By Andy Brown
The changing social landscape brought on by new technology has helped create a ‘hidden epidemic’ of HIV among adolescents in the Asia-Pacific region. Through research, policy support and direct outreach, UNICEF is joining the effort to reverse an alarming trend.
BANGKOK, Thailand, 1 December 2015 – Nest is a 19-year-old living in Bangkok. Like many other gay adolescents, he uses mobile apps to meet up for dates. “I use apps to meet other guys nearby,” he says. “I don’t like to have sex at the first meeting, I prefer to chat and get to know the person first. But some of my friends just meet up for sex.”
A new report – Adolescents: Under the Radar in the Asia-Pacific AIDS Response – published by the Asia-Pacific Inter-Agency Task Team on Young Key Populations, which includes UNICEF, UNAIDS and others, shows that the Asia-Pacific region is facing a ‘hidden epidemic’ of HIV among adolescents. Although new HIV infections are falling overall, they are rising among teenagers. In 2014, there were at least 220,000 adolescents aged 10-19 living with HIV in the region, with major cities like Bangkok and Hong Kong hubs of new infections.
The epidemic is growing fastest among young gay and bisexual men, and the rise of mobile dating apps is one of the key driving factors. Unlike Internet dating, their precursor, mobile apps are location based – they show other users available in the immediate area, in real time. This can lead to spontaneous sex and risky behaviour. By connecting adolescents to a larger network of potential sexual partners, the apps also enable any HIV infections to spread further and faster.
Nest sits in the garden of a trendy coffee shop in Ari, where Thai students meet to sip cappuccinos, hang out and play songs on an acoustic guitar.
Unlike some of his older friends, Nest had relatively few problems coming out. “I’ve known I was gay since I was 11 or 12,” he says. “I’ve never hidden it, and I didn’t have any trouble at school – most of my friends are gay or transgender, and my teachers liked me because I worked hard. My mum wasn’t happy at first, but she’s come to accept it.”
Nest met his first boyfriend online in 2010 when he was 14, through a video chatting site. “I was living in Bang Kapi at the time,” he recalls. “We talked online for two months, then I came to Bangkok to meet him. We met at a shopping mall, then went to a hotel nearby.”
A year later, in 2011, Nest got his first smart phone and discovered mobile dating apps. At first, he used Grindr and Jack’d, the most popular gay apps. But he later shifted to Growlr, a niche app for ‘bears’ – gay men who present a rugged, macho image.
“There are a lot of bears in Bangkok,” he says. “Usually, if you go on Growlr, there will be around 50 guys available during the day, or 100 at night. Some are looking for long-term relationships, but others just want sex. You can search for people by preference, including what kind of sex they’re into.”
Nest practices safe sex with people he doesn’t know well, but not with his regular partners. Once, after he accidently cut himself during unsafe sex, he went for an HIV test. “It was two years ago,” he recalls. “I was very tense, and it took time to build up my courage to get the test. I read all about HIV on the Internet – what would happen if I got a positive result, and what it’s like living on ARV [antiretroviral] drugs.”
In the end, Nest’s HIV test was negative, although he did test positive for herpes. “I was very relieved,” he says. “I’ve been safer since then.”
UNICEF is working with governments across the Asia-Pacific region to ensure they meet their obligations to protect adolescents’ health. Those particularly at risk of contracting HIV include gay and bisexual teenagers, those who sell sex, injecting drug users, and transgender people. Adolescents with HIV also face stigma and discrimination, which can discourage them from seeking treatment.
“In order to tackle this issue, governments need better data on adolescents, strategies for HIV prevention, and adolescent-specific laws and policies,” says Shirley Mark Prabhu, HIV Specialist for UNICEF East Asia and Pacific. “These should include sex education in schools, condom distribution, and HIV testing and treatment services designed for adolescents.”
In Thailand, for example, UNICEF has worked with the Government to reduce the age of consent for HIV tests to under 18, so that adolescents can access testing services without adult consent, which otherwise might act as a deterrent. In addition, research on young at-risk communities has helped better understand behaviours that put adolescents at risk of HIV and to advocate for adolescent-specific strategies for HIV prevention.
In China, UNICEF is reaching out directly to young gay men via the apps they use to hook up. On World AIDS Day 2014, UNICEF worked with UNAIDS and Chinese gay dating app Blued to add a red ribbon next to every user’s profile picture. The ribbons linked to information about HIV and details of the user’s nearest voluntary testing centre.
In Hong Kong, Peter Sabine, a 34-year-old DJ and founder of the city’s first gay football team, One Nil, confirms the picture found in the UNICEF report. He chats on Skype from his downtown apartment, wearing a large pair of DJ headphones.
The social scene has changed enormously since Peter was in his late teens. “Instead of going to gay bars and saunas, people also meet using mobile apps like Grindr and Jack’d,” he says. “Access to casual encounters has gone up enormously as a result.”
“It’s not uncommon for users to request ‘bareback’, or unprotected sex, often with methamphetamines,” he continues. “Paying for sex is not unusual, as the apps have also opened up new avenues for prostitution. And I have heard of instances where people have been sexually assaulted after meeting up via mobile apps.”
The rise of gay dating apps in recent years can be seen as both a blessing and a curse. On the one hand, they make it easier for young people to explore their sexuality and come out gradually, on their own terms. But they also carry risks, and adolescents are less prepared to deal with these.
“Mobile apps have opened up the true spectrum of sexuality,” Peter says. “They have liberalized and normalized gay identity. But society has not caught up with the technology, and sex education does not prepare adolescents for the app world. They don’t know how to navigate it safely.”
Today’s gay teenagers clearly have no intention of stopping using dating apps. But they might respond well to more information about HIV.
“I’ve seen health information on Hornet,” Nest says of one social network site. “I know all about HIV now, so I don’t read it. But for other young people, that could definitely help.”