"We really need to find out what are we lacking [in HIV programme], why are we still falling behind? Why are the new HIV infections not declining steeply, especially in the young key populations?" rightly questions Applesta.
Legal and policy coherence is missing
Applesta said that legal and policy coherence is vital to achieve across the region to progress on public health and other sustainable development agenda.
"We are aware that adolescents as young as 13 or 14 years may be sexually active," said Applesta. But if they wish to get a HIV test then they need their parent or legal guardian's consent in India. "Lot of young people do not want to go for a HIV test because they do not want to be judged by their parents or legal guardians. Also, there are prejudices related to being sexually active as well."
There are punitive laws. For instance, those young people who inject drugs may be reluctant to access harm reduction related health services.
We need legal and policy harmonization so that everyone including the young can access the full spectrum of HIV services everywhere, especially those who are at a greater risk.
Privacy and confidentiality
Legal requirement to show government identity cards for accessing range of HIV-related services may deter some young key populations from accessing care. Applesta also points out that most of the HIV services are available during the time when young people may be in school or college or at workplaces. We need HIV services to be available at the time convenient or preferable for those most in need.
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