Chapter 7: Population-specific status report: HIV/AIDS and other sexually transmitted and blood borne infections among youth in Canada – Conclusion

Chapter 7 – Conclusion

The transition from childhood to adulthood is marked by many changes including physical maturation, increased independence, completion of high school and entry into post-secondary education or the labour force. While most youth make the transition to adulthood free from HIV and other sexually transmitted and blood borne infections (STBBIs), others face various challenges and obstacles. Some youth are more vulnerable to infection than others due to factors within their social, cultural, economic and physical environments. Historically, efforts to prevent HIV and other STBBIs among youth have directed at changing individual knowledge, attitudes and behaviours, failing to produce consistent, significant, long-term impacts.  While addressing these individual factors is important, they must be considered within youths’ broader social contexts.

This report focused on the complexity of social, cultural, political and economic factors that shape youths’ vulnerability to HIV and other STBBIs. It explored how broader determinants of health such as education, income, employment, living conditions, and social environments affect the health and wellbeing of youth. The evidence and information provided in this report is intended to support communities, governments, non-governmental organizations, public health practitioners, researchers and others as they develop programs and policies targeted at these ‘upstream’ determinants to help all youth prevent poor health outcomes, including HIV and other STBBIs. The report has also attempted to balance a focus on vulnerabilities to infection, with one on resilience against infection.  The report has elaborated on factors related to resiliency among youth in order to support communities, governments, non-governmental organizations, public health practitioners and others build community capacity, build upon the existing strengths of communities and foster individual resilience against HIV and other STBBIs.

Surveillance data indicate that youth in Canada remain disproportionately affected by HIV and STBBIs such as chlamydia and gonorrhea. This report confirms that vulnerability to and resilience against infection are directly and indirectly influenced by a variety of factors found in a youth’s broader social context. An examination of these health determinants contribute to a better understanding of how and why particular groups of youth in Canada, such as street-involved youth, those who use injection drugs, and Aboriginal youth are particularly vulnerable to infection.

An overview of current research projects in Canada shows that researchers across the country are working to address the wide range of issues that affect youth and their vulnerability to STBBIs, including HIV. The report also identifies knowledge gaps and opportunities for further research, in areas such as youth living in rural and remote areas, specific groups of youth such as immigrant and newcomer youth, determinants of health such as mental health and STBBI and HIV vulnerability, and factors that promote resilience among youth.

Similarly, the Canadian response to HIV and other STBBIs demonstrates involvement from a wide array of organizations and communities. This report identifies numerous strategies, networks and organizations, both nationally and in provinces and territories that focus on education and capacity building among the youth population. Findings emphasize the importance of knowledge exchange activities and inclusive, culturally relevant approaches to HIV and STBBI prevention. Current evidence also highlights the importance of sharing best practices across sectors and jurisdictions, developing evidence-informed strategies and interventions, and continuing to collaborate across a wider range of stakeholders. There is a need for more programs that deal with the broader determinants of health, including increasing social support and access to services for Canadian youth vulnerable to or living with HIV and other STBBIs.

HIV and other STBBIs remain a significant public health challenge that requires a collaborative and comprehensive response. Stakeholders have demonstrated a strong collective will to increase awareness of these illnesses and reduce youth’s vulnerability to them through prevention, education, care, treatment and support. This report acknowledges the key role that governments, stakeholders and communities continue to play in promoting and providing effective leadership, research, policy, programs and support services in preventing HIV and other STBBIs.