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Falling Through the Cracks of the Big Cities

Who is Meeting the Needs of HIV-positive Youth?


Background: Globally, half of all new HIV infections occur among youth under 25. As of June 30, 2002, more than 13,000 youth and young adults had tested positive for HIV in Canada. Despite this prevalence, there is a lack of resources for Canadian HIV-positive youth.

Objective: To investigate what can be done to better support the needs of HIV-positive youth in Canada.

Methods: A community-based participatory research approach was adopted. Thirty-four qualitative in-depth semi-structured interviews were conducted with youth (ages 12–24) living with HIV in Ontario. A stakeholder group of youth living with HIV, professionals and researchers collaboratively analyzed the data for emerging themes.

Results: When asked about areas in their lives where youth needed support, three major themes emerged: 1) Personal feelings about HIV: Youth identified a wide range of emotional response to their HIV status; however feelings of isolation, loneliness and hopelessness were dominant. 2) Barriers to full participation in society: Youth described a number of social and structural barriers to their full participation in society. 3) Specific support needs: Youth had difficulty accessing appropriate support services; they had very mixed feelings about both youth- and AIDS-serving organizations.

Interpretation: The youth we interviewed are interested in targeted programs, have difficulty accessing appropriate resources and would benefit greatly from increased social support. Specialized health and support services that are developmentally appropriate may be necessary. Where specialized services do exist, more research may be necessary to understand why they are underutilized and/or perceived as inappropriate. While this was a small exploratory study, our data suggest that better supporting the needs of HIV-positive youth might directly benefit this vulnerable population.


Contexte: à l’échelle planétaire, les jeunes de moins de 25 ans contractent la moitié des nouvelles infections à VIH. Au 30 juin 2002, plus de 13 000 adolescents et jeunes adultes étaient séropositifs pour le VIH au Canada. Malgré cette prévalence, on manque de ressources pour les jeunes Canadiens séropositifs.

Objectif: Examiner ce qui peut être fait pour mieux répondre aux besoins des jeunes séropositifs pour le VIH au Canada.

Méthode: Nous avons utilisé une méthode de recherche participative communautaire. Trente- quatre entretiens en profondeur semi-structurés ont été menés auprès de jeunes (de 12 à 24 ans) vivant avec le VIH en Ontario. Ensuite, des jeunes séropositifs pour le VIH, des professionnels et des chercheurs ont analysé ensemble les résultats de ces entretiens pour en dégager les grands thèmes.

Résultats: Trois grands thèmes se dégagent des réponses des jeunes à la question sur les aspects de leur vie où ils ont besoin d’aide: 1) Les sentiments personnels à l’égard du VIH: les jeunes présentaient un vaste éventail de réactions émotionnelles à leur état sérologique relativement au VIH, mais l’isolement, la solitude et le désespoir étaient leurs sentiments dominants; 2) Les obstacles à la pleine participation à la société: les jeunes ont cité plusieurs obstacles sociaux et structurels à leur pleine participation à la société; 3) Les besoins de soutien spécifiques: les jeunes avaient du mal à obtenir les services de soutien dont ils auraient eu besoin; ils nourrissaient des sentiments très contradictoires envers les organismes de service aux jeunes et/ou aux sidéens.

Interprétation: Les jeunes que nous avons interrogés manifestent un intérêt pour les programmes ciblés, ils ont du mal à obtenir les ressources appropriées, et ils ont un besoin pressant d’un soutien social accru. Des services de soutien et de santé spécialisés, adaptés à leur niveau de développement, pourraient être nécessaires. Il faudrait pousser la recherche pour comprendre pourquoi de tels services, lorsqu’ils existent, sont sous-utilisés ou considérés comme étant inadaptés. Même si la présente étude est préliminaire et très restreinte, les résultats obtenus donnent à penser qu’une meilleure réponse aux besoins des jeunes séropositifs pour le VIH pourrait procurer des avantages directs à cette population vulnérable.

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Correspondence to Sarah Flicker PhD.

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Flicker, S., Skinner, H., Read, S. et al. Falling Through the Cracks of the Big Cities. Can J Public Health 96, 308–312 (2005).

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MeSH terms

  • Youth
  • HIV
  • support
  • community health services
  • stigma