In or Out? Asia-Pacific Regional Review of the Inclusion of Young Key Populations in National AIDS Strategic Plans

"National strategic frameworks or plans (NSPs) determine a country’s national response to HIV and AIDS, guiding allocation of funding, resources and human capacity and are now critical for Global Fund investments.  Many plans are not strategic, include limited situational analysis and do not identify the key drivers of the epidemic and the programmes necessary to reverse its course."
 
This document investigates how young key populations are being addressed in national AIDS strategic plans in the Asia-Pacific region through an analysis of their inclusion in the NSPs for HIV and AIDS of 19 countries, namely: Afghanistan, Bangladesh, Bhutan, Cambodia, China, Fiji, Indonesia, Lao PDR, Malaysia, Mongolia, Myanmar, Nepal, Papua New Guinea, Philippines, Samoa, Sri Lanka, Thailand, Timor-Leste, and Viet Nam. It is a collaboration of: the United Nations Educational, Scientific and Cultural Organization (UNESCO), the United Nations Population Fund (UNFPA), the United Nations Children’s Fund (UNICEF), the United Nations Development Programme (UNDP), the Joint United Nations Programme on HIV/AIDS (UNAIDS), Save the Children, and the Global Network of People living with HIV/AIDS (GNP+).

The review used an analytical framework developed after consideration of: seven existing NSP reviews; guidance documents on comprehensive packages for key populations; and the HIV and AIDS Investment Framework. It looks specifically at young people in the following groups: men who have sex with men, transgender people, people who sell sex, people who inject drugs and people living with HIV, and includes an analysis of interventions for young people, more generally, as broader interventions for youth may also reach those at higher risk of HIV exposure.

Findings suggest inadequate strategic information on key populations, lack of their involvement in plan development, and lack of plans for further research. "Involvement of representatives of all key populations, including younger members, as stakeholders in the development of NSPs would assist in improving the relevance of plans and ensure a stronger sense of ownership of interventions. Their engagement in the development, implementation, and monitoring and evaluation of HIV programmes is likely to be critical to programme success."

Recommendations include:

• "Goals and overarching targets be included for young people and the relevant key populations.
• Basic programmes be developed which are friendly and accessible to young people and, where relevant, tailored to young key populations.
• Interventions to create an enabling environment and synergistic development activities not only address adult key populations with comprehensive interventions but also include efforts to reach young key populations as they are particularly at risk of acquiring HIV.
• Support groups and organisations for key populations be encouraged to have representation and chapters for young people.
• Governments adopt a human rights approach that recognises the rights of young people and offers protection from discrimination and abuse. This should include review and reform of the laws, policies and regulations that impede young people and young key populations from accessing services, education and information.
• Legal literacy and support services for key populations be inclusive of young people, so that they may understand their rights and address any violations.
• Education programmes in and out of school address homophobic bullying and other forms of GBV, sexual orientation and gender identity issues.
• Health care providers be trained with respect to the needs and rights of young people as well as those of adult key populations.
• Interventions include efforts to assist young key populations in accessing education, child and social protection.
• Monitoring and evaluation frameworks be strengthened for countries across the region, including greater attention to young key populations. Indicators and targets should be developed for key populations with specific inclusion of younger cohorts.
• Data gathered to track the progress of the strategic plan against targets and milestones be disaggregated by age, sex, diversity and the use of services.
• Costing and budget allocation be included for young people and key populations within operational plans."