Assessment of Policies and Harm Reduction Services for Young People Who Use Drugs in Kathmandu Valley of Nepal: Identifying Gaps and Opportunities

Background: Young people under 30 represent the majority of people who use drugs in the Kathmandu Valley, Nepal. Young people who use drugs (YPWUD) may have particular needs and require different service and policy responses when compared to their older peers. This research examines the strengths and limitations of currently available policies and services; their effectiveness in meeting the needs of YPWUD and identifies gaps and opportunities for their improvement.Methodology: Semi-structured interviews (n=9) with key stakeholders and one focus group (n=5) discussion with YPWUD were conducted. Results were analyzed using the Rhodes Risk Environment framework which considers the ‘physical’, ‘social’, ‘economic’ and ‘policy’ level factors shaping risk at ‘micro’, ‘meso’ and ‘macro’ levels.Results: Drug use patterns among YPWUD in the Kathmandu Valley, Nepal are changing. Several trends have been identified including increased use of methamphetamine, diverted pharmaceuticals and ‘Southasian-Cocktail’ (a mixture of buprenorphine, benzodiazepine and antihistamines); use at the border regions and a move away from drug dealing ‘hotspots’ to online drug purchasing. YPWUD and service providers report a range of barriers to accessing services including stigma and discrimination; a lack of local services; a lack of knowledge of existing services; age of consent legislation and opening hours which may conflict with commitments such as school and college. YPWUD report a range of human rights violations including involuntary treatment, arbitrary detention, forced labour and public body searches. Service providers and policymakers report precarious international donor funding of services through HIV prevention programs with little to no youth-specific services for YPWUD.Conclusion: The findings of this study highlight the importance of youth-friendly harm reduction services that are relevant and responsive to the unique needs and experiences of YPWUD. These services should address current trends including the use of new substances (for example, methamphetamine and ‘Southasian Cocktail’) in diverse environments (including at the border regions and online). The perspectives of YPWUD are vital while developing and implementing harm reduction programs to ensure that the programs are effective, efficient and based on the diverse needs of YPWUD.

Bad Queers: LGBTQ People and the Carceral State in Modern America

The war on sex offenders was an American campaign against sex crime that began in the 1930s and is still ongoing. In this review essay, I argue that the architects and opponents of that war engaged in political struggles that—especially during the pivotal era of the long 1970s—produced, criminalized, and hierarchized multiple new categories of “good” and “bad” LGBTQ legal subjects. In making this argument, my aim is to bring the field of LGBTQ political and legal history—especially the work of George Chauncey ([1994] 2019) and Margot Canaday (2009)—into closer conversation with scholarship by queer theorists who are not historians—especially Gayle Rubin ([1984] 2011a) and Michael Warner (1999)—about the stigmatization of non-normative gender and sexual practices. While historians have examined the policing of multiple queer behaviors in the early twentieth century, their examinations of the post-1945 period have been concerned primarily with the consolidation of a starker social and legal binary between homo- and heterosexuality. As their narratives get closer to the present, the most stigmatized “bad” queers become more and more tangential. At least in part, this has been because historians have been under the same pressure as LGBTQ activists to distance LGBTQ identity from the stigma of sexual “deviance”—especially sex that violated age-of-consent statutes—in order to promote the political project of LGBTQ rights. Placing bad queers at the center of LGBTQ political and legal history diversifies who counts as a subject of this history and reveals an even bigger carceral state that governed them.

Membership, Mobilization, and Policy Adoption in the Gilded Age: The Case of the Woman’s Christian Temperance Union

Relatively little is known about how late nineteenth-century associations worked to get their policy goals adopted by state governments. We study this question here, considering the Woman’s Christian Temperance Union (WCTU) and three policies it supported: scientific temperance instruction, increasing the age of consent, and prohibiting tobacco sales to minors. Overall, WCTU-supported legislation was more likely to succeed in states with unified Republican state legislatures, aided by neighboring state adoptions (scientific temperance) and greater WCTU membership (increasing age of consent and prohibiting tobacco sales to minors). These findings are supported by historical evidence, which reveals how WCTU leadership targeted particular states when lobbying for scientific temperance instruction laws and utilized its broad membership base to pressure state legislatures on the other two issues. In total, these results show how one late nineteenth-century membership group was able to facilitate the successful spread of its policies throughout the nation.

