Are the Youth being Are the Youth being Neglected in Neglected in

Comprehensive Care?Comprehensive Care?

For The 2nd National Conference on Peer Education, For The 2nd National Conference on Peer Education, HIV & AIDSHIV & AIDS

AUTHOR: AUTHOR: Chrispine Otieno MkadoChrispine Otieno Mkado

PRESENTER: PRESENTER: Alphonce Ali MollaAlphonce Ali Molla

CO-AUTHORS: CO-AUTHORS: Njoki Mwangi, Saraphina; Ali Molla, Alphonce; Wasike, Charles; Njoki Mwangi, Saraphina; Ali Molla, Alphonce; Wasike, Charles; Olweny, Fred; Matola,FOlweny, Fred; Matola,F

What is Comprehensive Care?What is Comprehensive Care?

Comprehensive CareComprehensive Care includes includes

Prevention:Prevention: helping people not to get helping people not to get infected or re-infected with HIV infected or re-infected with HIV

Care and SupportCare and Support for those who are for those who are infected or affected by HIV/AIDSinfected or affected by HIV/AIDS

What is Voluntary Counseling What is Voluntary Counseling and Testing (VCT)and Testing (VCT)

Voluntary Counseling and Testing (VCT) is both a Voluntary Counseling and Testing (VCT) is both a preventive intervention and a care and support preventive intervention and a care and support

intervention and is part of Comprehensive Care.intervention and is part of Comprehensive Care.

Most new infections of HIV/ AIDS in Most new infections of HIV/ AIDS in Kenya is in the age group of 15-25 Kenya is in the age group of 15-25 years…….years…….

………….so why aren’t youth going for VCT?.so why aren’t youth going for VCT?

……Why aren’t the Youth going for Why aren’t the Youth going for VCT?VCT?

““Invulnerability Risk”-Invulnerability Risk”- The feeling that The feeling that you are not at risk of infection.you are not at risk of infection.

Statistics show: Statistics show:

2/10 men surveyed are not worried about their 2/10 men surveyed are not worried about their status status

7/10 women surveyed are not worried about their 7/10 women surveyed are not worried about their status.status.

Confusion due to conflicting messagesConfusion due to conflicting messagesLack of peer support:Lack of peer support:

Statistics show:Statistics show:

6/10 Men surveyed were given peer encouragement6/10 Men surveyed were given peer encouragement

2/10 Women surveyed were given peer encouragement2/10 Women surveyed were given peer encouragement

Why aren’t women given the same support and encouragement?Why aren’t women given the same support and encouragement?

Why aren’t the Youth going for Why aren’t the Youth going for VCT?VCT?

Again, Youth are not going for VCT…Again, Youth are not going for VCT…Lack of mentors and good role models Lack of mentors and good role models

Why are Why are celebritiescelebrities, eg, Kleptomaniax and CMB promoting , eg, Kleptomaniax and CMB promoting

condoms and condoms and non- celebritiesnon- celebrities promoting Abstinence? promoting Abstinence?

If a condom is so successful, why go for a VCT?If a condom is so successful, why go for a VCT?

……Youth not going for VCT…Youth not going for VCT…

Lack of advertisement directed at Youth.Lack of advertisement directed at Youth. There are adverts for going for VCT as a There are adverts for going for VCT as a

couple………what about adverts on VCT for couple………what about adverts on VCT for youths?youths?

When was the last time you saw an advert When was the last time you saw an advert encouraging a youth to go for VCT alone or as encouraging a youth to go for VCT alone or as partners?partners?

Discouraging views about Youth Discouraging views about Youth can stop them from going for VCTcan stop them from going for VCT

Adult views are discouraging the youth:Adult views are discouraging the youth: ““During our time we were different”During our time we were different”

““The attitude that youths are ‘sexually active’ The attitude that youths are ‘sexually active’ make the youth and adults believe that every make the youth and adults believe that every young person is having sex”young person is having sex”

““We’ll all die anyway...”We’ll all die anyway...”

Why is it that more young men are willing Why is it that more young men are willing to be tested?to be tested?

8/10 Men surveyed have been for a VCT8/10 Men surveyed have been for a VCT

5/10 Women surveyed have been for a VCT5/10 Women surveyed have been for a VCT

Do the youth feel invulnerable because they have been Do the youth feel invulnerable because they have been abstaining or have previously been for a test?abstaining or have previously been for a test?

StigmaStigmaYouth suffer triple stigma due to:Youth suffer triple stigma due to:

1. Status- the age group1. Status- the age group

2. If infected2. If infected

3. If Abstaining3. If Abstaining

Pre VCT Pre VCT - What is meant to happen:- What is meant to happen:

Preparing that person for receiving the Preparing that person for receiving the resultsresults

InformationInformationHIV/AIDS information useful to the personHIV/AIDS information useful to the person

Follow-up for the client who decides not to be Follow-up for the client who decides not to be testedtested

Address the causes of HIV spreadAddress the causes of HIV spread

Friendly information to the youthFriendly information to the youth

Post TestPost Test- What is meant to happen:- What is meant to happen:

If Negative or PositiveIf Negative or Positive Friendly, empathetic environmentFriendly, empathetic environment

Time taken to counsel Time taken to counsel

Follow up for referrals and supportFollow up for referrals and support

VCT facilities linked to Support ServicesVCT facilities linked to Support Services

Separate Information targeting the youthSeparate Information targeting the youth

VCT in Clinical SettingsVCT in Clinical SettingsWHAT IS GOING WRONG?WHAT IS GOING WRONG?

