Youth Space

By Fahe Kerubo

The World Health Organisation first developed the consolidated guidelines on key populations in 2014 to promote a comprehensive package for all key populations. WHO defines key populations as “groups who, due to specific higher-risk behaviours, are at increased risk of HIV irrespective of the epidemic type or local context” (WHO 2016). In addition, key populations often encounter legal and social issues related to their behaviours that increase their vulnerability to HIV. The consolidated guidelines include specific considerations such as service delivery recommendations and structural interventions for each key population group consisting of “1) men who have sex with men, 2) people who inject drugs, 3) people in prisons and other closed settings, 4) sex workers and 5) transgender people” (WHO 2016) under each major intervention. Lesbians, Bisexuals, Intersex people, Queer people and Young people living with HIV are excluded from the groups categorised as key populations by WHO. Stigma and discrimination, state and non-state violence and harassment, restrictive laws and policies, and the criminalisation of behaviours and practices all put Lesbians, Bisexuals, Intersex people, Queer People and Young People living with HIV at risk and limit their access to help and services. Sexual reproductive health, under STI and HIV interventions, included those of hepatitis, diagnosis, treatment and prevention of co-infections among TB and mental health.

Updated once in 2016, this is now the second time the guidelines have been updated, providing a good opportunity for marginalized communities to weigh their issues to create more comprehensive guidelines for use around the world. As a non-binary person, with the support of The Love Alliance, I was invited to share my contribution on the guidelines and tailor the recommendations to the realities of young populations.

It is important to prioritize investment in comprehensive, evidence-based programs for key populations, while removing barriers to health services, implementing inclusive laws and policies, and providing support to meaningfully engage all youth in all their diversity. In this way, the voices of young people in all their diversity are heard and meaningfully involved in solving the problems they face. Nothing for young people without them.

As a young sexual and reproductive health and rights advocate and gender activist, it was an eye opener for me to be involved in this process as a young expert in weighing the experiences of queer and gender non-conforming people. It was an opportunity to share lived experiences and perspectives from a queer point of view not normally heard. I had the opportunity to share the experiences of these excluded communities, describe how their access to services is limited and emphasize the need to make their voices heard in this important process. Often, these populations are not included in HIV interventions and programs, even though these communities face oppression, gender discrimination, and social and legal challenges that make them highly vulnerable and at increased risk of contracting HIV.

Some of the primary problems I observed are that there may be no information to be had on LBIQ Persons, notwithstanding a maximum of the problems that strongly have an effect on them. There may be little or no data and information on chemsex and the feasibility of enforcing interventions in curtailing chemsex.

Young key populations in all their diversity are vulnerable to the risks of the use of sexualized substances or chemsex. The lack of available data and knowledge about chemsex were discussed during the discussion of the guidelines and an acknowledgement that the research was not diverse. This is a first step in the right direction as it takes into account the importance of integrating LBIQ communities.

Finally, as a representative of Young Key Populations, my role was to ensure that the whole process included all Young Key Populations in all their diversity. It was a great opportunity to ask important questions about inclusion and the benefits of having different policies and guidelines for improving communities. It is essential and a priority to always include all categories of young key populations to integrate their experiences to ensure that the completeness of any process for young key populations is respected. There is nothing for young people in all their diversity without being present as the experts they are!

World Health Organisation [WHO]. 2016. Consolidated guidelines on HIV prevention, diagnosis, treatment and care for key populations - 2016 update. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK379697/.