In the Maldives, UNICEF and partners work to increase adolescent-friendly services

By equipping health care workers with the skills they need to support young people, UNICEF is helping prevent and protect youth from HIV.

Elissa Miolene
Participants of the training pretend to be adolescents chatting about sex. In a skit, they illustrate how easy it is for teens to access the wrong types of information.
UNICEFMaldives/2019/Miolene
14 March 2019

In the Maldives, UNICEF and partners work to increase adolescent-friendly services and prevent the spread of HIV

The HIV prevalence rate in the Maldives is low: between 1991 and 2018, the country reported only 25 cases of HIV among Maldivians. However, the population of the Maldives is small, tight-knit and compact, a situation that, with the wrong set of circumstances, could lead to an escalation  of the virus across the nation.  

To prevent an outbreak from occurring, UNICEF is training health workers and organizations to incorporate adolescent-friendly services – and HIV prevention strategies – into their daily operations.

“Right now, it takes a lot of effort for adolescents to seek help on these matters,” said Shabana Ali, a participant of the training and the Assistant Director of Hdh. Atoll Health Services. 

“They’re in need of help, but they won’t ask for it because they fear judgement. We can make it easier for adolescents by providing services in a youth-friendly way.”

From February 20-25, UNICEF partnered with the Ministry of Health and others to train individuals to integrate youth-friendly services into their operations. Though largely composed of individuals from the health sector, representatives from health- and youth-focused organizations like the Ministry of Youth, Sports and Community Empowerment, Society for Health Education (SHE) and Journey also attended the training.

The group discussed the rising risk factors rising across the Maldives, including unsafe sex among youth, injecting drug use, and transactional sex. They also talked about the fact that youth in the Maldives, like youth throughout the world, feel they cannot talk about such issues with their doctors, parents or teachers.

“Youth don’t talk about these things, but we need them to,” said Ismail Shihab from the Ministry of Youth and Sports. “Social stigma, and the fear of what other people might think of them, impact young people to the point where they won’t talk about what’s important.”

Especially in small island communities, young people often do not feel comfortable asking for sensitive information, even inside a doctor’s office. By teaching participants to more effectively communicate with adolescents, the training taught health care workers to approach youth in a way that will encourage them to keep coming back.

Participants also learned about stigma, discrimination and the difficulty of accessing health care as an adolescent. And, they learned about the need for adolescent-friendly interventions, and why it is important to personalize health care services for the most at-risk groups.

“By changing the way health care provider interact with young people, youth will be more likely to access prevention services that could save their lives,” said Aishath Shahula Ahmed, the Health, Nutrition and HIV/AIDS Prevention Programme Specialist at the UNICEF Maldives Office.

“Youth don’t talk about these things, but we need them to,” said Ismail Shihab from the Ministry of Youth and Sports. “Social stigma, and the fear of what other people might think of them, impact young people to the point where they won’t talk about what’s important.”

In groups, participants identified the resources available and challenges faced by young people in their islands. They then created an intervention plan to reach adolescents and other key populations, including injecting drug users, men who have sex with men, and sex workers.

One example of these interventions is a project designed to increase testing rates, as only 33 percent of men and 36 percent of women have been tested for HIV in the Maldives. To do so, the group developed an intervention to promote the confidentiality of lab workers, which will hopefully increase public perceptions of privacy and trust at every level of the health care system.

For the next few months, UNICEF and the Ministry of Health will check up on these interventions to track their progress. 

“The HIV prevalence rate in Maldives is still low,” said Fathmath Suha, a participant of the training and member of the Society for Health Education. “We need to keep it that way or eliminate it completely.”

Two participants of UNICEF’s recent training demonstrate how to talk to adolescents in the health care setting while remaining impartial, confidential and respectful, regardless of their own personal views.
UNICEFMaldives/2019/Miolene
Two participants of UNICEF’s recent training demonstrate how to talk to adolescents in the health care setting while remaining impartial, confidential and respectful, regardless of their own personal views.

Fast facts: HIV in Maldives

Though the HIV prevalence rate is low in the Maldives, the risk factors of the virus are growing. According to Ministry of Health, the Maldives Demographic and Health Survey (2016-2017) and the World Health Organization:

Men who have sex with men used condoms in only 21 percent of their sexual encounters with men. The same group reported using condoms less than 2 percent of the time when they had sexual encounters with women.

A third of all sex workers are also injecting drugs.

Between 1991 and 2018, a total of 415 cases of HIV were identified among expatriate workers in the Maldives.

One in three injecting drug users share needles.

98% of sex workers in Addu and 88% of sex workers in Malé had unprotected sex with a client within seven days of being surveyed.

In some regions of the country, only 19 percent of people know that using condoms can prevent the virus.