In The Former Yugoslav Republic of Macedonia the impact of conflict, poverty, unemployment and the breakdown of societal and cultural norms have resulted in an increase in risk behaviour among young people. Over the past decade traditional structures around sex and marriage have been breaking down, increasing sexual activity outside of marriage. However, in many cases, taboos surrounding the discussion of sexual matters persist.

A recent UNFPA-sponsored situation analysis found that The Former Yugoslav Republic of Macedonia’s youth often possess incomplete knowledge about STI and HIV/AIDS and lack the life skills necessary to avoid infection. While young people are, for the most part, aware of condoms as a prevention measure for STI/HIV, they fail to use them on a regular basis. Young people need to be educated about healthy behavior and attitudes and encouraged to use prevention measures. Existing health and social services are not youth-friendly and young people report that they do not talk to their parents or teachers about sexual health and related issues. As a result, young people obtain information about prevention of HIV, other STIs and pregnancy largely from their peer group and/or older siblings. The response analysis found that media information campaigns have targeted youth with HIV/AIDS information, as has the education system. However, these campaigns are not reaching all young people and in particular may not reach vulnerable youth outside the education system.

The National Policy on HIV/AIDS therefore contains elements that move beyond providing youth with basic knowledge and strives to strengthen the skills of young people in life skills and negotiation of safe health behavior. It further recognizes the need for young people to contribute through their active involvement in future STI/HIV prevention programs. These programs will be more effective if they move beyond information dissemination and encourage group norms for safe and healthy behavior.