available preventive approaches, and how to seek health care when infected. Teachers must be conversant with HIV care programs to effectively provide health education on HIV infection.

• Peer involvement in youth HIV prevention programs

The influence of peers in youth development cannot be underestimated. Normally, peers have a strong influence on each other. In HIV care, peer involvement provides social support for newly diagnosed youth. Here, the youth feel welcome, can share their experiences without being judged.

Through peer support, the youth learns how to take care of themselves, the importance of accessing care, and how to grow and live positively with HIV infection. Peer-to-peer support group creates an enabling environment for HIV discussion that is unbiased. It encourages the youth to seek HIV health care services, counseling and testing, and the importance of adherence to HIV treatment.  

• An enabling environment for youth to transit into adulthood.

When the youth transit from childhood into a young adults, they move from dependent to partially independent adults. It is the responsibility of the employing institutions to ensure that the young employee is supported to start living independently without the vulnerability that leads to HIV exposure.  

With this in mind, let us all join forces and mentor our youth and salvage the future generations. To add your voice, leave a comment in the post box.