The epidemic is fueled by risky behaviour – mainly drug use and unsafe sex – particularly among marginalized groups such as intravenous drug users, sex workers, men who have sex with men, and populations on the move. Increasingly, infection is spreading from these groups through their partners to more young people. Even within these groups, HIV has a young face.
Across the region, young people face poverty, unemployment levels that are three times higher than among adults, trafficking in drugs and humans, economic migration and violence. Youth poverty, unemployment and lack of hope fuel the trades in people and drugs that feed the HIV epidemic. While they are the most vulnerable, young people are the least likely to know the risks or how to avoid them, least likely to have access to the services that they need and least likely to be adequately protected by policies and laws.
The share of female infections is rising, leading to more HIV infection among pregnant women and their infants. More children in the region are being abandoned by vulnerable young mothers who are HIV positive and injecting drugs. Evidence of rising sexual transmission raises fears that the region is heading for a more generalized epidemic.