Governments urged to prioritise youth in sexual health to end AIDS by 2030

The goal to end AIDS by 2030 may go unaccomplished unless young people are prioritised in sexual and reproductive health policy and programmes.

The goal to end AIDS by 2030 may go unaccomplished unless young people are prioritised in sexual and reproductive health policy and programmes.

By virtue of physical energy and sexual activeness, as well as lack of awareness and access to services, young people remain most vulnerable to sexual-related health risks. To address this, it is vital their voices are amplified in post 2015 negotiations around sexual and reproductive health and rights (SRHR), including the response to HIV.

Over 50 youth advocates working on SRHR across sub-Saharan Africa have developed messages to be incorporated in the post 2015 development agenda with hopes to address the stigma, discrimination and injustice that confront them across sexual and reproductive health (SRH) platforms. The advocates, who gathered last month for a youth high-level dialogue in Nairobi, Kenya, argue that SRH services are inaccessible and unfriendly to young people, as a result millions of young women and girls under the age of 20 end up with unplanned pregnancies.

According to the World Health Organization around 16 million women aged 15–19 give birth each year, with more than 50 per cent of adolescent births taking place in sub-Saharan Africa.

Human rights issues in Kenya

In Kenya, the youth constitute 60 per cent of the general population. A Kenyan HIV estimates report released on 20 August by Kenya’s cabinet secretary for health James Macharia pointed out there are at least 100,000 new infections in Kenya annually. While the cabinet minister called for concerted efforts from all stakeholders to wrestle down the epidemic, there will not be an end to AIDS without the youth’s full and active participation.

A 2013 inquiry by the Kenya National Commission on Human Rights ‘Realising Sexual and Reproductive Health Rights in Kenya: A myth or reality?’ indicated that due to lack of recognition from society and exclusion from decision-making processes, lesbians, gay, bisexual, transgender and intersex (LGBTI) people’s needs are never captured. Involving young LGBTI people in particular is absolutely critical to meeting the goal of ending AIDS by 2030. Yet Kenya, like many countries, is a long way from that reality.

Judy Oketch, an executive committee member of Africa Youth and Adolescent on Population and Development (AfriYAN), argues that most sexual minorities fall in the youth bracket yet suffer numerous human rights violations on the basis of their sexual behaviour and orientation. “There are health facilities which discriminate LGBTIs to the extent of denying them access to sexual and reproductive health information and services,” she remarks.

Unprofessional health services

And it’s not just LGBTI youth who suffer at the hands of unprofessional health services. Gracah Mundu, a 23 year old Nairobi sex worker laments that the services in health facilities are unfriendly to young people and that health providers are judgmental. She remembers the first day she visited an anti-natal clinic and the health provider demanded she be accompanied by the father of the unborn baby. “As a sex worker I can choose to have a baby with a client in a one night stand; I don’t have to be married or be in a stable relationship to be pregnant!” she said.

Linah*, a 22 year old University student in Nairobi, says she also had a share of injustice in a health facility. She narrates: “I had gone for an inter-uterine device in a Nairobi hospital and amid sneers the service provider insisted that I cannot have it if I am not married!”

Linah then had to attend a private hospital for the device and had to pay a substantial amount of money. The device would have been much more affordable for the university student in a public health facility.

These injustices and others, such as lack of treatment after rape, go unreported as the youth claim their voices go unheard when they attempt to have such issues addressed. Sometimes, health service providers confront patients with embarrassing questions until they give up seeking medical attention.

“Rape is common among sex workers and their cases ought to be treated with the dignity and confidentiality any other patient deserves,” Linah notes, adding that young people can understand each other better.

One proposal of youth advocates is that health and human rights organisations should employ young people as service providers to make facilities more youth-friendly.

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