As World AIDS Day approaches on December 1, there is renewed political commitment to achieving an ‘AIDS-free generation.’ While progress can be seen in many countries, a world without AIDS is not possible unless we get real about meeting the needs of young people most affected by HIV.
One region where this is particularly evident is Eastern Europe and Central Asia (EECA). Four out of five people living with HIV in EECA are under the age of 30. In these countries, women are increasingly affected by HIV, and now account for 40 percent of new infections (up from 24 percent ten years ago). In a region where the primary mode of HIV transmission is injection drug use, new HIV infections among young women are increasing steadily—and faster than among young men.
To help combat the growing trend of HIV among young people, HIV Young Leaders Fund recently announced four new grants to support young women who use drugs in Kyrgyzstan, Russia, and Ukraine. Selected by a peer review panel of young women from the region, all four grantee organizations are led by young women under 30, involve young people living with HIV in decision making, and work at the local level to improve services and amplify the voices of young women affected by HIV. Today, HIV Young Leaders Fund has released a short video, highlighting these women’s stories.
Access to health services is key to addressing the HIV epidemic in Eastern Europe and Central Asia. In this region, age restrictions block young people under 18 and sometimes young people under 25 from accessing critical interventions—such as HIV testing, clean needle exchange programs, and substitution therapy—that help young women stay healthy. In Ukraine for example, young people under 18 need parental consent to get tested for HIV, which results in few young people seeking out HIV testing, and adds to the stigma of testing.
Too often prejudice and discrimination—including attitudes about what behaviors are “appropriate” for women and young people—adversely affect young women who use drugs. It is not uncommon for doctors to advise young HIV-positive women that it would be “better” if she did not give birth, as her child would not be “normal.” This happened to one of the project participants in Russia. Counseling and peer support provided by the project are often the only ways that vulnerable young women can get the help and support they need to access basic health services and protect their rights.
But there is hope. We know what works for young women who use drugs: evidence-informed health programs that provide harm reduction, peer support groups, nondiscriminatory sexual, and reproductive healthcare and legal services. To ensure young women who use drugs can access these services, we need to change the policy and legal environment, including abolishing parental consent laws and pushing for the decriminalization of drugs for personal use so that young people are, as a new campaign from Youth RISE notes, “supported not punished.” We must also increase support for the community organizing of young women who use drugs, which creates an opportunity for them to address the discrimination they face and become leaders in their community.
Young people in Eastern Europe, Central Asia, and around the world don’t just hope the HIV response will change to better meet our needs—we demand it.