Looking ahead to another World AIDS Day this Sunday - the 26th such occasion since the annual solidarity day was introduced - it seems to me that there is an urgent need to prioritise and involve young people in efforts to tackle the global HIV epidemic, and in particular those from marginalised groups who are most at risk.
There are over 1.8 billion young people in the world today, 90 per cent of whom live in developing countries; around five million are living with HIV. Young people aged between 15 and 24 account for 40% of new HIV infections with some 2400 new infections among this age group every day. Young women are particularly vulnerable to HIV with infection rates twice as high as in young men.
Lack of knowledge, gender inequalities, cultural norms, stigma and discrimination, limited youth-friendly interventions and service providers' attitudes are just some of the factors that prevent young people from accessing sexual and reproductive health services.
Many young people simply do not have the information or means to protect themselves from HIV. Denying them knowledge and access to services is jeopardising their future. If we fail to reach young people who are most affected by HIV, including those living with the virus and those who are particularly vulnerable, we will never get new infections under control.
Take the example of Momina, 22, from Adama in central Ethiopia who found out that she was living with HIV three years ago when she was already seven months pregnant with her second son Yerosa and unable to get treatment to prevent onward transmission of the virus. Having left home at 16 to avoid being married off to an older husband, she was then rejected by her family for fear that she would infect her siblings. With a limited support network, she subsequently gave Yerosa up for adoption after he was diagnosed HIV positive four months after birth in the hope that he would have better medical treatment overseas.
Photo: Benjamin Chesterton/duckrabbit
Life for Momina and her family could have turned out so very differently if she had known how to protect herself against HIV, if she had had proper antenatal care when she was pregnant with Yerosa, if she had not felt compelled to run away from home for fear of early marriage. Offering a full range of contraceptive methods, comprehensive information and HIV prevention tools empowers young people to make healthy decisions and access dual protection, enabling them to prevent HIV, unintended pregnancies and sexually transmitted infections.
This week the Department for International Development's has published its new position paper on HIV and it was encouraging to see their commitment to focus on women and girls and vulnerable groups most affected by HIV. Addressing HIV among young women and high risk groups will require bold action on the legal and structural barriers currently preventing access to HIV treatment, care and support. In low and middle income countries men who have sex with men are 19 times more likely to have HIV than the general population, and people who inject drugs 22 times more likely.
The criminalisation of men who have sex with men, people who use drugs and sex workers alongside laws and practices which discriminate against women and girls remain major obstacles to overcome if we are ever to see an end to AIDS. Closer working on such issues between DFID, the Foreign Office and the relevant Commonwealth institutions would be a step in the right direction.
Together with a consortium of international and national non governmental organisations, my organisation is currently spearheading an ambitious three year country programme - Link Up - which aims to improve the sexual and reproductive health and rights of more than a million young people living with and affected by HIV in Ethiopia, Bangladesh, Burundi, Myanmar and Uganda. The current generation of young people is really the first never to have known a world without AIDS. We're thirty years into the epidemic now and young people living with HIV continue to face discrimination and exclusion on a daily basis. Protecting, respecting and promoting their human rights, including their sexual and reproductive rights, is critical.
Follow Dr Alvaro Bermejo on Twitter: www.twitter.com/theaidsalliance