Public Health, Societies and Belonging Division, Human Sciences Research Council, Pretoria, South Africa.
School of Health Studies, University of Western Ontario, London, Canada.
AIDS Care. 2024 Jul;36(sup1):85-88. doi: 10.1080/09540121.2024.2307391. Epub 2024 Jan 24.
This paper highlights the pressing need to address the HIV epidemic among adolescent boys and young men (ABYM) in sub-Saharan Africa. Despite progress in HIV prevention, ABYM still experience low diagnosis rates, treatment adherence, and linkage to care. The paper emphasizes ABYM's vulnerability due to societal norms, limited healthcare access, and economic pressures. It calls for gender-responsive interventions, including comprehensive sexual education, youth-friendly health services, community engagement, and targeted outreach. Comprehensive sexual education is pivotal in HIV prevention for ABYM, providing them with age-appropriate sexual health knowledge and safer sexual practices to reduce HIV incidence. Harmful masculine norms must be countered to promote respectful relationships, benefiting boys, men, and their partners. Inadequate access to youth-friendly health services hampers HIV prevention. Establishing spaces with confidential, non-judgmental care offering testing, counselling, circumcision, and provision of pre-exposure prophylaxis (PrEP) is essential, especially considering ABYM's unique clinic experiences. Engaging communities, leaders, educators, and peers combats stigma and discrimination. ABYM's input in intervention design, targeted outreach, and innovative technology enhances effectiveness of HIV prevention programmes. Economic factors should also be addressed. Comprehensive multi-sectoral interventions, including conditional cash transfers, effective for AGYW, could benefit ABYM. Addressing structural factors alongside behaviour change and social support is key.
本文强调了在撒哈拉以南非洲地区解决青少年男孩和年轻男性(ABYM)中艾滋病流行问题的迫切需要。尽管在艾滋病预防方面取得了进展,但 ABYM 的诊断率、治疗依从性和与护理的联系仍然很低。本文强调了 ABYM 由于社会规范、有限的医疗保健机会和经济压力而面临的脆弱性。它呼吁采取性别响应的干预措施,包括全面的性教育、青年友好型卫生服务、社区参与和有针对性的外展服务。全面的性教育对于 ABYM 的艾滋病预防至关重要,为他们提供适合年龄的性健康知识和更安全的性行为实践,以降低艾滋病发病率。必须反对有害的男性规范,以促进尊重关系,使男孩、男人及其伴侣受益。青年友好型卫生服务的获取不足阻碍了艾滋病的预防。建立具有保密性、非评判性的服务空间,提供检测、咨询、割礼和提供暴露前预防(PrEP)至关重要,特别是考虑到 ABYM 独特的诊所体验。让社区、领导、教育者和同伴参与进来,可以打击污名化和歧视。ABYM 在干预措施设计、有针对性的外展和创新技术方面的投入可以提高艾滋病预防方案的效果。还应解决经济因素。全面的多部门干预措施,包括对 AGYW 有效的有条件现金转移,可以使 ABYM 受益。解决结构因素以及行为改变和社会支持是关键。
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