Jaevion Nelson: Stop ignoring young people's needs
We have been failing our sexually active adolescents and youth because we have not been having frank conversations around sex and sexuality, including making provisions of comprehensive sexuality education.
It is unfortunate that we adults have allowed our biases and ignorance to determine how we treat with this critical issue to empower our adolescents and youth to delay sexual initiation, abstain or make more responsible decisions about sexual and reproductive health.
Why are we so resigned in our unwillingness to implement initiatives that will address the challenges they face to enable them to safeguard and protect their health and well-being? We cannot continue to act as if there is no need for concern and urgency.
Since 2008, when I started working on sexual reproductive health and rights issues, I have met many young people who have been disadvantaged and put at risk, and a number of them who are living with HIV because adults in authority do not take decisions in the best interest of children, adolescents and youth. I have heard more stories from my colleagues who work directly with adolescents and youth around risk reduction, building resilience, HIV testing and treatment, and other critically needed services.
In February, on International Condom Day, a 15-year-old girl approached a colleague wanting to talk privately to someone she felt she could trust someone she knew would not judge her. The 15-year-old told the person that she had genital warts which were very painful and causing discomfort and affecting her concentration at school. When someone has genital warts, it is the advanced presentation of HPV. She wanted to see a doctor, but was afraid to go to the clinic in her community. She was also fearful of going because she would have to bring her parent/guardian.
CHALLENGES WITH HIV TESTING
There is an urgent need for action to (1) raise awareness about and sharpen the focus on adolescent and youth-specific issues in the response to HIV and AIDS; (2) engage, mobilise and support a wide range of stakeholders as champions and agents of change for adolescent and youth to increase the impact of HIV prevention, treatment and care programmes; and (3) generate political will to invest in adolescent and youth programmes/initiatives in the national HIV/AIDS response as a critical element towards ending AIDS.
In Jamaica, HIV prevalence among young adolescent girls and boys aged 10-14 years old is 0.1 per cent. There are an estimated 685 adolescent girls (aged 10-19) living with HIV and an estimated 825 adolescent boys living with HIV, including long-term survivors of mother-to-child transmission (MTCT), and behaviourally infected adolescents. There is an estimated fivefold increase in HIV prevalence among adolescents 15-19 years of 0.4-0.5 per cent. By age 24, there is a further increase in HIV prevalence rising to 1 per cent in young women aged 20-24 and to 1.4 per cent in young men in the same the group.
Data show HIV prevalence among key and vulnerable populations within this age group such as young girls, young sex workers, and young men who have sex with men (MSM). There are also challenges with HIV testing among adolescents which at the moment is below the target of 75 per cent because only 30 per cent of girls aged 10-19 years old and 18 per cent of boys are tested for HIV.
The data for key populations of adolescents and youth is even more worrying. It reveals that 27 per cent of transgender youth aged 15-19 years are living with HIV. Among young men who have sex with men, HIV prevalence is 14 per cent among those aged 15-19.
Indications are that MSM account for a significant portion of new infections among boys in the age group 10-19 years old within the last two years, making them the only population group that has shown a significant increase in estimated new infections. An estimated 4 per cent of adolescent female and male sex workers under age 19 are living with HIV.
Other sexually transmitted infections are reportedly very high among adolescent sex workers. Data show that 27.1 per cent reported chlamydia, 17.8 per cent, gonorrhoea, 4.7 per cent syphilis and 29.9 per cent trichomoniasis. Condom use among adolescent sex workers aged 15-19 years old is reported at 90 per cent.
The time for action is now. We have been vacillating for far too long about taking a meaningful approach to address the challenges faced by our young people, especially those who are sexually active. We need to demonstrate our commitment to safeguarding the health and well-being of our adolescents and youth.