Delany-Moretlwe, S., Cowan, F. M., Busza, J., et al. Journal of the International AIDS Society (February 2015), Vol. 18, Issue 2, Supplement 1, doi: 10.7448/IAS.18.2.19833.
This review summarized the health needs of young key populations (YKPs) aged 10–24, including sexual and reproductive health, mental health, violence, and substance use problems, and barriers to care for young sex workers, men who have sex with men, transgender people, and people who inject drugs. The findings from the 110 eligible articles demonstrated, overall, that YKPs experienced a higher burden of disease relative to both older key population members and their age peers in the general population. For example, younger sex workers are less experienced in condom negotiation than older sex workers and thus, are more vulnerable to forced sex without a condom. In addition, stigma, discrimination, social exclusion, and victimization contributed to higher rates of mental health problems in YKPs compared to their peers in the general population. Barriers to care for YKPs occur at the individual, health system, and structural levels; these include low levels of education and HIV knowledge or risk perception, concerns about privacy and confidentiality, lack of “youth-friendly” facilities, and the requirement, in many countries, of parental permission to access testing, treatment, or procedures. The authors concluded that programming for YKPs requires comprehensive, integrated services that respond to their specific developmental and health needs, along with educational and social services within the context of a human rights-based approach.