HIV Prevention: The Key for Young People
Today’s young population is constantly changing. The speed at which information moves seems to be the same at which their interests, language, or their forms of relationship change. In light of this, the messages and tools to help them protect themselves from HIV must be just as dynamic.
Within the framework of International Youth Day, we spoke with Miriam Ruiz, AHF Director of Prevention and Rapid Tests for Latin America and the Caribbean, who talks about the challenges young people face when seeking services and tools to prevent HIV.
Youth Relationships During the Pandemic
AHF offers HIV testing, condoms, and other medical services in more than 45 countries around the world. In the Latin American region alone, more than half of the people who come to our services are young people, that is, between 15 and 29 years of age. This is not by chance, as the organization has been concerned about reaching this population, as it is considered a key group to stop the advance of HIV.
With this proportion of young people, they have been able to identify problems that are taken into account to improve prevention strategies.
Especially during the lockdown resulting from the COVID-19 pandemic, certain beliefs that were taken for granted have collapsed. In the first place, that young people were not going to have sex during the contingency. Second, that sex refers only to coital relationships.
The truth, explains Miriam, is that relationships between young people occur in very different ways than just a few years ago, since many of them begin on the Internet. “In addition to physical protection as such, a recurring concern in young people is how to protect themselves from unpleasant or even violent situations in relationships that begin online.”
The whole context changes so fast that strategies need to change at the same rate, so it is important to listen to the concerns that arise. However, there are some doubts that have not changed for 20 years, such as: “I had this sexual practice, could I have acquired HIV?” or “who can get HIV?” are basic questions that have remained.
Another recurring question is “where can I get condoms?”. For Miriam, it is a question that does not have a good answer, since she considers that access to condoms is not real. “Access will be real when condoms are free at the door of the school bathroom or in the park, not the way it has been happening until now, that you must go to a clinic and follow a whole process in order to get them”.
(In our AHF Centers you can get condoms for free and confidential. Find the closest one here).
This is important because of the users served by AHF in Latin America and the Caribbean in 2019, 67% went for the test because they did not have protection at hand when having a sexual encounter.
But the experience of 40 years of the HIV pandemic has taught us that the condom is not the only way to prevent the transmission of the virus and that in any case, its use is submerged in a series of social factors that must be modified.
For this reason, we are currently working on what is known as combined prevention. These are social, behavioral and service access strategies. What is sought is to adjust two or more of these interventions to the needs of each population. And the fact is that the young population is not just one, but within it, there are different groups.
“For example, the needs of young women, their perception of risk and their real risk of acquiring HIV are very different from those of young gay men, and it does not have to do with identity, but with practices that have been demonstrated throughout time showing they might have either a higher or lower risk of HIV ”.
Another great concern of the organization is being able to work with young trans women since their risk of acquiring HIV is increased by their social context and their sexual practices. “From January to June, 1,029 trans people, the vast majority women, have come with us to get tested, and the proportion of reactive (positive) results is very high compared to any other group.”
In this case, it is necessary to promote structural changes such as laws that protect the identity of these people, because as long as they cannot live their lives as they have chosen, vulnerability will continue to be very high.
In the case of young gay men, according to the activist, many of them know that there is a treatment called pre-exposure prophylaxis (PrEP), which is given regularly to people without HIV who are at risk of contracting it due to their practices. “We have observed that it is something that is talked about a lot, but in reality, there is very little access, because it is only properly regulated in Brazil, Argentina, and the Dominican Republic.” In the rest of the countries, it is provided only as part of pilot programs that are evaluating their implementation.
The same is true for post-exposure prophylaxis (PEP) treatment, which is given to people who have already been exposed to HIV. Among the most representative cases of its usefulness are sexual assaults. “I can tell you that it is regulated in all countries, but there is real access to treatment.”
In fact, the problem of sexual violence is something that AHF has documented through its services. Assaults occur against men and women in very similar proportions, and when they go to get tested for HIV and the result comes back positive, they find out that they could have prevented this if they had known about PEP treatment.
You Have to Change the World
The regular offer of HIV testing and linkage to treatment for people who are detected are two more strategies that work as prevention. Following antiretroviral treatment will reduce the amount of virus in your blood so much that it is impossible to transmit it to another person. This is known as undetectable = untransmittable.
But all of these strategies require young people to get involved. Miriam knows that her work is also required there: communication should not only include information about how to use a condom or when to get tested but should also raise awareness about the possibility of claiming their rights.
“It is time to tell young people that it is their right to demand what they need and that it is in their hands to change the world and they have to do it.”
AHF is the world’s largest organization working in the response to HIV and AIDS and offers free rapid HIV tests in Latin America and the Caribbean in Mexico, Guatemala, Jamaica, the Dominican Republic, Haiti, Panama, Peru, Argentina, Brazil, Chile, and Colombia. Find your nearest center here.