Empowering young people to take control of their sexual and reproductive health and rights

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Youth leadership and empowerment

<p>Peer educator Mariam in Kampala, Uganda</p>

Often, young people most affected by HIV are excluded from shaping the programmes and policies that directly affect their sexual health and rights - or do not feel comfortable in doing so due to stigma and discrimination based on age, gender, HIV status and sexual orientation or because of a perceived lack of knowledge, skills or abilities.

To tackle this, Link Up met with a diverse range of young people to establish what matters most when it comes to their sexual and reproductive health and rights (SRHR).

Link Up consortium members the Global Youth Coalition on HIV/AIDS and the ATHENA Network consulted with young people living with and affected by HIV in all five Link Up countries. From this it became resoundingly clear that many young people, particularly those facing multiple layers of marginalisation, felt their needs were being ignored by healthcare systems, governments and society-at-large.

Click on the following links to read young people's views from each country on their SRHR:

To address these issues, Link Up worked extensively with young people to strengthen their leadership skills, providing them with opportunities to make a difference in their own communities through mentorship and peer educator programmes. Through this, many incredible role models emerged.

Some went on to become inspiring advocates, representing their views and those of their peers with decision-and policy-makers. For more on this aspect of Link Up's work, visit our Youth advocacy section.

As a result of this work, more than 11,500 young people affected by HIV have been assisted to participate in youth-friendly programming and planning.

Developing young leaders

Letting young people lead lies at the heart of Link Up. These key resources have been developed by Link Up to help those looking to unlock young people's potential.

Mentoring toolkit: Step Up, Link Up, Speak Up

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This mentoring toolkit was developed in collaboration with young advocates and draws on their diverse experiences of working in communities to advance their rights.

The mentoring programme is designed to build the confidence of young people to participate in policy processes, and to help identify and expand the knowledge, leadership skills, and abilities they feel they need to meaningfully advocate for their priorities. It enables the young mentees to benefit from each other’s knowledge, experience and perceptions.

Aiming High: Strategies for Meaningful Youth Engagement

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In this brief we provide practical guidelines for working with young people in unlock their potential.

The brief outlines ten effective strategies for working with young people in relation to their sexual and reproductive health and rights and HIV integration. These can be adapted and applied to any level of decision-making and programming.

Workshop guide: Safeguarding the rights of children and young people

LinkUp safeguarding manual

This workshop guide is designed to enable peer educators, social workers, midwives, nurse counsellors and clinical staff to address the rights of children and adolescents.

Role models

In society, if you talk about sex you'll be punished - and with my family I'm never allowed to talk about such things.

- Mulualem Samson, member of Addis Beza

Mulualem Samson is one of many inspiring young people who is driving change through Link Up. This video follows him and dance group Addis Beza as they use entertainment to bring integrated SRHR and HIV messages to young people in Ethiopia, where cultural attitudes make sex a difficult issue to discuss.

Strictly Beza

In Burundi, where more than half the population are aged 17 or under, RNJ+ (Réseau National des Jeunes Vivant avec le VIH/SIDA) runs a social centre staffed by and for young people most affected by HIV. This video follows 20-year-old Pacifique, a regular visitor to the centre who discovered he was HIV positive as a child, and now runs his own drama group to spread messages of SRHR and HIV far and wide.

HIV is my good friend

Case study: Working with young key populations in a hostile legal, socio-cultural and political environment

Burundi: Working with young key populations

Read this case study from Burundi to learn more about the challenges of working to support young people from key populations in a hostile legal, socio-cultural and political environment.

Peer educators

Providing young people with the skills and knowledge they need to link other young people to integrated SRHR/HIV services has enabled hundreds of thousands of young people to realise their sexual and reproductive health and rights.

Peer educators are best placed to reach other young people as they speak the same language, both culturally and socially, and can foster trust, answer questions clearly, and talk openly about sensitive issues.

