Young people

Amongst black African people, those under the age of 20 are the least likely to have diagnosed HIV and the least likely to have had unprotected sex in the past year, according to the BASS Line survey of African people in England. However, this age group still have considerable HIV prevention needs. The benefits of meeting these needs will not be restricted to this age group if today’s young people are able to carry healthy behaviours into adulthood.

Young people are least knowledgeable about HIV, not knowing an average of three out of thirteen facts about HIV. Moreover, 20% wanted to take a test but did not know where to get one. Although reported HIV-related knowledge among African people improves as they get older, it is of concern that the age group most likely to be in full-time educational settings (a captive audience for sexual and health education) are the least informed.¹

There are also issues for young people regarding a lack of confidence in sexual negotiation. More than 17% said they did not have the power to reduce the risk of passing on or acquiring HIV, with 12% saying they would find it difficult to discuss safer sex and HIV with a new sexual partner. Troublingly, more than one-in-ten under-20s were unsure of or disagreed with the statement: “I do not want to get or pass on HIV”. Either this shows a tremendous disregard for their own and others’ health, or a great misunderstanding of the realities of HIV infection.

There is now a generation of adolescents and young people who acquired HIV as infants, from their mothers. The HIV and Young People Network (HYPNet) and the Children’s HIV Association (CHIVA) are developing guidelines for health professionals on the sexual and reproductive health of these young people, and have already produced a series of sexual health promotion leaflets for HIV-positive young people.

One-third of unaccompanied asylum seeking children (mostly aged 16 to 18) in care are from Africa. It is unknown how many of these young people are living with HIV, but the needs of this group are considerable. Many may have come from backgrounds where HIV has taken a huge toll on their family and community; others may have escaped violent conflict. Given their past experience in African countries, many perceive HIV infection to be a death sentence, so diagnosis can be hugely distressing. In the unsettled context of their lives, living with foster families, relying on strangers like social workers for support, many of whom may not be proficient at dealing with HIV, they will have substantial social and emotional needs related to living with the disease.²

The needs of young people living with HIV will vary considerably and specialised services, such as those provided by organisations such as Body and Soul, are crucial to meet the needs of this population group (see www.bodyandsoulcharity.org).