The state of the national response to prevent HIV among young people:
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The state of the national response to prevent HIV among young people: A review of national reporting in 20 high-prevalence countries. I Birdthistle , S Dringus, L Knight, E Yankah , P Idele, C Suzuki, L Nguyen, S Kasedde. Outline.

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The state of the national response to prevent HIV among young people:

A review of national reporting

in 20 high-prevalence countries

I Birdthistle, S Dringus, L Knight, E Yankah, P Idele, C Suzuki, L Nguyen, S Kasedde


Outline

Evidence-Based Recommendations(Steady, Ready, Go! Review)

  • Purpose of the review

  • Methods

  • Epidemiology of HIV in countries studied

  • Review Findings

  • Conclusions


Purpose of the review

For 20 countries with generalized HIV epidemics, national reports were reviewed to assess the national response for YP in terms of:

  • Planning

    What priority is given to prevention among YP aged 10-24 in national AIDS plans?

    2.Implementation

    Are HIV prevention programs reaching young people? If so, through what activities and settings?

  • Financing

    What are the absolute and relative amounts spent on youth-specific prevention activities, and are they adequate?


Methods


20 countries included in review

East Africa (7)

Kenya, Malawi, Mozambique, Tanzania, Uganda, Zambia, Zimbabwe

Southern Africa (5)

Botswana, Lesotho, Namibia, South Africa, Swaziland

West Africa(3)

Cote d’Ivoire, Ghana, Nigeria

Central Africa (3)

Cameroon, Central African Republic, Gabon

Caribbean (2)

The Bahamas, Guyana


Documents Reviewed

And other important national reports where available (e.g., National Strategies for Behavior Change; National HIV Prevention Strategy, etc)


Epidemiological Context:

‘Know Your Epidemic’


Epidemiological Context: Summary

Progress toward the UNGASS goal for YP

*Source: Intl Group on Analysis of Trends, Sex TransmInf 2010 [national data for 3 points in time]

^Source: UNAIDS Global AIDS Report 2010 [data for 2 points in time: 2001 and 2009]


Epidemiological Context: Summary

Progress toward the UNGASS goal for Young People

*Source: Intl Group on Analysis of Trends, Sex TransmInf 2010 [national data for 3 points in time]

^Source: UNAIDS Global AIDS Report 2010 [data for 2 points in time: 2001 and 2009]


Epidemiological Context: Summary

Progress toward the UNGASS goal for YP

*Source: Intl Group on Analysis of Trends, Sex TransmInf 2010 [national data for 3 points in time]

^Source: UNAIDS Global AIDS Report 2010 [data for 2 points in time: 2001 and 2009]


Epidemiological Context :

HIV prevalence by gender and age

Swaziland


Epidemiological Context:

Numbers of orphans 2001-2009

Numbers of orphans in 2001 and 2009

Source: UNAIDS Global Epidemic Report 2010


Findings from the review

The state of national response

1. Planning

2. Implementation

3. Financing

…and the quality of national reporting


Part 1: National Planning

The review of all current and most recent National AIDS Plans showed that:

  • All 20 countries include youth-specific strategies in their current national AIDS plan.

  • A wide range of youth-specific strategies are included across countries

  • School-based HIV prevention is the youth-specific strategy most often included …


Part 1: National Planning


Findings from the review

The state of national response

1. Planning

2. Implementation

3. Financing

…and the quality of national reporting


Scale of Programmes for YP

“The majority of people in need have access to...?”


Evidence-based programming:

‘Steady, Ready, Go!’ review of research

Evidence-Based Recommendations(Steady, Ready, Go! Review)

Adapted from SRG2 review in JoAH 2011


In-School Investment in Young People Focuses on Lifeskills Education


Assessing Quality


Findings from the review

The state of national response

1. Planning

2. Implementation

3. Financing

…and the quality of national reporting


Funding for HIV Prevention

Breakdown of National AIDS Spending by ‘Broad Area’ in 2008


Funding for Youth-Specific

HIV prevention

Proportion of all national HIV prevention funds spent on youth-specific prevention


Spending by Beneficiary

Example Cote d’Ivoire (2008)

OVC: 3%

Children and youth out of school: 0%

Junior high / high school students: 0.47%

General population of young people (15-24): 1.05%

So, who are the main beneficiaries…?

1. General population not disaggregated: 50%

2. People living with HIV/AIDS, not disaggregated: 27%


Conclusions

  • Young people are a priority within national plans and strategies.

  • Relatively little is reported on youth specific coverage and investments in priority areas like HTC and condom promotion.

  • The intervention most widely planned, implemented and reported on for youth is school-based prevention.

  • Limited targeted spending on youth and predominant source of funding for youth programmes from external rather than government resources.

  • Critical to strengthen:

    • routine age-specific reporting

    • validation of quality

    • alignment of investments with evidence

    • domestic funding to ensure sustainability and effective scale of delivery.


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