youth aged 15-24 accounted for 22 percent of all HIV
infections in 1999. Young Dominican women’s vulnerability
to infection has increased greatly in the past decade.
In 1987 the male/female ratio of HIV infection was 7:1,
but by 2003 the ratio of male positive youth to female
positive youth was 1.3 :1. Pregnancy has become the principal
cause of death among females between ages 15 and 19 in
the Dominican Republic. Nearly one in four in this age
group is either pregnant or has already given birth.
There are few reproductive health services for young
people in the marginal communities surrounding major
cities, where 64 per cent of the population is concentrated.
Using peer education and counseling, the UNFPA supported
Programme aims to reduce adolescent pregnancy, STIs
and HIV infection rates by making young people more
aware of the health risks of unprotected sex. Teens
are encouraged to postpone their first sexual encounter
or to maintain a faithful relationship with one partner.
Some 360 adolescents have been trained as voluntary
peer counselors on sexual and reproductive health matters.
They each counsel between 15 to 30 youths, distribute educational material and, with parental consent, contraceptive methods (condoms, spermicides and pills, after their first prescription by a physician) and refer special cases to health services.
The counselors also conduct town meetings and theatrical
presentations for their communities. In two years,
the project has counseled nearly 9,000 young people,
30 per cent of whom are not in school. Growing demand
has given rise to open educational activities in schools,
churches and community gathering places. The project
has also trained 90 Ministry of Health physicians,
nurses and psychologists in integrated adolescent health
care, and produced a manual on sexual and reproductive
health, a video and other educational materials.
The Dominican Republic approved a National Youth
Law incorporating adolescent sexual and reproductive
health in 1998 with the support of the Vice President
and the input of a National Youth Forum. Young people
called for a law to establish a cabinet-level Youth
Ministry and to devote 1 per cent of the national budget
to it, legislation that was eventually passed with
some modifications. “Of symbolic and equal importance,” wrote
one observer, “is the law’s recognition
of youth as a national resource and positive force.
This recognition is in striking contrast to existing
laws that portray young people as potential troublemakers
who must be controlled or punished.”
of World Population 2003: Giving Adolescents Priority):