A global look
The Link Up Project - HIV and Sexual and Reproductive Health and Rights: visions, voices and priorities of young people living with and most affected by HIV - was begun in 2013 by a group of global and national partners, led by Global Youth Coalition on HIV/AIDS and Athena Network.
Its purpose was to amplify the voices of young people in the development of a framework and vision for designing and implementing programs to address the needs of sexual and reproductive health and rights of young men who have sex with men, young people who do sex work, young people who use drugs, young transgender people and young people living with HIV. L
800 young people ages 10-24 responded globally to questionnaires and shared experiences. Also, 400 youth from Ethiopia, Uganda, Burundi, Bangladesh and Myanmar participated in a series of community dialogues. service delivery
My impression? Although Canada is more advanced in terms of program development for young people living with or affected by HIV, iin spite of being a high income country, some priorities and fundamental concerns expressed by youth in the project are strikingly similar to those in Canada.
Canada's strengths and weaknesses
In Canada we are fortunate enough to have trained professionals in health care settings who provide quality services to the LGBTQ community in a sensitized manner in relation to all of diversity, for the most part. The chronology of basic human rights and progress of the LGBTG community in Canada can be found here and although circumstances are not ideal, Canada is much more advanced in terms of respecting basic human rights for those in the LGBTQ community than most other countries.
However we have to ask why treatment as prevention-based plans are resisted in most of Canada, with the exception of Quebec and British Columbia, when statistics show that this UNAIDS plan, referred to globally as 90-90-90 has as its underpinnings a proven track record for reducing transmission rates of HIV.
Why too is harm reduction resisted by most provinces and the federal government in Canada when safe injection sites and distribution of harm reduction supplies and other harm reduction measures have been shown to be more effective than criminalizing young people and the general population for drug use and addictions?
Services for transgender youth are progressing while there is recognition that this area is relatively new and access to clinics is limited. Transgender youth in Canada experience higher than average rates of suicide, experience stigma, discrimination, rejection by families and the public, remain part of the population of homeless LGBTQ youth and are generally misunderstood. Care and support is developing and there are now five clinics in Canada which offer treatment and interventions for this population.
As transgender youth are slowly starting to receive care, they still have a long way to go in eliminating stigma and reaching a point where they can expect to have their basic human rights respected. The struggle is demonstrated at a basic level, yet speaks volumes about the lack of understanding and acceptance of transgender youth in Canada as our House of Commons has focused on what has become a controversial bill to be passed as legislation.
Believe it or not, the pressing issue for the conservative government is the banning of transgender people from the use of public washrooms. Our conservative government believes transgender women should in fact be using men's washrooms. This of course poses many problems for transgender people and places them at risk of violence and abuse. What appears to be a very minor issue and concern is in fact a manifestation of the overall lack of understanding of the needs of transgender youth on the part of our government and a reflection of how the general public feels about transgender people which includes youth.
As young people in the Link Up project describe their struggles to obtain basic information about sex and HIV, sex education in Quebec was removed from the curriculum in 2005 and has since been the responsibility of parents, community organizations and youth themselves. The controversy was reignited recently when the province of Ontario moved ahead with plans for comprehensive sex classes for students which reflects current realities including sexuality, online pornography and text messaging. In presenting basic HIV information to high school and college students, given the current situation in schools, I was not entirely surprised to learn that most students did not know that female condoms existed and their basic level of knowledge concerning HIV was poor.
The ongoing and most striking similarity to the young people in Link Up is the criminalization of HIV for non-disclosure. Canada continues to have harsh legislation for non-disclosure of HIV and is one of the countries in the world that utilizes these kind of laws most and young people are not exempt from criminalization.
In fact "While application for adult sentence used to be at the discretion of the Crown, with the introduction of the Safe Streets and Communities Act,( a bill that was passed with the Canadian government in 2012) the legislation will now require the Crown to consider seeking adult sentences for youth convicted of the most seriousviolent crimes such as murder, attempted murder, manslaughter, and aggravated sexual assault — a charge commonly used in cases of HIV non-disclosure."
Young people involved in sex work describe harsh treatment by state run organizations and the many risks involved as sex workers. Yet recent new legislation in Canada criminalizes sex work, places sex workers at greater risk for violence and completely ignores their basic human rights. Again, this is in spite of evidence that decriminalizing sex work does in fact protect sex workers and provides them with a safer work environment.
The bottom line
As mentioned, Canada does have more advanced programs in comparison to the shared experiences of young people in the Link Up project. But can we consider ourselves role models or mentors in their vision for designing and implementing programs to address the needs of sexual and reproductive health and rights of young men who have sex with men, young people who do sex work, young people who use drugs, young transgender people and young people living with HIV?
What do you think?