Evidence and good practices on HIV prevention for young people From evidence to action: experience from Ukraine Olena Sakovych UNICEF Ukraine 2011

Ukraine Street Children, years old (UNICEF baseline study, 2007) 47% of street children reported condom use at the last sex 57% of girls living on the street are involved in transactional sex Only 8% of girls living on the street and involved in transactional sex always use condom with clients Most At Risk Adolescents (MARA ), years old (BSS, 2009). Reported condom use at the last sex: 70% boys-IDUs 55% girls-IDUs 65% boys-MSM

MARA: Ukrainian context HIV Prevalence exceeds: 19% among A-FSWs 29% among A-IDUs Adolescents comprise: 26% of FSWs 24% of IDUs 32% of MSM A lower knowledge of HIV/AIDS and lower use of prevention services than among adults at risk Generalized PSE – 1,602 out of 100,000 adolescents UNICEF, 2010

Interventions integrated HIV/STI prevention programmes for girls engaging in sex work or transactional sex Multidisciplinary outreach team approach for children living or working on the streets peer education approach for adolescent injecting drug users one-stop shop approach for rehabilitation and HIV/STI prevention for girls exploited for sex or experienced sexual violence ‘MARA-Friendly’ Youth Friendly Clinic psycho-social rehabilitation and HIV/STI prevention programme for in-patient adolescent drug users

‘ Pirozzi/ % coverage of MARA to date (UNICEF/UISR, 2010)

UKRAINE: school-aged children* Only 17% correctly identify the ways of HIV transmission 15% and 42% had the sexual debut at the age of and respectively 25% aged and 20% aged did not use a condom at the last sex, but almost one in three consumed alcohols or took drugs More girls than boys practice unsafe sex. One in four girls did not use condom at the last sex; among those aged 17 years old – 1/3. 25% did not use a condom during their first sex. More girls reported having unsafe first sex (some 40%). Boys, however, had more sexual partners during last 12 months than girls. * HBSC, 2010&ESPAD, 2009*

Way Forward for Systemic Inclusion Integration of interventions into the system of existing services Scaling up and strengthening inter-sectoral linkages Intensification through ‘equity lens’ Finding practical solutions to problems inherent in systems & sectors Maintaining political commitment and increasing accountability

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