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

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:

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  1. 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

  2. Outline Evidence-Based Recommendations(Steady, Ready, Go! Review) • Purpose of the review • Methods • Epidemiology of HIV in countries studied • Review Findings • Conclusions

  3. 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?

  4. Methods

  5. 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

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

  7. Epidemiological Context: ‘Know Your Epidemic’

  8. 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]

  9. 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]

  10. 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]

  11. Epidemiological Context : HIV prevalence by gender and age Swaziland

  12. Epidemiological Context: Numbers of orphans 2001-2009 Numbers of orphans in 2001 and 2009 Source: UNAIDS Global Epidemic Report 2010

  13. Findings from the review The state of national response 1. Planning 2. Implementation 3. Financing …and the quality of national reporting

  14. 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 …

  15. Part 1: National Planning

  16. Findings from the review The state of national response 1. Planning 2. Implementation 3. Financing …and the quality of national reporting

  17. Scale of Programmes for YP “The majority of people in need have access to...?”

  18. Evidence-based programming: ‘Steady, Ready, Go!’ review of research Evidence-Based Recommendations(Steady, Ready, Go! Review) Adapted from SRG2 review in JoAH 2011

  19. In-School Investment in Young People Focuses on Lifeskills Education

  20. Assessing Quality

  21. Findings from the review The state of national response 1. Planning 2. Implementation 3. Financing …and the quality of national reporting

  22. Funding for HIV Prevention Breakdown of National AIDS Spending by ‘Broad Area’ in 2008

  23. Funding for Youth-Specific HIV prevention Proportion of all national HIV prevention funds spent on youth-specific prevention

  24. 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%

  25. 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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