The region is seeing one of the steepest increases in the spread of HIV and AIDS worldwide. The epidemic is fuelled by risky behaviour – mainly drug use and unsafe sex – particularly among marginalized groups such as intravenous drug users, sex workers, men who have unprotected sex with men, and populations on the move. HIV Infection is, increasingly, spreading from these groups to more young people.
As a result of the successful introduction of antiretroviral (ARV) treatment, many children who were infected with HIV perinatally are now reaching their teenage years and becoming young adults, ready to take their place in society.
Across the region, however, many young people face poverty, trafficking in drugs and humans, economic migration, violence and unemployment levels that are three times higher than among adults. Youth poverty, unemployment and lack of hope fuel the trades in people and drugs that, in turn, fuel the HIV epidemic.
While they are the most vulnerable, young people are the least likely to have access to the services they need and often underestimate the risks or know how to avoid them. They are also least likely to be adequately protected by policies and laws.
Fewer than one-third of young people have ever been tested for HIV and know their HIV status. While access to life-saving antiretroviral treatment (ART) has increased, under a quarter of young people are able to access it – the result of low HIV testing rates, discrimination and stigma, as well as a lack of youth-friendly HIV services.
The share of female infections is rising.
As the share of female infections continues to rise, so do the risks of HIV infection among pregnant women and their infants. While the rate of mother-to-child transmission has slowed, thanks to determined efforts in this area, the number of children living with HIV in the region is still rising.
As the proportion of HIV positive mothers who inject drugs decreases, and as the number of children living in institutions falls, fewer children who live with or are affected by HIV are growing up in residential care. More efforts are needed, however, to prevent abandonment and make sure all children live in a family environment.
Meanwhile, evidence of rising sexual transmission raises concerns that the region might be heading for a generalized epidemic. Growing numbers of vulnerable girls and women are being exploited in the commercial sex industry, often facing violence and abuse, with the inevitable risk of HIV infection.
This vicious circle of risk and vulnerability can only be addressed by combining HIV prevention measures with approaches to tackle the social causes of adolescent vulnerability, backed by greater political commitment to an effective response.