Robert Newells

Youth-focused session started with a description of neurocognitive reasons for ways that adolescents process and respond to information compared to young adults and adults. The session ended with results from a study that showed improved knowledge and attitudes, increased HIV testing, and reduced risky sex among viewers of MTV Shuga.

The adolescent neurocognitive development work of Dr. Anne-Lise Goddings from University College London concluded that adolescents are particularly susceptible to social influence. Minister of Foreign Affairs Reina Buijs described the involvement of parents, communities, and health services in comprehensive sexuality education in the Netherlands focused on teaching children that it’s okay to make choices. Reinforcing those narratives were preliminary results from a study conducted in Nigeria showing that MTV Shuga effectively transmitted information, changed attitudes, increased HIV testing, and among women, led to fewer sexually transmitted infections. O'Cindy Cynthia Samuels of the Guyana Sex Work Coalition explained that “Sex work is work which is both formal and informal.” It is a misconception to think of all sex workers as victims. Sex work is not sexual exploitation, human trafficking, or violence against women. Framing all sex work in these ways feeds stigma that violates human rights and impedes the HIV response.

Children have lamented for generations that adults don’t understand them. It’s true! If we are truly concerned about building bridges for the next generation, we are required to communicate in ways that will engage the next generation. And we may be required to have some uncomfortable conversations in the process.

Shona Dalal

The plenary today focused on the next generation – adolescents and young adults. Presenters covered the science on adolescent neurocognitive development, experiences of young people with HIV, young sex workers, sex rights and education, and reaching young people through non-traditional media from MTVShuga.

Anne-Lise Goddings reviewed the mechanics of the developing adolescent brain. She summarized the role of the social brain, prefrontal cortex and subcortical development in shaping adolescent behaviour and choices. A study of risk-taking using simulated car driving showed that when adolescents were alone their decisions were similar to those of adults, but a marked increase in crashes/risk-taking occurred if virtual peers were present, with an age-specific dose response. O’Cindy Cynthia Samuels highlighted the need to empower sex workers, and to define sex work as “work”. Gautam Yadav shared his experience of a “triple stigma” of being young, gay and HIV-positive and the need to remove structural barriers to health. Kim Barrow Simplis advocated for policies that support families and youth, and Reina Buijs added the importance of comprehensive sexuality education for children and adolescents. Finally, MTVShuga showed a vibrant approach to reach youth and influence health behaviour through entertainment.

The takeaway from the science on adolescents is that they are indeed rational and have the capacity to make good decisions, but are particularly susceptible to social influence and the presence of peers, which affects executive functioning. These tendencies offer an opportunity to positively engage adolescents in health care, for example through peer-led education and engagement. However, it highlights their vulnerabilities to negative emotional responses; experiential learning is one way to help adolescents learn how to manage real-life situations. Improving healthcare access, ending stigma and discrimination, and fostering inclusion is important for improving health outcomes and needs further implementation research.