Deriving and interpreting population size estimates for adolescent and young key populations at higher risk of HIV transmission: Men who have sex with men and females who sell sex.

Abstract

Population sizes of adolescent (15- to 19-years) and young (20 to 24-years) key populations at risk for HIV transmission are essential for developing effective national HIV control strategies. We present new population size estimates of adolescent and young men who have sex with men and females who sell sex from 184 countries in nine UNICEF regions using UNAIDS published population size estimations submitted by national governments to derive 15-24-year-old population proportions based on the size of equivalent adult general populations. Imputed sizes based on regional estimates were used for countries or regions where adult proportion estimates were unavailable. Proportions were apportioned to adolescents and young adults based on age at sexual debut, by adjusting for the cumulative percentage of the sexually active population at each age for sex. Among roughly 69.5 million men who have sex with men, 12 million are under the age of 24 years, of whom 3 million are adolescents. There are an estimated 1.4 million adolescent and 3.7 million young females who sell sex. Roughly four and a half million adolescent men who have sex with men and females who sell sex would benefit from early HIV interventions. These population size estimates suggest there are roughly 17 million adolescent and young men who have sex with men and females who sell sex who need HIV prevention services and social support. These data provide evidence for national and international programs to determine how many adolescent and young key populations need essential health services and are living with HIV and other infections. Age disaggregated population sizes inform epidemic models, which increasingly use age-sex structures and are often used to obtain and allocate resources and human capacity and to plan critical prevention, treatment, and infection control programs.