The age of consent relates to a number of things. The age of consent is the age that someone can legally consent to having sex. If they have sex before this age and the person they have sex with is above the age of consent, the older person has committed a crime.

The age of consent also relates to the age that someone can legally get sexual and reproductive health services (SRHR) without their parent or guardian’s permission. In many countries, people have to be aged 18 or over to get SRHR services, including HIV services, without parental consent. This stops many young people from getting the services they need to stop HIV, STIs and unintended pregnancies.
 

Some countries also have laws that say women can only access SRHR services with their husband or male family members’ permission, regardless of her age. 

The age of consent depends on the country you are in. Find out what yours is by researching the laws in your country.

As well as biomedical services (services that relate to the body), such as providing condoms, lubricants, PrEP, PEP and HIV and testing, other services can help prevent HIV infections among young people. 

This includes:

- supporting families to help young people, especially girls, stay in school

- providing comprehensive sexuality education in after-school clubs or youth-friendly community spaces 

- HIV prevention information campaigns, presented in ways that are appealing to young people, communicated in ways they will engage with

- preventing and addressing gender-based violence, including couples counselling, counselling for men, counselling and post-violence support for young people who have experienced violence (biomedical services such as PEP and HIV testing should also be provided)

- training and education to provide young people with more opportunities and prospects, which reduces their risk of sexual exploitation, transactional sex and intimate partner violence 

- wider sexual and reproductive health services, including STI testing and contraceptive services.

The most effective way to provide effective HIV services for young people is to find out what issues and challenges they face that affect their sexual health, then work with youth representatives to design, deliver and evaluate services to meet these needs. 

Young people who inject drugs, young sex workers, young men who have sex with men and young LGBTIQ+ people often fall between the gaps of HIV programmes. 

HIV services for these at-risk groups don’t consider the special vulnerabilities and needs of young people. (Things like not being able to get HIV services without parental consent before the age of 18 and being vulnerable to exploitation and control from older people.) While HIV services for young people are often designed for young heterosexual married couples and young pregnant women. The needs of young people who are socially marginalised and often criminalised tend not to be considered. But these young people are highly at risk of HIV.

It is effective to train and work with peer representatives (young people from these groups). This helps to build trust and encourages other young people from at-risk groups to use the services on offer. 

All young people from at-risk groups should have access to HIV prevention, testing and treatment in ways that don’t stigmatise them or threaten their well-being. One-to-one counselling, peer support groups and one-on-one peer support should be offered to support the mental health of these young people, who often experience trauma and ill-treatment.
 

Remember that the needs between groups will differ. Young people who inject drugs need access to harm reduction (things like clean needles and syringes), if possible. And they may prefer to use young-person-only harm reduction services, which can make them feel safer. Young sex workers are likely to need more condoms and lubricant than other young people. While young LGBTIQ+ people may need specialist counselling to deal with things like homophobia and transphobia. All may need people to act as legal guardians so they can access HIV and other SRHR services. 

In some places, the law requires a parent or guardian’s consent for young people to access health services. But some young people may not feel able to speak openly to their parents or caregivers about their circumstances, which means they may miss out on vital HIV testing, prevention and treatment.

Inaccurate information circulated by word of mouth or social media can also make young people feel too worried to access health services. If they have HIV, or think they might have it, they might feel too ashamed to get help (this is called self-stigma).

Sometimes, practical things can stop young people with HIV from getting healthcare. They may not be able to afford to travel to a clinic or cannot get an appointment outside of their work or school commitments. Sometimes there might be a lack of HIV testing or treatment supplies. 

If a young person with HIV accesses healthcare they can face stigma, judgement and discrimination. This is when they are perceived in a negative way by other patients or by clinic staff because of who they are or what they do. They may be treated differently - for instance, a health provider may refuse to speak to them about HIV prevention if they feel they are too young to be having sex.

They may also encounter fearmongering, which is when clinic staff make them feel scared for their health and future. They may even be blamed or made to feel ashamed for having HIV. 

Many young people experience confidentiality breaches, including having their HIV status disclosed to other staff, their parents or the wider community without their consent. 

Do not judge them for being sexually active, for their sexuality or for showing an interest in sexual health issues. These are all normal and healthy parts of life. Be respectful of their privacy and confidentiality – this is important for building trust.

If a young person begins to tell you something regarding their health, give them time and listen. Don’t rush them, or interrupt to ask irrelevant questions. Be sure to give them room to ask their own questions too – it’s important they have a chance to ask for more information or clarity.

Stay calm and positive. Let them know that HIV can be managed and people can have a long and healthy life with the help of medication. When the time is right, talk to them about U=U (undetectable=untransmittable). U=U means that people with HIV who are on effective antiretroviral treatment, with an undetectable viral load, cannot pass on HIV through sex or during pregnancy. This can give young people with HIV hope for the future and encourage them to adhere to their treatment.

The service must be welcoming and open to young people and have staff who will not judge any young person who comes there for support. It is important to be inclusive of all young people and not to assume anything about them, including their lifestyle, relationship status, gender identity, sexuality or sexual experience. 

Being youth-friendly also means providing sexual health information and services that young people want and need, and in ways that they understand and trust. To do this, consult young people to find out what sexual health information and services would benefit them, and what kinds of opening times and locations suit them. Ask young people to review the information and services you provide so you know what is working and what is not. 

Marketing your service to relevant youth groups or holding an after-school clinic can help increase uptake. Being clear about how you respect privacy and confidentiality can also encourage young people to attend.