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Data on the prevalence of 10 to 17 year-olds who are sexually exploited is particularly weak.
In general, even fewer data are available on young men and young transgender people who sell sex than on young women who do so.46 Young transgender people’s immediate HIV risk is related primarily to sexual behaviour, especially unprotected anal sex.
An estimated 4.2% of men who have sex with men aged 25 and under are living with HIV, compared to 3.7% among all men who have sex with men.54 Young men who have sex with men are often more vulnerable to the effects of homophobia (manifested in discrimination, bullying, harassment, family disapproval, social isolation and violence), as well as criminalisation and self-stigmatisation.
This can have serious repercussions for their physical and mental health and their ability to access HIV testing, counselling and treatment.55 Use of drugs or alcohol and selling sex contribute to HIV risk and represent overlapping vulnerabilities that some young men who have sex with men share with other young key populations.56 Young MSM are often unable to respond effectively to homophobia because of their age – they have no income, no employment, and they are dependent on family for housing.
Not only do young people from key populations face widespread discrimination, stigma and violence they also face specific vulnerabilities associated with youth, including power imbalances in relationships and, sometimes, the impact of alienation from family.35 Young people within key populations often have lower knowledge of HIV risks, or lower ability to mitigate those risks, compared with their older, more experienced counterparts.36 There is little agreement on how to meet the needs of the significant numbers of young people involved in selling sex.37 There is varying data on the age of entry of children into sexual exploitation and young people into sex work.Around 70% of adolescents living with HIV will have acquired it through vertical transmission and so will have been living with the virus since birth.18 Whilst programmes to prevent mother-to-child transmission (PMTCT) have been hugely successful in recent years, reducing new infections among adolescents is more difficult.19 There are many factors that put young people at an elevated risk of HIV.Adolescence and early adulthood is a critical period of development when significant physical and emotional changes occur.If they get kicked out, and they often do, they end up on the street where they may be forced to trade sex for food, shelter or protection.57 Current methods of gathering and reporting data make it impossible to calculate a reliable global estimate of the number of young people who inject drugs.58 HIV prevalence among young people who inject drugs worldwide is estimated at 5.2%.59 However, it is much higher in certain countries.