Supplement: Sexual and Reproductive Health and Rights and HIV Programming Among Young People Most Affected by HIV: Lessons From the Link Up Project in Five Countries
The current cohort of adolescents and young adults (10–24 years) is the largest the world has ever seen, representing an enormous challenge for health systems and health services, particularly in low- and middle-income countries. Unmet need for both sexual and reproductive health and rights (SRHR) and HIV services is substantial in the developing world; unmet need is often highest among older adolescent girls and young women (15–24 years), who tend to have high rates of unintended pregnancy and sexually transmitted infections. For example, in Africa, and especially in eastern and southern Africa, HIV-related mortality is the major cause of mortality among adolescent girls and a substantial cause among adolescent boys.
Adolescents and young adults are at risk for poor SRHR outcomes because of social and structural factors and partner-related risk factors. Particularly vulnerable subpopulations include young people who are poor, are living with HIV, are living on the streets, are engaged in transactional sex, are sexual minorities, and are without educational and employment opportunities. Thus, empowering young people—in addition to providing SRHR and HIV services—is essential.
The three commentaries and five articles in this supplement report on the Link Up consortium project (2013–2016), which aimed to improve the SRHR of young people (10–24 years old) most affected by HIV in five countries; three in Africa (Burundi, Ethiopia, and Uganda), and two in Asia (Bangladesh and Myanmar). The primary groups of young people engaged in the research were young men and women who sell or transact sex or are living with HIV, men who have sex with men, and young transgender people. The project was a consortium effort led by the International HIV/AIDS Alliance and funded by the Dutch Ministry of Foreign Affairs.