COVID-19 is a serious pandemic, unprecedented in our lifetime. The Interagency Task Team (IATT) on Young Key Populations (YKPs) in Asia and the Pacific, concerned about the welfare of young key populations and young people living with HIV and the possibility of severe disruption to HIV prevention, testing, treatment and other related services during COVID-19 outbreak, launched a rapid survey to contribute to mitigating the impact of this pandemic. This survey assesses information needs, medication on hand, and ability to access HIV services and support networks among young key populations and young people living with HIV from Asia and the Pacific region during the COVID-19 outbreak. The survey was developed in English but has later been translated into Thai, Burmese and Bahasa Indonesia. The outcomes of the survey are expected to help support local solutions through the leadership of young key populations and young people living with HIV in providing information, finding joint problem-solving measures, and being a voice for the voiceless. Initial responses in English will be considered in this paper and will be enriched by the analysis of findings in the other languages (Thai, Burmese and Bahasa Indonesia).

Analysis of preliminary findings

The respondents are a combination of young people living with HIV and young key populations between 18 and 29 years old. Almost 50% of the respondents identify themselves as young men who have sex with men, 10% as young drug users, 10% as young transgender people, 6% as young sex workers and 5% as young migrants. 51% of the respondents identify themselves as young people living with HIV. In the context of the COVID-19 situation, 91% of the respondents are practicing social distancing, 60% are on self-quarantine and 36% are on complete lockdown.

Socio-economic impact

The pandemic is having a significant negative socio-economic impact on young key populations and young people living with HIV who responded to the survey. 46% of young people informed that the restrictive measures put in place to curb the spread of the pandemic are affecting them in accessing food supplies and basic commodities that they need daily to survive. 46% reported that these measures led to a loss of income and employment. The following graph shows how the restrictions of movement being implemented in the region are impacting the access of young key populations and young people living with HIV to different services.

Access to information

80% of the respondents reported that information on COVID-19 transmission and prevention is being provided in their community. The majority of the respondents want more information on COVID-19: 70% want to receive more information on how people living with HIV can protect themselves from COVID-19 and 73% want to learn more about testing and treatment measures of COVID-19. The following graph shows more in detail what kind of information young people want to obtain.

As expected, social media is the most popular source of information young people use to keep themselves updated about COVID-19 (82%), followed by local and national TV (68%) and global WHO website (61%).

Access to HIV and health services

Young people living with HIV

51% of the respondents are currently on ARV treatment. 30% of those have a 2-3 month refill of ARV medicines, 29% have only one month dose and 22% have 3 weeks or less. 17% of the respondents say they do not have ARV refills on hand. 43% of young people on ARV treatment are currently unaware if their country allows multi-month prescriptions for essential medicines.

Among young people living with HIV who are on ARV treatment, more than 64% are concerned about the exposure to COVID-19, while 50% have identified distance to ARV clinics and lockdowns (48%) as challenges in getting ARVs. 19% have identified that they are concerned about stockouts. The following graph shows in detail what are the main challenges for young people living with HIV to get ARV treatment during the COVID-19 pandemic.

70% of young people living with HIV think that a way to get to the medications safely is crucial to adhere to HIV treatment during the crisis. 50% consider that counseling for anxiety and depression is also key to maintain adherence. The following graph shows which services are considered critical by young key populations and people living with HIV during the COVID-19 outbreak.

Access to HIV prevention and other services

Young key populations are experiencing delays or disruptions in accessing HIV prevention services due to the COVID-19 situation: 27% of young people experienced delays or disruptions when accessing condoms, 11% when accessing opioid substitution therapy (OST), 17% clean needles, 14% PrEP and 26% HIV testing. 30% of young people experienced delays or disruptions in accessing psychological support and 19% in accessing mental health medications. With regards to mental health needs, more than 70% of the respondents feel anxious or very anxious about COVID-19. Almost all young people who responded expressed a desire to access to counselling and mental health support services. Young people strongly believe that they can contribute to the response to COVID-19 in support to the communities.

Key recommendations

Access to information

  • Use social media to develop and disseminate targeted, timely and appropriate information on HIV and COVID-19 among YKP and young people living with HIV;
  • Adopt innovative methods to provide correct information to the young key population who lacks access to the digital technologies;
  • Promote and support digital literacy among young key populations to equip them to make the right decisions to prevent COVID-19 and access services and reject fake news and misconceptions;
  • Encourage young people to read information from reliable sources such as official UN websites, Facebook and twitter pages, including WHO, UNAIDS, UNDP, UNICEF, UNWOMEN, UNFPA, UNESCO, etc…, and official government websites;
  • Use friendly and simplified language for young people and encourage translation of communication materials into regional languages.

Access to HIV and health services

  • Immediately promote and put in place innovative solutions to avoid disruption to HIV-related and health services including sexual and reproductive health services;
  • Ensure access to multi-month dispensing (three months or more) of ARVs and other medicines, commodities like condoms, sanitary napkins to adolescents, young people living with HIV and young key populations;
  • Promote ARV treatment literacy interventions among young people living with HIV;
  • Ensure provision of mental health and counselling services for the young key populations;
  • Reach out to local groups/networks, vulnerable populations and young people and encourage them to take care of themselves and their loved ones and share information about COVID-19 prevention;
  • Work with YKP and community based-organizations to ensure a continuum of care for young people living with HIV and young key populations.
  • The response to COVID-19 must be grounded in the realities of people’s lives and focused on eliminating the barriers people face in being able to protect themselves and their communities.

Social Protection

  • Ensure provision of food and other social protection services including shelter for vulnerable populations;
  • Explore the opportunities to provide cash transfer to YKPs who have lost employment or in vulnerable condition;
  • Ensure provision of services and support for the young key population affected by the violence specially among the girls.

This is part of a series of blogs that analyze the results of the survey “Assessing the needs of young key populations during COVID-19 outbreak in Asia and the Pacific”. Further specific recommendations will be on mental health, psychosocial support and YKP-led initiatives. Through its members the IATT on YKP is using these findings to advocate for a strengthened response to COVID-19 in Asia and the Pacific. Youth LEAD has recently created the YKP COVID-19 Emergency Relief Fund with the support of the Robert Carr Fund drawing upon the preliminary results of the survey.

Contact details

Michela Polesana | Advocacy Adviser | UNAIDS Regional Office for Asia and the Pacific | [email protected]

Jawying (Honey) Lyster | Programme Management and M&E Consultant | Bangkok Regional Centre, UNDP | [email protected]

Jeffry P. Acaba | Programme Officer | APCASO | [email protected]

Eddy Rudram | Communications Officer | Youth LEAD | [email protected]