Title

PrEP, prevent, test: Increasing young key populations’ uptake of HIV prevention and testing services

Code

WESY03

Session Type

Symposia Session

Venue

Palacio de Valparaíso 2

Date Time

Wednesday 24 July, 14:30 - 16:00

Co-Chairs:

Pascal Macharia Irungu, Health Options for Young Men on HIV/AIDS/STI (HOYMAS), Kenya
Nittaya Phanuphak, Thai Red Cross AIDS Research Centre, Thailand

While young people’s uptake of HIV testing and prevention programmes remains low, young people from key populations (men who have sex with men, sex workers, transgender people, people who inject drugs) face additional barriers. Due to stigma and lack of youth-friendly services, reaching them with HIV prevention and testing services is a pervasive challenge. To prevent new HIV infections and increase the number of these young people who know their status, innovative approaches, including social media and mobile apps, are being utilized to scale up access to HIV prevention and PrEP and increase testing rates. The objective of the session is to share best-practice examples of young key population-friendly prevention and testing programmes, sensitize service providers to young key population’s specific needs, and discuss ways to foster their engagement in research and programming.

14:30 WESY0301	Welcome & Introduction

14:33 WESY0302	Leaving no one behind: Young key populations in the HIV response Rachel Baggaley, World Health Organization, Switzerland	Slides

14:43 WESY0303	Engaging young MSM and transgender women in HIV prevention/PrEP Wipaporn Natalie Songtaweesin, Center of Excellence for Pediatric Infectious Diseases and Vaccines, Chulalongkorn University, Thailand	Slides

14:53 WESY0304	Overcoming barriers to HIV testing among young MSM and transgender women in Jamaica Carmen Logie, University of Toronto, Canada	Slides

15:03 WESY0305	Engaging young female sex workers in HIV testing in Malawi with mobile outreach clinics Tanaka George Chirombo, Youth and Society (YAS), Malawi	Slides

15:13 WESY0307	Panel discussion

15:33 WESY0308	Questions and answers

15:48 WESY0309	Closing remarks

AUTHOR

Colleen Kelley

SUMMARY

Globally, 2.8 million children and adolescents are living with HIV. Children and adolescents with HIV face significant obstacles. In general, many have been infected early in life with a developing immune system, may have been exposed to suboptimal ART, and often face difficult social circumstances such as loss of parents.

HIGHLIGHTS

In the IeDEA cohort, clinical outcomes were assessed for >25,00 adolescents living with HIV. Approximately 1/3 had stunted growth and were underweight, and loss to follow-up was common—only 60% were retained in the cohort. In Ethiopia, among >300 children who switched ART regimens, 22% switched for treatment failure that was associated with more advanced disease, younger age at initiation, and caretaker characteristics. In Zimbabwe, many adolescents and young adults failing first-line therapy have drug resistance to NRTIs calling into question whether the second line regimen, TDF/3TC/DTG, will provide optimal coverage. In a study of cognitive function in 200 HIV positive children in Zambia, children with HIV performed significantly worse than controls on summary score of cognition which was compounded by low SES. Finally, DAA therapy in HIV/HCV perinatally infected young adults was effective in achieving cure (n=27; 100% cure); however, some with advanced fibrosis did not improve after therapy.

CRITICAL ASSESSMENT

As outlined in this session, children and adolescents living with HIV face formidable challenges in clinical management including retention in care, HIV treatment failure, cognitive dysfunction, and co-infections in addition to a multitude of social determinant barriers. These challenges are evident in resource rich and limited settings, and particularly notable as they will stand in the way of reaching the UNAIDS 90:90:90 goals. Increased attention and resources must be dedicated to design programs supporting children and adolescents living with HIV.

AUTHOR

Omar Sued

SUMMARY

In this session, experiences of HIV testing and PrEP implementation for young individuals were presented that helped to understand the challenges, complexities and enabling factors.

HIGHLIGHTS

After a very complete introduction by Rachel Baggaley, programmatic data from LINKAGES project in Thailand shows the very high prevalence and incidence among MSM, but low testing uptake, with 13% of testers less than 20 years. In the country, only 7% of the 3542 who receive PrEP were less than 20 years old, and the retention is very low. Project Raincoat was implemented for improving retention, based on a community-based KP-led care, resulting in more than 90% retention. In Jamaica, qualitative research identified critical barriers to testing such as healthcare mistreatment, confidentiality issues, and HIV-related stigma. The facilitators included improved access, social support, the benefit of knowing one´s status and the reduction of multi-level stigma. In Malawi, the mobile clinic for PrEP improved STI diagnosis, treatment and HIV testing and treatment initiation.

CRITICAL ASSESSMENT

The session showed the importance of focusing on youth populations and proposed innovative approaches for reaching and retaining this population.