{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T06:41:51Z","timestamp":1768286511243,"version":"3.49.0"},"reference-count":38,"publisher":"Wiley","issue":"2S1","license":[{"start":{"date-parts":[[2015,2,26]],"date-time":"2015-02-26T00:00:00Z","timestamp":1424908800000},"content-version":"vor","delay-in-days":25,"URL":"http:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of the International AIDS Society"],"published-print":{"date-parts":[[2015,2]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>There is a strong evidence base that the stigma, discrimination and criminalization affecting adolescent key populations (KPs) aged 10\u201317 is intensified due to domestic and international legal constructs that rely on law\u2010enforcement\u2010based interventions dependent upon arrest, pre\u2010trial detention, incarceration and compulsory \u201crehabilitation\u201d in institutional placement. While there exists evidence and rights\u2010based technical guidelines for interventions among older cohorts, these guidelines have not yet been embraced by international public health actors for fear that international law applies different standards to adolescents aged 10\u201317 who engage in behaviours such as selling sex or injecting drugs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>As a matter of international human rights, health, juvenile justice and child protection law, interventions among adolescent KPs aged 10\u201317 must not involve arrest, prosecution or detention of any kind. It is imperative that interventions not rely on law enforcement, but instead low\u2010threshold, voluntary services, shelter and support, utilizing peer\u2010based outreach as much as possible. These services must be mobile and accessible, and permit alternatives to parental consent for the provision of life\u2010saving support, including HIV testing, treatment and care, needle and syringe programmes, opioid substitution therapy, safe abortions, antiretroviral therapy and gender\u2010affirming care and hormone treatment for transgender adolescents. To ensure enrolment in services, international guidance indicates that informed consent and confidentiality must be ensured, including by waiver of parental consent requirements. To remove the disincentive to health practitioners and researchers to engaging with adolescent KPs aged 10\u201317 government agencies and ethical review boards are advised to exempt or grant waivers for mandatory reporting. In the event that, in violation of international law and guidance, authorities seek to involuntarily place adolescent KPs in institutions, they are entitled to judicial process. Legal guidelines also provide that these adolescents have influence over their placement, access to legal counsel to challenge the conditions of their detention and regular visitation from peers, friends and family, and that all facilities be subject to frequent and periodic review by independent agencies, including community\u2010based groups led by KPs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Controlling international law specifies that protective interventions among KPs aged 10\u201317 must not only include low\u2010threshold, voluntary services but also \u201cprotect\u201d adolescent KPs from the harms attendant to law\u2010enforcement\u2010based interventions. Going forward, health practitioners must honour the right to health by adjusting programmes according to principles of minimum intervention, due process and proportionality, and duly limit juvenile justice and child protection involvement as a measure of last resort, if any.<\/jats:p><\/jats:sec>","DOI":"10.7448\/ias.18.2.19437","type":"journal-article","created":{"date-parts":[[2015,2,26]],"date-time":"2015-02-26T08:37:08Z","timestamp":1424939828000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["\u201cFirst, do no harm\u201d: legal guidelines for health programmes affecting adolescents aged 10\u201317 who sell sex or inject drugs"],"prefix":"10.1002","volume":"18","author":[{"given":"Brendan","family":"Conner","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,2,26]]},"reference":[{"key":"e_1_2_7_2_1","volume-title":"Draft report","author":"WHO, UNAIDS, IAWG","year":"2014"},{"key":"e_1_2_7_3_1","volume-title":"Draft report","author":"WHO, UNAIDS, IAWG","year":"2014"},{"key":"e_1_2_7_4_1","volume-title":"Draft report","author":"WHO, UNAIDS, Inter\u2010Agency Working Group on Key Populations (\u201cIAWG\u201d)","year":"2014"},{"key":"e_1_2_7_5_1","volume-title":"Draft report","author":"WHO, UNAIDS, IAWG","year":"2014"},{"key":"e_1_2_7_6_1","volume-title":"Final report","author":"Global Commission on HIV and the Law","year":"2012"},{"key":"e_1_2_7_7_1","unstructured":"RahmanF.Legal and policy considerations in reaching young key populations.20th International AIDS Conference; 2014 Jul 20\u201325; Melbourne Australia: International AIDS Society."},{"key":"e_1_2_7_8_1","volume-title":"Article 33: protection from narcotic drugs and psychotropic substances","author":"Barrett D","year":"2012"},{"key":"e_1_2_7_9_1","volume-title":"Sexual and reproductive health needs and access to health services for adolescents under 18 engaged in selling sex in Asia Pacific","author":"Conner B","year":"2014"},{"key":"e_1_2_7_10_1","volume-title":"Policy brief on self\u2010stigma among young men who have sex with men and young transgender women and the linkages with HIV in Asia","author":"Youth Voices Count","year":"2013"},{"key":"e_1_2_7_11_1","volume-title":"Final report","author":"UNESCO, UNFPA, UNAIDS, UNDP, Youth Lead","year":"2013"},{"key":"e_1_2_7_12_1","unstructured":"McClureC ChandlerC BissellS.Responses to HIV in sexually exploited children or adolescents who sell sex.Lancet.2014. pii: S0140\u20106736(14) 60933."},{"key":"e_1_2_7_13_1","volume-title":"Final report","author":"WHO, UNFPA, UNAIDS, NSWP","year":"2012"},{"key":"e_1_2_7_14_1","volume-title":"Technical guide for countries to set targets for universal access to HIV prevention, treatment and care for injecting drug users","author":"WHO, UNODC, UNAIDS","year":"2009"},{"key":"e_1_2_7_15_1","unstructured":"UN Convention on the Rights of the Child G.A. res. 44\/25 annex 44 UN GAOR Supp. (No. 49) at 167 UN Doc. 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