Abstract
IntroductionThe international community's commitment to halve by 2015 the HIV transmission among people who inject drugs has not only been largely missed, instead new HIV infections have increased by 30%. Moreover, drug injection remains one of the drivers of new HIV infections due to punitive responses and lack of harm reduction resourcing. In the midst of this situation, adolescents are a forgotten component of the global response to illegal drugs and their link with HIV infection. The Sustainable Development Goals (SDGs) present an opportunity to achieve the global objective of ending AIDS among adolescents who use drugs, by addressing the structural vulnerabilities they face be they economic, social, criminal, health‐related or environmental.DiscussionThe implementation of the SDGs presents an opportunity to address the horizontal nature of drug policy and to efficiently address the drugs‐adolescents‐HIV risk nexus. Adolescent‐focused drug policies are linked to goals 1, 3, 4, 10, 16 and 17. Goals 3 and 16 are the most relevant; the targets of the latter link to the criminalization of drug use and punitive policy environments and their impact on adolescents' health and HIV transmission risks. Moreover, it presents an opportunity to include adolescent needs that are missing in the three drug control conventions (1961, 1971 and 1988), and link them with the provisions of the Convention on the Rights of the Child (1989). Finally, the six principles to deliver on sustainable development are also an opportunity to divert adolescents who use drugs away from criminalization and punitive environments in which their vulnerability to HIV is greater.ConclusionsAddressing HIV among adolescents who use drugs is an extremely complex policy issue depending on different sets of binding and non‐binding commitments, interventions and stakeholders. The complexity requires a horizontal response provided by the SDGs framework, starting with the collection of disaggregated data on this specific subgroup. Ending AIDS among adolescents who use drugs requires the implementation of national drugs and HIV plans based on the multi‐sectoral approach and the transformative nature of the SDGs, to provide a comprehensive response to the epidemic among this key affected subgroup.
Highlights
Ending AIDS among adolescents who use drugs requires the implementation of national drugs and HIV plans based on the multi-sectoral approach and the transformative nature of the Sustainable Development Goals (SDGs), to provide a comprehensive response to the epidemic among this key affected subgroup
While there is no disaggregated data on the prevalence of drug use or injection among adolescents, or on the prevalence of HIV among adolescents who use or inject drugs, people who inject drugs (PWID) of all age groups are the key population with new infections increasing by 30% between 2011 and 2015 [4], while the 2011 political declaration on HIV and AIDS committed its signatory countries to halve the transmission among this population [5]
Addressing HIV among adolescents who use drugs is an extremely complex policy issue, especially since it relies on different sets of binding and non-binding commitments by countries, and on different sets of interventions provided by different stakeholders
Summary
Responding to paediatric HIV has been high on every national political agenda for the last decade, with encouraging results in terms of declining new infections among children by 70% between 2000 and 2015 [1]. To achieve the All In 2020 targets [7] and end AIDS among AWUD by 2030, this commentary will focus exclusively on policy development by reviewing countries’ obligations through legally binding conventions (Convention on the Rights of the Child (CRC), 1989; drug control conventions, 1961, 1971, 1988) as well as non-binding commitments countries took through designated political declarations (on the world drug problem, 2009 as complemented by the UNGASS 2016 outcome document; on ending AIDS by 2030, 2016; and on the public health dimension of drugs at the WHA, 2017) It will lay down the role of the Sustainable Development Goals (SDGs) as a general policy framework allowing a multisectoral response to HIV among AWUD, before framing HIV and drug use within the SDGs agenda to illustrate the needed policy interventions to end AIDS among adolescents by 2030
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