The Caribbean Regional Strategic Framework (CRSF) 2014-2018 articulates the vision and collective priorities of Caribbean states through their membership in the Pan Caribbean Partnership against HIV and AIDS (PANCAP). The CRSF recognizes that resources must be strategically allocated to target the epidemic at regional, country, community and individual levels. Doing so effectively will require establishing and sustaining an enabling environment (Strategic Priority Area 1) by addressing social and cultural drivers of the epidemic and by removing barriers to access sexual and reproductive health information, education and services. In particular, more conscious efforts to address human sexuality are needed in order to equip young people with the regional public goods including knowledge and tools they need for healthy development.
As of 2014, there were 280 000 [210 000–340 000] people living with HIV, 8800 [5700–13 000] AIDS-related deaths among adults, and 44% [33%-54%] of adults living with HIV accessing HIV treatment in the Caribbean. Young people, especially among key populations, in Caribbean are disproportionately at risk of HIV infection, and they face greater barriers to accessing prevention services. According to the Pan American Health Orgranization, HIV prevalence among young people is 0.07% and 0.05% in females and males in the non-Hispanic Caribbean and 0.2% and 0.3% in the Hispanic Caribbean both respectively. In Jamaica, where the data are available, higher estimated HIV prevalence has been reported among gay bisexual (14%) and transgender adolescent boys (27%). While the regional response has realized some progress with a 43% reduction among adults and a 90% reduction in children acquiring HIV, gaps and challenges remain. HIV prevalence still remains high among key populations such as sex workers, men who have sex with men, and young people. At the same time challenges regarding stigma and discrimination, violations of human rights and gender-based violence continue to hinder access to services for young people in general.
Although progress has also been made in supporting the inclusion and participation of some key population (KP) groups (i.e. PLHIV, MSM, SW) in the regional response, PANCAP has had limited success in engaging with young people, a critical gap given the overwhelming evidence that early initiation of sex (coupled with young people’s exposure to risky sexual behaviours/practices) is a main driver of HIV transmission and that national programmes do not adequately meet the needs of mainstream youth, much less those youth belonging to KP communities and other marginalized youth. The dissonance between the age of sexual initiation (before age 15), prevailing legislation on the age of consent (16 years), and the age for independent access to health care (18 years) make serious risk reduction interventions among youth difficult, and access to condoms and to basic sexual health unacceptably limited (CRSF 2014-2018). While CARICOM Youth Ambassadors Programme (CYAP), a regional network of Caribbean young people, is represented on the PANCAP Executive Board/RCM, we recognize that this youth governance structure may not fully be representative of the diversity of youth population in the region and cannot fully represent the needs of youth belonging to KP communities, in particular.
There is need to work more systematically with young people belonging to KPs who are more difficult to reach. Nevertheless, we believe that CYAP provides a unique platform for leadership development and collaboration that can strengthen the participation of a more diverse and better informed youth constituency in CARICOM decision making. With this in mind the PANCAP Global Fund grant programme proposed to collaborate with CVC/COIN to link at-risk youth (those benefitting from capacity building interventions proposed in their concept note) with the CYAP. This will serve a mutually beneficial purpose of strengthening the relevance and impact of the Youth Ambassadors as well as providing access to high-level CARICOM fora for KP youth, allowing for collaborative approaches to high-level advocacy that better links the issues and priorities of CARICOM to those of young people.
The meeting of youth leaders allowed for in-depth discussion of sexual health issues affecting young people, identify what they view as barriers to their access to sexual health services, as well as identify what knowledge and tools they require to protect themselves from HIV.
The meeting provided an opportunity to solicit the input required for developing a framework for regional advocacy on key sexual health issues affecting youth and to inform subsequent training to strengthen advocacy skills of regional youth leaders. This would enable youth to work towards a more coherent and holistic approach to issues affecting youth from key populations and young people living with HIV and for their strengthened inclusion in the regional and national responses.
The meeting and subsequent advocacy training of youth held in September 2017 enabled PANCAP to develop and support an innovative approach to mobilizing regional youth leaders to actively engage in high-level advocacy and policy dialogues by linking the CYAP with PLHIV youth leaders and other sexual and reproductive health youth activities/leaders supported under CVC/COIN’s activities aimed at fostering leadership, governance and strategic strengthening of emerging youth and transgender regional networks (including YurWorld and Trans in Action). The CYAP will provide access to high-level regional representatives of the education, health and social security sectors, and will facilitate the inclusion of PLHIV youth leaders in advocacy for a more coherent and holistic approach to issues affecting key population youth across the region, and for strengthened inclusion of youth in the regional and national responses. Advocacy tools and materials will be informed by information generation from CVC/COIN’s work with young people living with HIV in addition to a review of policies, practices and laws that impact on young people’s vulnerabilities to HIV, including age of consent laws.
The objectives of the meeting were:
- To provide a forum for in-depth discussion of sexual health issues affecting young people including identifying barriers that impede their access to sexual health services.
- To determine what knowledge and tools youth require to reduce their vulnerabilities to poor sexual health outcomes.
- To update youth on the new strategic directions required for ending the AIDS epidemic and discuss their role in the national and regional response.
- To discuss and agree on the key elements of a framework for regional youth advocacy.
Expected Outcomes were:
- Increased understanding of the sexual health issues that are affecting young people and barriers that hinder their access to sexual health services.
- Increased understanding of the knowledge gaps and tools required for reducing young people’s vulnerabilities to poor sexual health outcomes.
- Increased understanding of the new strategic directions for ending the AIDS epidemic and the role of youth in the response to HIV.
- Consensus on the key elements of a framework for regional youth advocacy.
The meeting included presentations by PANCAP and CVC-COIN, youth representatives of CARICOM Youth Ambassadors and Youth from key population groups. Plenary and working group sessions; panel discussions and edutainment.
The key Audiences encompassed CARICOM Youth Ambassadors, youth from key populations, PCU, CFPA and CVC-COIN.
- Antigua and Barbuda
- The Bahamas
- Dominican Republic
- Saint Lucia
- St. Kitts and Nevis
- St. Vincent and the Grenadines
- Trinidad and Tobago
- British Virgin Islands
- Cayman Islands
- Turks and Caicos Islands