It was clearly not possible to include all groups of young people who might be at particular risk in all epidemic scenarios. It was therefore decided to focus on groups most at risk in areas of low-level and concentrated epidemics, since many of the groups of young people most at risk in generalized epidemics are likely to have some access to information, skills and services through existing channels. Within low-level and concentrated epidemics it was decided to focus on young injecting drug users, young sex workers and young men who have sex with men, since data are more likely to be available for these groups than other at-risk groups, such as mobile populations or prisoners. However, it needs to be emphasized that there is significant overlap among these groups. For example, young men who have sex with men may be sex workers, and sex workers may be injecting drug users.
In addition to selecting specific groups for inclusion in this review, it was also necessary to have a process for assessing the evidence for the effectiveness of interventions. An initial search for studies focusing on at-risk young people in developing countries indicated that there were relatively few data, either in the published literature or the grey literature. It was therefore decided also to review studies of interventions directed at young people in developed countries as well as studies that had been undertaken within general populations of sex workers, injecting drug users and men who have sex with men in developing countries but that had not disaggregated their data by age.
This chapter therefore reviews studies and reports that:
1. quantify the number of young people most at risk of HIV and assess their specific needs compared with older age groups of at-risk populations;
2. focus on young people most at risk of HIV in developing countries;
3. focus on young people most at risk of HIV in developed countries;
4. focus on people most at risk of HIV in developing countries that do not disaggregate data by age.
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