HIV/AIDS AMONG YOUTH Presented by Mr. Julius Ananura International Team Leader Reach the Un-Reached Ministry P.O BOX 5090 Kampala -Uganda [email protected].

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BACKGROUNDBACKGROUNDUganda has registered declining HIV

rates since 1992 especially among the youth.

NGO,S have offered VCT services without special consideration of the peculiar needs of youth.

HIV rates have remained higher among young females than males.

Out of school youths are particularly a hard group to reach.

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HIV/AIDS SITUATION HIV/AIDS SITUATION AMONG YOUNG PEOPLEAMONG YOUNG PEOPLE

Young people are at the centre of the HIV/AIDS epidemic

Young people are particularly susceptible to HIV infection

They also carry the burden of caring for family members living with HIV/AIDS

AIDS is shattering young people’s opportunities for healthy adult lives

It is the young people who offer the greatest hope for changing the course of the epidemic

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UGANDA’S NATIONAL AIDS UGANDA’S NATIONAL AIDS POLICYPOLICY

Vision: To have a healthy, AIDS free, socially responsible and economically productive population.

Mission: To create an environment in which the national response to HIV/AIDS is coherent, systematic and effective.

Goal: The policy goal is to minimize the prevalence of HIV/AIDS and eliminate it’s social – economic impact

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PRINCIPLES AND CORE PRINCIPLES AND CORE VALUESVALUES

There will be continued openness about HIV/AIDS HIV/AIDS activities shall have political support at

all levels PHAs shall be involved at all levels and in all

matters of policy, management and services concerning HIV/AIDS

Individual rights, including their confidentiality shall be protected

There will be equal protection of the lives of PHAs as any other persons in Uganda

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PRINCIPLES AND CORE PRINCIPLES AND CORE VALUES (Cont’d)VALUES (Cont’d)

There will be no discrimination of PHAs on any grounds

There will be equal treatment under the laws of Uganda regardless of HIV status

There will be shared responsibility between the Government and the public to care for PHAs

Human rights approach shall be used to respond to the challenges of HIV/AIDS and PHAs.

Orphans and widows shall be protected through legislation and through welfare services

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PRINCIPLES AND CORE PRINCIPLES AND CORE VALUES (Cont’d)VALUES (Cont’d)

There will be a multi- sectoral approach to the management of HIV/AIDS with the involvement of communities.

HIV/AIDS management shall be an integral part of the national development.

Equal opportunity shall be given to PHAs as the rest of Ugandans for health care, employment, education and any other socio-economic benefits.

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UGANDA’S NATIONAL POLICY UGANDA’S NATIONAL POLICY IMPLEMENTATION GUIDELINES IMPLEMENTATION GUIDELINES FOR HIV VCT FOR CHILDREN FOR HIV VCT FOR CHILDREN

Legal age of consent in Uganda is 18 years. For VCT the policy prescribes the age of 12 years.

Children 12 – 17 years should consent but with the approval of parents or guardians –controversial!!!

For children below 12 yrs, the parent or guardian should sign the consent. Where no parent/guardian available, the head of the institution, hospital, clinic or any other person responsible

The counselor should assess the child’s ability to cope with the results

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HIGHLIGHTS OF RETUM’S HIGHLIGHTS OF RETUM’S HISTORYHISTORY

RETUM has been reaching youth in several districts in Uganda since 1999.

It has registered over 23,000 youth change their behavior and influence others.

HIV testing has been encouraged and accepted.

The main Hospital In Uganda Mulago has been visited several times a year.

Youth friendly VCT services introduced in 2001 HIV Positive Clients screening for TB and treatment of

both latent and active TB has been encouraged.

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SERVICES THAT NEED INTERVATION•Testing for HIV and syphilis•Syndromic management of other STDs•TB Treatment and TB preventive therapy•Support for on-going counseling and social support•Family Planning services•Continuous training and teaching •CD4+/CD8 testing•Youth Friendly Services•Training of VCT providers in and outside Uganda

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INTRODUCTION OF THE INTRODUCTION OF THE YOUTH PROGRAM YOUTH PROGRAM

An exploratory research carried out in Kampala and Masaka, Uganda revealed that youth perceived barriers that prevent them from accessing VCT as:– Lack of helping counseling– Lack of information on VCT process– Lack of confidentiality– Lack of referral services– High costs of HIV test

We are therefore planning to construct a Teenage Information & Health Center (TIHC), and introduce Youth Friendly intervention programmes

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PROJECT ACTIVITIESPROJECT ACTIVITIESStrengthening VCT services in Kampala

and upcountry.VCT outreach services at Youth InstitutionsBehavior change communication (BCC)

campaign to increase awarenessStrengthening formalized referral systemBasic training in VCT counseling for health

providers .Training in VCT counseling for youth.

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ACCOMPLISHMENTSACCOMPLISHMENTSTrained 32 service providers on Youth

Friendly VCT counselingOriented 30 Youth volunteers on the youth

VCT programmePromoted positive living through Radio &

Posters

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Benefits of VCT for Benefits of VCT for HIV+ ClientsHIV+ Clients

Referral for AIDS care and supportBetter management of opportunistic

infections and other STDsInformed decisions about marriage,

pregnancy and sexual relationshipsTB screening and preventive therapyPossible reduced length of breastfeeding

and/or alternative feedingAnti retroviral drugs where affordable

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Benefits of VCT for HIV- Benefits of VCT for HIV- ClientsClients

Encourages behavioral change Marriage decisions Pregnancy decisions Couple counseling Opportunity for STD detection and treatment Reduction of fear, anxiety and a sense of

hopelessness and futility Increased sense of hope, empowerment and

efficiency

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PROPORTION OF CLIENTS PROPORTION OF CLIENTS SERVED BY AGE GROUP - 2010SERVED BY AGE GROUP - 2010

3%

29%

68%

13-17yrs18-24yrs25+yrs

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PROPORTION OF YOUTH BY PROPORTION OF YOUTH BY MARITAL STATUSMARITAL STATUS

90.6

77.6

7.514.8

27.7

0102030405060708090

100

13-17yrs 18-24yrs

Never marriedMarriedDiv/ Sep/ Widowed

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HIV PREVALENCE BY AGE GROUPS - among youth 1st time testers

05

10152025303540

92 93 94 95 96 97 98 99 '00 '01 '02

Test Year

% a

ge H

IV p

ositi

ve

F:15-19yrs F:20-24yrs M:15-19yrs M:20-24yrs

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SERO POSITIVITY BY GENDER SERO POSITIVITY BY GENDER 1990- 20031990- 2003

0

5

10

15

20

25

30

35

40

1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003

PE

RC

EN

TA

GE

S

MALE FEMALE

9466, 20976, 40188, 69679, 62985, 56034, 42413, 40098, 53816, 58321, 58150, 67,648 113,488

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CHALLENGES/CONSTRAINTSCHALLENGES/CONSTRAINTS

Inadequate funds for expanding facilities/services Sustainability of youth clubs Few organizations offering Youth Friendly referral

services Funding availability for the existing plans and network. Poor road network that need strong vehicles. Training materials for counselors. Lack of counselors

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CHALLENGES cont’d CHALLENGES cont’d

Older children being accompanied by their parents or guardians compromises confidentiality so they often do not open up

Competences in child and youth counseling are limited

Stigma and discrimination against young people living with HIV/AIDS

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Thank you.contact

[email protected]

+256 782 370307