HIV Services for Young People A Regional Perspective from the Caribbean Korey Chisholm UNAIDS Special Youth Fellow Guyana 2008

Overview of the Caribbean region The diversity of the region. Inadequate surveillance systems Modes of HIV Transmission: heterosexual, homosexual, injecting drug use

Overview of the Caribbean region HIV Prevalence in the region Source: UNAIDS Report on the Global AIDS Epidemic 2008 Country UNGASS Report 2008

HIV services for general population

HIV services for young people in the region Services Prevention Treatment Care & Support Categories of Young People Young people in general Most- at-risk young people (men who have sex with men, sex workers, injecting drugs users and incarcerated young people) Young people living with HIV

HIV services for young people in the region Con't HIV Prevention: Awareness raising Behaviour change Communication & Peer Education Youth friendly health services Voluntary testing & counselling Prevention of mother to child transmission Sexual health services Reproductive health services Condon distribution Harm reduction services Youth friendly spaces Legal support

HIV services for young people in the region Con't HIV Treatment Anti-retroviral therapy Home base care HIV Care & Support Services for orphans and vulnerable children Nutritional support Counselling & psychosocial support Support groups

HIV services for young people in general Number of countries Category of HIV service

HIV services for most- at-risk young people Barbados reported providing voluntary counselling & testing to young sex workers. Barbados considering to lowering the medical consent from 18 to 16 which will help facilitate access of young people to HIV and sexual and reproductive health services.

HIV services for young people living with HIV Jamaica 1.Anti-retroviral Therapy 2.Home Base Care 3.Nutritional and Legal Support 4.Counselling and Psychosocial Support Barbados 1. Support groups

Service in Focus (Guyana) Youth Friendly Health Service (YFHS) Standards established to guide in the conversion health centre to be youth- friendly Provides adolescents with a friendly environment where they can seek assistance on matters relating to their physical and psychosocial spiritual, health. Young people where reintegrated to education system Young people are empowered and involved in the mobilizing communities.

Service in Focus (Guyana) Youth Friendly Health Service (YFHS) An increase in boys accessing the YFS services Guidelines and policies are currently under review by NAPS, in the interim an adolescent who is 16 years and above can access VCT services. A draft policy and guidelines document is under development and will be finalized by the end of the year for the YFHS. The creation of a Lesbian, Gay, Bi-sexual & Transgender Manual for Health Care Workers by the Ministry of Health Youth Friendly Services Programme

Key Findings and Gaps Very few countries provide services for most at-risk young people and/or young people living with HIV. Virtually no data available on services for most at-risk young people and young people living with HIV. Reporting does not distinguish the different types of services for young people in general, those most at risk and young people living with HIV Variety of terminologies and definitions used (young people, youth, teenager, adolescent) has impact on age categorization Difficult to determine whether all country level partners are reporting on the services they provide – especially civil society activities

Key Findings and Gaps Limited age and sex disaggregation for the services provided to the general population Limited reporting on youth friendly spaces; no mention of different services available in these spaces No information on the quality and /or impact of the services provided to young people Sexual relationships between young girls and older men and the HIV related risk are known and understood, but no particular service is offered to address this. Need for reliable estimates of number of orphans and vulnerable children Need for increased sexual and reproductive health services for young girls

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