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Joy Cunningham is a Senior Technical Officer at FHI 360 where she manages a portfolio of global youth activities, including oversight for activities conducted under USAID’s Interagency Youth Working Group (IYWG).
Ukraine has one the fastest growing HIV epidemics in the world; the virus is spreading faster there than anywhere else in Europe. Youth are disproportionately affected: more than 80% of the approximately 440,000 Ukrainians living with HIV are under the age of 30. It’s also estimated that between 40,000 and 300,000 young people are living on the streets, and they are often engaged in injection drug use (IDU) and trading or selling sex for drugs, activities that put people at high risk of acquiring and transmitting HIV.
In a recent issue of AIDS, the link between orphaned status, homelessness, IDU, and HIV risk among street youth in Ukraine is documented. In the same issue, FHI 360 experts in youth and HIV wrote an editorial comment, calling for an urgent and comprehensive approach to address the needs of most-at-risk young people. The authors argue that the response to this crisis must involve a multisectoral approach that:
- Strengthens social welfare policies and programs to support the needs of orphaned youth and young people living on the streets
- Improves the national child protection system to better prevent abuse, provide effective methods for reporting cases of abuse, and support those who have been affected by violence and abuse
- Addresses the quality of institutional care services for homeless youth, with particular attention paid to the needs of orphaned adolescents
- Reduces stigma and discrimination against homeless youth, including decriminalizing the act of living on the streets
- Includes a rights-based, evidence-informed approach with combination interventions that allow young people who inject drugs to gain full access to HIV prevention and treatment services
Too often, most-at-risk young people fall into a gap between HIV prevention programs for the broader youth population and programs for most-at-risk people that fail to address the specific needs of adolescents. Prevention and mitigation are crucial to address the growing HIV crisis in the Ukraine.
We want to hear from you! We are currently conducting an online survey to find out what our readers think of us. Sharing the most up-to-date and relevant information on youth sexual and reproductive health is important to us. We want to be sure that the information we provide is useful to your work and helps reach the goal of improving the sexual and reproductive health of young people worldwide.
We want to know what you have learned from the IYWG-supported activities and how your work might have benefitted from this information. Please take a few moments to fill out our online survey and share your thoughts. We’re grateful for your opinions!
Laura Dickinson is communications officer for Girls Not Brides: The Global Partnership to End Child Marriage. You can follow Girls Not Brides on Twitter @GirlsNotBrides or join them on Facebook: www.Facebook.com/GirlsNotBrides
“Nobody seems to talk about child brides,” says Archbishop Desmond Tutu, Nobel Peace Prize winner and Chair of The Elders. “But I cannot stay silent.”
The plight of child brides has long been ignored by the international community, despite the sheer scale of the problem: in the next year alone, 10 million girls around the world will marry before they are 18. That’s 100 million girls within the next decade who will marry as children.
Child brides are among the world’s most voiceless and vulnerable people. Rarely do they have any choice in when or whom they marry, nor do they have a voice in their relationship with their often much older husbands. They usually drop out of school, too, which only serves to reinforce their isolation.
Hard to reach and invisible, child brides rarely benefit from aid and development programs designed to curb maternal deaths, infant mortality or the spread of HIV and AIDS – despite the fact that they are among those who could most benefit from such support. Pressured to prove their fertility, young brides often become pregnant before their bodies are physically ready for childbearing. The results can be devastating: girls under 15 are five times more likely to die in childbirth than women in their 20s.
Child brides rarely receive support and guidance on issues such as family planning and safe sexual health. They are less likely to space out their children and, unable to negotiate safe sexual practices with their husbands, they are more likely than their unmarried peers to contract HIV and other sexually transmitted infections.
The repercussions of early marriage are serious, even dangerous – so why has it received so little attention from leaders and policy makers?
Desmond Tutu is right: very few people talk about child brides. Not only are they invisible, talking about their plight is deemed taboo – a topic too closely related to sensitive issues of tradition and culture for leaders to address.
That’s why he and his fellow Elders, an independent group of global leaders working for peace and human rights, brought together Girls Not Brides, a partnership of nongovernmental organizations from around the world that work to tackle child marriage at the grassroots, national and global levels.
The aim of the Partnership is to give girls a voice, to connect those who work closely with girls vulnerable to early marriage to the leaders and policy makers who have a real opportunity to implement policies that protect and empower young girls and help them avoid early marriage.
Addressing sensitive issues such as child marriage can be lonely work, and organizations have long had to act in isolation. By coming together in partnership, Girls Not Brides members find strength in unity, sharing experiences and learning from each other about the successful programs that have helped to reduce child marriage. It also enables them to raise their collective voice, increasing awareness of the solutions that help to end child marriage and calling on leaders to take action.
Girls Not Brides and its members are determined to show that there’s a growing, global movement to end child marriage and enable millions of girls to fulfill their potential. We won’t be staying silent.
Find out more about Girls Not Brides at www.GirlsNotBrides.org, follow us on Twitter @GirlsNotBrides or join us on Facebook. Watch our video, featuring Graça Machel, Mary Robinson and Desmond Tutu of The Elders: Traditions can change: ending child marriage
“The Stories Behind the Statistics” is a series we put together for the Gates Foundation blog, “Impatient Optimists.” The following post is the first in this three part series. The original post, located on “Impatient Optimists,” is available here.
By the end of today, 2,500 young people will become infected with HIV and 1,400 girls and women will die in childbirth.
These are alarming statistics. Half of the world’s population is under 25 and nine out of ten young people live in developing countries, where they face profound challenges, such as high rates of early marriage, unintended pregnancy, HIV and other sexually transmitted infections, and maternal mortality and morbidity.
Young people account for almost one-quarter of all people living with HIV, and nearly 60 percent all HIV-positive young people are female. The number of young people living with HIV is rising as children who are pertinently infected gain access to life-prolonging ARV treatment and new infections among youth continue. Young people living with HIV are just as sexually active or curious as other teens, yet they are seldom offered information or support about their emerging sexuality or their reproductive choices. Furthermore, they may be less inclined than their peers to access reproductive health services due to fear of stigma and judgment from their providers. There is a vital need to address the sexual and reproductive health needs of this population.
Young women face a dual challenge: in addition the threat of HIV, pregnancy is one of the most significant threats to the health of adolescent females.
Approximately 16 million girls between the ages of 15 and 19 give birth each year and, in developing countries, approximately one-third of adolescent girls give birth before their 20th birthday. An unintended pregnancy can be a difficult experience for any women, and can be especially upsetting for an unmarried adolescent.
Adolescent pregnancy is life-threatening for many girls. Childbirth-related complications are the number one cause of death among girls ages 15-19. Fortunately, unintended pregnancy and adolescent maternal mortality are preventable; yet in some regions of the world the unmet contraceptive need among adolescents is as high as 68 percent. This lack of access to family planning services leads to approximately 7.4 million unintended adolescent pregnancies each year.
Ensuring that young people’s reproductive health needs are met has never been more critical. In 2011, the IYWG developed a set of programming and strategy recommendations to improve youth sexual and reproductive health. The document was created with the input of both professionals in the field of youth sexual and reproductive health and young people themselves. The purpose of these recommendations is to inform programing and guide investment at international, country, and local levels.
The 2,500 young people who will become infected with HIV and the 1,400 girls and women who will die in childbirth today represent more than striking statistics: each of these numbers represents a young person whose fate could be different if provided with access to reproductive health services.
The IYWG recommendations are meant to accomplish more than simply lowering statistics; we want them to help improve young people’s quality of life. In this short series, we will share the stories of two young people who have experienced first-hand the sexual and reproductive health challenges young people around the world face every day.