European legislators’ attitudes toward childhood sexuality from the perspective of age of consent legislation

Childhood sexuality is a culturally constructed notion, which has constantly been subjected to change. Various constructions of childhood sexuality represent different attitudes toward children's engagement in sex. As a substantial factor in regulating children's sexuality, a country's age of consent legislation is an important indicator of the national legislator's attitudes toward childhood sexuality. This study summarizes four main discourses around child sexuality, ranging from traditional constructions that solely focus on protecting the child's “innocence” to modern notions that provide more leeway for children to explore their sexuality. By juxtaposing these discourses against the current age of consent laws in 57 European jurisdictions, it appears that national law makers in Europe are still mainly influenced by the traditional construction of childhood sexuality, which results in various negative consequences. To avoid the disconnect between academic discussions about childhood sexuality and legislatos' rationales for their actions, it is recommended that legislators take the latest findings in academia into account and reflect on the rationales behind their legislation.

Adolescents and age of consent to HIV testing: an updated review of national policies in sub-Saharan Africa

ObjectivesIn sub-Saharan Africa (SSA) where HIV burden is highest, access to testing, a key entry point for prevention and treatment, remains low for adolescents (aged 10–19). Access may be hampered by policies requiring parental consent for adolescents to receive HIV testing services (HTS). In 2013, the WHO recommended countries to review HTS age of consent policies. Here, we investigate country progress and policies on age of consent for HIV testing.DesignComprehensive policy review.Data sourcesPolicies addressing HTS were obtained through searching WHO repositories and governmental and non-governmental websites and consulting country and regional experts.Eligibility criteriaHTS policies published by SSA governments before 2019 that included age of consent.Data extraction and synthesisData were extracted on HTS age of consent including exceptions based on risk and maturity. Descriptive analyses of included policies were disaggregated by Eastern and Southern Africa (ESA) and Western and Central Africa (WCA) subregions.ResultsThirty-nine policies were reviewed, 38 were eligible; 19/38 (50%) permitted HTS for adolescents ≤16 years old without parental consent. Of these, six allowed HTS at ≥12 years old, two at ≥13, two at ≥14, five at ≥15 and four at ≥16. In ESA, 71% (n=15/21) allowed those of ≤16 years old to access HTS, while only 24% (n=6/25) of WCA countries allowed the same. Maturity exceptions including marriage, sexual activity, pregnancy or key population were identified in 18 policies. In 2019, 63% (n=19/30) of policies with clear age-based criteria allowed adolescents of 12–16 years old to access HIV testing without parental consent, an increase from 37% (n=14/38) in 2013.ConclusionsWhile many countries in SSA have revised their HTS policies, many do not specify age of consent. Revision of SSA consent to HTS policies, particularly in WCA, remains a priority to achieve the 2025 goal of 95% of people with HIV knowing their status.

The Indian Girl-Wife: Not Even a Woman, But Already a Wife

The institution of child marriage throughout the nineteenth and early twentieth century not only stripped Indian girls of their agency, but also frequently denied them their education. In 1884, Rukhmabai, a young Indian girl of just eleven-years-old, was married to Dadaji Bhikaji, a man eight years older. Although Rukhmabai was able to resist the forced marriage and eventually went on to become India’s first female doctor, Rukhmabai’s victory was generally an anomaly of the time and reflected a tenacity to attain greater education. Throughout her writings, Rukhmabai expresses deep sadness from being denied the opportunity for an adequate education, and identifies female education as one of the chief disproportionate impacts of child marriage for girls. This project will trace the evolution of child marriage negotiations from the 1891 Age of Consent Act to the 1929 Child Marriage Restraint Act, specifically addressing the way that related discussions allowed Indian women to establish the importance of their adolescent years in their educational pursuit. By uncovering the voices of both child marriage victims and female reformers, we are able to garner an understanding of the changing Indian social landscape at the time and the way that Indian women negotiated their agency against the backdrop of globalization, the nationalist agenda, and caste, religious, and regional differences. This project will stress female adolescence as an evolving concept throughout twentieth century India, and will draw on the important relationship between education and female agency.

Child marriage debates during British India

The social reformers continuously attacked the custom of child marriage in the mid-nineteenth century, but they could not start an organized campaign for various reasons. Apart from individual feminism, the female voice was also quiet. In the late Nineteenth Century, the reformer’s campaign did not attack the religious aspect of child marriage rather focused on its moral and physical elements. Consequently, they restricted their efforts to the sphere of Age of Consent for sexual Consummation of girls only. The Revivalist leaders' massive opposition compelled the British Indian Government not to interfere with its domestic sphere. The various changes in the first half of the twentieth century supplied a favourable environment to reopen child marriage. In this paper, the author will examine those changes and delineate the shift from “Age of Consent to the age of marriage”.