Challenging parental consent laws to increase young people’s access to vital HIV services

http://www.unaids.org/en/resources/presscentre/featurestories/2014/july/20140723youth/

There remain serious challenges in reaching the world’s adolescents with HIV, sexual and reproductive health and harm reduction services. The situation is especially worrying given that this is the only age group in which AIDS-related deaths are increasing, and AIDS-related deaths are the number two contributor to global adolescent mortality.

A session at the International AIDS Conference in Melbourne, Australia, on 23 July explored one of the key barriers preventing young people from accessing interventions: the need for parental consent before they are allowed to benefit from services such as HIV counselling and testing and needle–syringe programmes. The session heard that in sub-Saharan Africa, for example, at least 33 countries had age-based or other specific criteria for consenting to HIV testing and counselling.

While acknowledging that parents, guardians and the state have an obligation to protect young people from harm, participants discussed adolescents’ evolving capacity to independently consent to accessing potentially life-saving programmes. Daniel McCartney, of the International Planned Parenthood Federation and a member of the pact for social transformation, a coalition of 26 youth-led organizations, supported by UNAIDS, presented the findings of a global online youth survey on parental consent laws and requirements at the session.

It was found in the survey that 72% of respondents said laws requiring parental consent were not a good way of involving their parents in decision-making about their sexual and reproductive health and harm reduction. Thirty-eight per cent said that they have not always been able to access relevant services without restrictions when they needed them, a situation that left them feeling discriminated against and disempowered.

Participants agreed to use the results of the survey to advocate for countries to review their policies on age-related legal, regulatory and social barriers to specific health services and to strive to ensure that young people feel empowered and in charge of their own sexual health and well-being.

Quotes

"Young people need harm reduction services. But parental consent remains a major barrier to access needle–syringe programmes for young people."

Anita Krug, Youth RISE

"My parents accepted my sexual orientation and my HIV status, but many young people are not that lucky."

Gautam Yadav, Youth Voices Count

"The journey to the end of the AIDS epidemic is a journey to inclusion and social justice."

Luiz Loures, UNAIDS Deputy Executive Director

"In order to facilitate access to services we need a better understanding of what are the barriers that exist in order to remove them."

Aram Barra, Espolea

UNAIDS Strategy 2011-2015

http://www.unaids.org/en/aboutunaids/unaidsstrategygoalsby2015/

The UNAIDS strategy aims to advance global progress in achieving country set targets for universal access to HIV prevention, treatment, care and support and to halt and reverse the spread of HIV and contribute to the achievement of the Millennium Development goals by 2015.

Adopted by the Programme Coordinating Board in December 2010, the strategy works to position the HIV response in the new global environment. The AIDS response is a long term investment and the intent of the strategy is to revolutionize HIV prevention, catalyse the next phase of treatment, care and support, and advance human rights and gender equality.

UNAIDS strategy goals by 2015:

• Sexual transmission of HIV reduced by half, including among young people, men who have sex with men and transmission in the context of sex work
• Vertical transmission of HIV eliminated, and AIDS-related maternal mortality reduced by half
• All new HIV infections prevented among people who use drugs
• Universal access to antiretroviral therapy for people living with HIV who are eligible for treatment
• TB deaths among people living with HIV reduced by half
• People living with HIV and households affected by HIV are addressed in all national social protection strategies and have access to essential care and support
• Countries with punitive laws and practices around HIV transmission, sex work, drug use or homosexuality that block effective responses reduced by half
• HIV-related restrictions on entry, stay and residence eliminated in half of the countries that have such restrictions
• HIV-specific needs of women and girls are addressed in at least half of all national HIV responses
• Zero tolerance for gender-based violence

The UNAIDS strategy is a roadmap for the Joint Programme with concrete goals marking milestones on the path to achieving UNAIDS’ vision of “Zero new HIV infections. Zero discrimination. Zero AIDS-related deaths.”

The strategy will be underpinned by a new Unified budget and accountability framework. The framework will operationalize the strategy, mobilize and allocate resources for its implementation, measure progress and report on results.

Ending the AIDS epidemic: a new target for HIV treatment

http://www.unaids.org/en/resources/presscentre/featurestories/2014/july/20140720treatment/

At a high-level political session on the opening day of the 20th International AIDS Conference, UNAIDS Executive Director Michel Sidibé called for a new set of treatment targets by 2020. These include that 90% of all people living with HIV know their HIV status, 90% of all people with diagnosed HIV infection receive HIV treatment and 90% of all people receiving HIV treatment have durable viral suppression.

These new targets will reflect a new paradigm for HIV treatment: targets for each stage of the treatment continuum, rather than a single number of people who initiate treatment; recognition not only of the life-saving therapeutic benefits of HIV treatment, but also its prevention potential; and a commitment to leave no one behind in the push to link all people living with HIV to treatment services.

Participants in the session included Mr Sidibé; the United States Global AIDS Coordinator, Deborah Birx; the Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria, Mark Dybul; the Executive Director of the Global Network of People Living with HIV, Suzette Moses-Burton; the Minister of Health, South Africa, Aaron Motsoaledi; and the Vice-Minister of Health and Surveillance, Brazil, Jarbas Barbosa.

They reviewed progress made in scaling up HIV treatment and explored issues surrounding the new treatment targets, such as how they can be integrated into the post-2015 development agenda and how the necessary treatment scale-up might be financed. It was recognized that new business models and partnerships are required to achieve the goal of accelerated treatment delivery for all people in need.

Civil society activists made a statement at the beginning of the meeting demanding the target of complete suppression of HIV for all people living with HIV by 2020.

Quotes

"The potential of HIV treatment needs to be leveraged to save peoples’ lives and stop this epidemic."

Michel Sidibé, UNAIDS Executive Director

"If we focus where the infections are happening by geography and population we can get to control the epidemic."

Mark Dybul, Executive Director, Global Fund to Fight AIDS, Tuberculosis and Malaria

"It is unacceptable that millions of people don’t have access to diagnostics and HIV treatment."

Jarbas Barbosa, Vice-Minister of Health and Surveillance, Brazil

"The closer we get to communities, the better the outcomes. Subnational data would allow us to use the dollars in the most effective way."

Deborah Birx, United States Global AIDS Coordinator

"The retargeting discussions should not be limited by financial and funding possibilities: we should start from real demands from the ground. The question is not how can we do it. The question is—how can we not?" 

Aaron Motsoaledi, Minister of Health, South Africa