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.

For more information on steps that programs can take to address the needs of young people most at risk of HIV, visit or download a copy of “Young People Most-at-risk of HIV” here.