Young people: the key to ending AIDS by 2030

By Key Correspondents

A post by Elena Obieta, an infectious diseases physician and community-based activist. This article was first published on the Key Correspondent site where Elena is a regular contributor.

What do you a call a group of young people including lesbians, gays, bisexuals, transgenders, sex workers and drug users? No, this isn’t a joke – it couldn’t be further from a joke.
For those of you who don’t work in the HIV sector, these different groups of people are known as ‘key affected populations’. The reason being, they share the following challenges in common:

•    they face stigma and discrimination
•    they are marginalised
•    their voices are not heard
•    they are criminalised and prosecuted
•    they are exposed to violence
•    they are most at risk for acquiring HIV.

Providing HIV treatment for all

Despite significant progress towards the Millennium Development Goal of achieving universal access to treatment for HIV for all those who need it by 2010, we have fallen short and those most underserved and neglected in the response are young people, and in particular key populations.
This week, leaders and members of civil society are gathered at the United Nations General Assembly and its side events to discuss and negotiate a huge and complex range of sustainable development and climate goals that will come into effect when the MDGs expire next year.
On 25 September, I attended a vibrant event held at the UN and led by young people to address the crucial role of community engagement, advocacy and service delivery in meeting the sexual and reproductive health needs of young people.

©Benjamin Chesterton\duckrabbit\International HIV/AIDS Alliance

The event was organized by a number of leading organisations focusing on HIV, including the International HIV/AIDS Alliance, who recognize that young people must be at the heart of the post 2015 development agenda if the mantra of ‘leaving no one behind’ in the new sustainable development goals is to become a reality.

Criminalisation and marginalisation

One of the major challenges to achieving the goal of universal access to HIV treatment is that many countries retain laws that criminalise people from key populations.

In fact homophobic laws still exist in more than 70 countries. The list is shocking, it is on Wikipedia. At the event, SM Shaikat, from SERAC, Bangladesh, and advisor for the Global Youth Coalition on HIV/AIDS, asked: “What can be done regarding HIV in men who have sex with men if according to the National Constitution same sex practices should not exist?”

There is a major historical opportunity for this generation of global leaders, including young people, to end AIDS. But leaving no one behind in the context of criminalization of key populations is one of the biggest challenges which must be taken up by young civil society HIV activists and advocates.

Stigma and discrimination

Dr Luiz Loures, from UNAIDS, reminded us of the beginning of the epidemic, in the early 1980s, when he saw his colleagues did not want to touch HIV positive patients, not just because of the virus itself, but also because patients were sex workers, injecting drug users or men who had sex with men. As an infectious diseases physician, I also witnessed this many years ago and sadly it still sometimes happens today.

Civil society has played a massive role in changing the HIV epidemic, by getting it on the agenda in the Millennium Development Goals and mobilizing funding. But there is more to do.
Loures said: “Today we have the knowledge and technology to end AIDS only discrimination and inequality hold us back.”

Shaikat added: “These inequalities are our greatest challenge to the HIV/AIDS agenda.”
What constantly boycotts our stepping forward is discrimination (still!) and filling up the gaps of inequity. Loures pointed out that AIDS can be used today as the front line of inequality, which is fueling the epidemic in young people, key populations and women.

Nobody left behind

Young people account for 40 per cent of new HIV infections. Transgender women are almost 50 per cent more likely to acquire the virus than the general population. Sex workers, men who have sex with men and people who inject drugs are 13, 19 and 22 per cent more likely to be living with HIV. If we don’t change this, we will continue to leave millions behind.

Ishita Chaudhry, CEO of YP Foundation, said: “We can only end AIDS in the post 2015 development framework if we address stigma and ensure young people are central to the response.”
But Pablo Torres Aguilera, director of HIV Young Leaders Fund, reminded us that having a young person at the table needs to be more than a tick box. “We need funding if we are to have impact and input to strategies and policies at a global level,” he said.

The time to listen to young people is now. While we are approaching the deadline for the finalization of the new sustainable development goals there is still much to be done. The only way to ensure equity in the post 2015 framework is to walk along together, side by side.

As Shaikat concluded: “Nothing for young people without young people.”