Offer HIV test routinelyExplain Confidentiality policy

If client accepts test

Provide pretest counselingExplain possible results

Administer the test

Provide post-test counseling which includes:

HIV-NegativeGive results, provide risk

reduction counseling, and offerReferrals to other health and support services as needed

HIV-PositiveGive results and provide counseling

on disclosure, support, treatment reducing risk for further infection and

other issues. Offer follow-ups and counseling

If Client Declines

Counsel for risk reduction; provide information, Education, and referrals to other health services

as need be

•VCTs are often too Public and youth don’t want to be seenbeing tested.

• Preparation time too short• Not friendly for youth

• Unfriendly• Not empathetic• Few support service• Less time given to negative youth• No follow up

Youth aren’t being tested because of:•Fear•Very few courses and workshops on VCT• No types of information offering support and encouragement (only billboard advertisements)

• In some centers, mothers including teens are given the “results” after PMTCT by publicly being told they can or cannot breast feed.

No wonder so many Youths are No wonder so many Youths are not going for VCT despite being not going for VCT despite being

very worried!!!very worried!!!

While some surveys show large While some surveys show large proportions of youth attending VCT this proportions of youth attending VCT this is not compared to the actual population is not compared to the actual population of that group. For example,youth form of that group. For example,youth form about 60% of the population of Kenyaabout 60% of the population of Kenya

Things can be differentThings can be different

In a very well run youth friendly VCT In a very well run youth friendly VCT centre like Korogocho, 148 youths centre like Korogocho, 148 youths between 16-35 years attended VCT between 16-35 years attended VCT between January and May 2006. This is between January and May 2006. This is only one client per day! only one client per day!

But in a one day test and abstain But in a one day test and abstain campain 60 youths tested out of the campain 60 youths tested out of the 350 who attended. 350 who attended.

Education For Life (EFL) Kenya and the Education For Life (EFL) Kenya and the Comprehensive Care Issue of VCT for the Youth.Comprehensive Care Issue of VCT for the Youth.

EFL Kenya meets the needs of the youths, both HIV+ EFL Kenya meets the needs of the youths, both HIV+ and HIV- by using the Behaviour Change Process and HIV- by using the Behaviour Change Process

(BCP) model of Gerald Egan(BCP) model of Gerald Egan

Through this Process:Through this Process:1.Youth discover how risky their behaviour 1.Youth discover how risky their behaviour

actually isactually is

2. Learn how to prevent risk of infection. 2. Learn how to prevent risk of infection.

3. Gives information and preparation on VCT to 3. Gives information and preparation on VCT to put the youth at ease. put the youth at ease.

4. Helps them choose values and goals that will 4. Helps them choose values and goals that will protect them in futureprotect them in future

5. Gives mentoring and guidance on spiritual and 5. Gives mentoring and guidance on spiritual and social issues.social issues.

6. Helps one live life to the fullest6. Helps one live life to the fullest

Our ExperienceOur ExperienceHIV+ youths can make a commitment HIV+ youths can make a commitment not to get re-infected and not to infect not to get re-infected and not to infect others.others.

The youth want to live a meaningful The youth want to live a meaningful life.life.

Most of the youth desire to be tested Most of the youth desire to be tested but fear pulls them away.but fear pulls them away.

Once tested it is a real means of Once tested it is a real means of prevention.prevention.

Lessons LearntLessons LearntMost Youths who Most Youths who undergo the processundergo the process Rediscover themselvesRediscover themselves See the need for change See the need for change

and begin to value life.and begin to value life. Refrain from infecting Refrain from infecting

others.others. AND….AND…. Go for VCT!Go for VCT!

RecommendationRecommendationLet’s care enough to encourage each other to know Let’s care enough to encourage each other to know their status as a first step in comprehensive care.their status as a first step in comprehensive care.

More forums are needed to enlighten youth on VCTMore forums are needed to enlighten youth on VCT

VCT counselors should be invited to schools to VCT counselors should be invited to schools to prepare youth for VCTprepare youth for VCT

Churches, Mosques and Temples to encourage VCT Churches, Mosques and Temples to encourage VCT and offer BCP to youth and adults.and offer BCP to youth and adults.

All interventions should include All interventions should include youth friendly encouragement to youth friendly encouragement to

go for VCTgo for VCT

Let’s Help the Let’s Help the Youth toYouth to

Choose LifeChoose LifeThank you. Thank you.