Engaging Youth to Access HIV/STI Screening
Research on HIV/AIDS Youth Engagement
Background and Objectives
There is currently a worldwide effort to stem the spread of sexually transmitted infections [STIs]. The motivation for such an intervention is that the spread of diseases such as AIDS remain a threat to human populations all over the world. Recent statistics show that 1 in every 4 new HIV infections in the United States occurs among young people aged between 13 and 24 years (CDC, 2010). This means about 12,000 youth were infected with HIV in 2010 alone (CDC, 2012). This situation therefore raises the question; What is the best way of engaging the youth to access STI screening programs? Such screening would help to stem the tide of new infections by making the youth aware of their status and counseling them in the process on how to avoid risky sexual behavior (UNFPA, 2014).
This paper primarily relies on secondary research to gather information on how such interventions can be successfully carried out.
The information for this research was gathered online aiming at relevant information on the issue of interventions against new HIV infections among the youth. The targeted sources included online journals, publications by health based NGOs and Department of Health releases. These, in turn, provided different resources quoted by these sites which were checked out in online libraries.
Those articles that did not study persons within this age bracket were considered irrelevant and thus discarded. Also, the resources that were found not to be directly related to initiatives targeting the youth on HIV control were purged from the research. There were several articles that only concentrated on the African Americans or Latinos, but since this was not an ethnographic study, they were discarded as well. The ones that were directly related were also checked to see if they included the issues of HIV testing and counseling programs. Those which did not fit this criterion were also eliminated. Testing and counseling were considered an integral part of this study since they are the interventions that directly tackle the problem of new infections. Ultimately, those which fitted the research requirement were scrutinized and the views gathered collated into this paper.
Ultimately, 4 relevant articles were identified after another 20 had been discarded. These were enough for the purposes of the research and thus the others were left out. The articles were studied qualitatively and the results compiled as such. Though this was quite labor intensive, it was considered important since the main intent was to gather views rather than mere facts on this matter. This was a cohort study in which those targeted were youths between ages 13-24. However, the findings were then presented in a quantitative form for easier interpretation and drawing of inferences.
Factors Predisposing the Youth to HIV
This analysis endeavors to consider the results in descending order of importance.
The study found that the youth between the ages of 13 and 24 were the most vulnerable group to new HIV and STI infections in all the studies that were taken into consideration (UNFPA, 2014). STIs were found to be directly related to HIV infections since one opened the way for the other. According to UNFPA the youth remain at the center of HIV infections worldwide (UNFPA, 2014). Even though they have grown in a world in which AIDS exists, many of them still lack the knowledge to help them tackle the epidemic (UNFPA, 2014). However they have the greatest potential for change. Statistics from the US Department of Health and Human Services [DHHS], show that in 2004 there were an estimated 40 million people living with HIV worldwide and a third of them were below the age of 25 (DHHS, 2004). At the same time there were 5 million new infections every year and more than half of these were in the same age category (DHHS, 2004). This particular study also identified girls as being particularly more susceptible to new infections than boys. More than half of the youth infected were girls. They therefore proposed that interventions being made for the youth should have particular sub-categories especially tailor made for girls.
The main reasons for youth vulnerability were presented at the United Nations Special Session on HIV Aids in 2001 in New York (UN, 2001). One of the predisposing factors for the youth was found to be pervasive ignorance about how to protect themselves against HIV infections (UN, 2001). Some youth were found to be unaware that healthy looking people, and rich ones at that, could be HIV positive (UN, 2001).
Poverty was another factor among this group most of whom do not own property or enterprises that can help them raise money (UN, 2001). Some of them, like street people, participated in sex in exchange for food or money. As a result, many indulged in unprotected sex. Moreover, some adults believe that younger persons have not had many sexual experiences and thus target them for sex. This makes girls particularly vulnerable.
The session also noted that homosexuals were afraid of the social stigma associated with their practice and thus lacked vital information on their vulnerability to HIV. Moreover, even heterosexual relationships were unplanned in many cases, and at times forced, and thus protection was not used by those involved.
The youth were also noted to be particularly sensitive and thus found it hard to access medical information and services (DHHS, 2004). Among the problems noted were lack of privacy and confidentiality by medical staff offering HIV health services. Some staff members of such facilities were also rude and threatening. Moreover, many young people found it hard to afford medical services and thus opted out of them.
Another major factor was found to be substance abuse. Many young persons experimented with drugs which involved injections thus infecting one another. Use of other drugs such as alcohol also led to risky sexual behavior once the youth were inebriated. In some cases girls were deliberately given alcohol to make them more responsive to sexual overtures.
The Proposed Interventions against Youth HIV
The main intervention that was proposed was to involve the youth in HIV prevention programs (DHHS, 2004). This would encourage the youth who saw adults as a threat to go for health services. The previous tendency had been to only have medical staff, who are mostly past the youth stage, to deal with the youth in all programs.
Another intervention was the introduction of free testing and counseling services (UNFPA, 2014). These would be provided in youth friendly centers. The youth would be given counseling before and after being tested so as to supply them with the correct information that they previously lacked. Attached to these testing services would be recommendations to go for viral load testing in health facilities and access antiretroviral drugs from there in case found positive.
The education system was also proposed to be revamped so as to accommodate health education, especially on STIs and HIV aids infections so as to curtail the spread. The existing educational institutions were either ignoring the epidemic, or where they tackled them, there was no structured syllabus for it. Moreover, some institutions refused to discuss sexual matters with children owing to stiff resistance from religious and cultural organizations.
Also recommended were outreach and peer education programs that would enable the youth to reach one another with the correct information in and out of school. Such programs would end up reaching more youth than previous interventions that did not involve their peers. The peer educators had to be trained to ensure that they not only had the correct information, but also knew the approaches to use in handling their peers.
The final intervention would have to be legislative. Governments have a responsibility to pass laws that protect the youth in the face of the HIV pandemic and other STIs they are vulnerable to. Among the laws would be those protecting girls from rape since unlike in the past, rape can lead to HIV or STI infections. There should therefore be serious deterrent action taken against rapists, pedophiles and pimps who use children.
Conclusion and Recommendations
From the foregoing it is clear that the problem of infections among the youth need health personnel to involve the youth in the intervention processes (DHHS, 2004). This will help bear better results than if purely medical health practitioners alone undertake this action. Moreover, it is also clear that it is a multi-sectored problem that needs the intervention of not only health practitioners, but other community leaders as well. It is clear that leaving the youth to their own devices to tackle the pandemic has so far proved to be unacceptable since the new infections among them keep increasing
This research was limited in scope due to shortage of time and resources. More research can be carried out which show the distribution of infections among ethnographic groups and social classes of youth so as to avoid the generalizations that have been employed here. Such an approach would give better insights into the matter.
Center for Diseases Control [CDC], 2014, “Vulnerability of the Youth to HIV AIDS”, retrieved on 17/9/2014 from: <www.cdc.org>
Department of Health and Human Services [DHHS], 2004, “HIV, Drug Use and Vulnerable Youth: Targeting Research Gaps”, Retrieved on 16/9/2014 from: <https://grants.nih.gov/grants/guide/rfa-files/RFA-DA-04-012.html>
United Nations [UN], 2001, “Special Session on HIV/AIDS: Global Crisis; Global Action”, Retrieved on 16/9/2014 from: <http://www.un.org/ga/aids/ungassfactsheets/html/fsyouth_en.htm>
United Nations Population Fund [UNFPA], 2014, Preventing HIV: Young People, Retrieved on 16/9/2014 from <http://www.unfpa.org/hiv/people.htm>