For an evaluation of Link Up's use of peer educators to improve the SRHR of young people living with HIV in Uganda, with sex workers in Bangladesh and with men who have sex with men in Myanmar, visit our Research and evidence page.

Bangladesh: Shameem’s journey

20-year-old *Shameem’s story reflects the reality of life for many transgender people in Bangladesh. Link Up has helped him take control of his sexual health - and he is helping others take control of theirs.

Overcoming stigma

Despite the Bangladesh government now recognising transgender as a third gender, little has really changed for the community. People who are transgender face discrimination from their families and wider society and there are few employment opportunities, leading many to turn to sex work. Despite this, transgender people are largely ignored by HIV prevention programmes, and denied access to condoms and HIV/STI services. Link Up has stepped in to fill in these gaps.

Shameem's story

Shameem is a young transgender sex worker who first heard about sexual rights, including the right to express and enjoy his sexuality, when Link Up began. Shameem says this knowledge inspired him and he began to attend weekly SRHR meetings, where he received training on leadership and first aid.

Reaching out

Shameem became a Link Up peer educator and began helping young people, particularly young men, leading difficult lives. He has helped people access SRHR services and distributed condoms and lubricants - many young people cannot afford such things or are too shy to buy them, particularly those under the age of 18.

The project has increased Shameem’s understanding of both his body and his right to access quality health services. These previously alien concepts are now integral parts of his thinking.

Transforming lives

Shameem says Link Up has had a huge impact on his life, one that will stay with him forever. He has gone from being insular and focusing only on transgender people to realising that many people face problems. He is now able to work with other communities which has given him a great deal of satisfaction.

He cannot go back home - that is out of the question - but he realises the importance of being healthy both in his body and mind.

Read Shameem's story in full plus accounts from two other young people most affected by HIV in our in depth case study Bangladesh - Transforming the lives of young people.

*Please note, Shameem indentifies as Hijra and uses the male pronoun 'he' to refer to himself.

I've really gained courage and strength to tell about my status wherever I am and to whoever I meet...

- Link Up peer educator Daphine, 19, from Kampala, Uganda. Follow her journey in this video:

"Love a positive life"

To learn more about Link Up’s experiences of working with young people living with HIV in Uganda read the Breaking down barriers case study.

Young people who sell sex in Ethiopia

In Ethiopia, Link Up implemented a model of peer education and outreach to empower young people who sell sex and increase their access to HIV and SRHR services. Health workers were trained on how to work with marginalised people, to ensure sex workers had positive experiences in health facilities.

The programme

The Organisation for Support Services for AIDS (OSSA) and partners trained 468 young people who sell sex to be SRHR and HIV peer educators. Once qualified, peer educators facilitated group sessions with other young people who sell sex, supported by OSSA nurse counsellors.

After each session, anyone who asked to access contraceptive methods, STI or HIV services, counselling or other support received a referral slip entitling them to free services at a designated health facility, accompanied by the nurse counsellor if requested.

The project trained staff at the health facilities in question on how to work with marginalised populations.

The results

This approach focuses on building the confidence and knowledge of young people who sell sex and the health workers they come into contact with. It invests in people, who in turn share information to their friends, peers, family members and children. The self-confidence individuals develop as a result of this approach can feed into future work, projects and individual lives.

After 12 months, the project achieved the following:

  • 16,087 young people who sell sex reached with peer education sessions in the community: 35% (5,635) of them received referrals for clinical services.
  • Of those who received a referral, 30% (1,707) went to health facilities where they took up or completed services.

The most common reasons for referral were:

  • Voluntary HIV counselling and testing
  • Cervical and breast cancer screenings
  • STI check-ups and treatment
  • Opportunistic infection check-ups and treatment
  • Safe abortion

Particularly good retention rates were reported for the peer educator training and the seven-week, peer educator-led sessions.

The nurse counsellors were critical to this intervention. They provided peer educators with support, enhanced their knowledge and instil confidence in them, helping them to gain respect from their peers.

To learn more about this programme read our in-depth case study Empowering each other: young people who sell sex in Ethiopia