Young people remain at the centre of the HIV/AIDS epidemic in terms of rates of infection, vulnerability, impact, and potential for change. They have grown up in a world changed by AIDS but many still lack comprehensive and correct knowledge about how to prevent HIV infection. This situation persists even though the world has agreed that young people have the human right to education, information and services that could protect them from harm.
Young people are disproportionately affected in the HIV pandemic. They face the economic and social impact of HIV/AIDS on families, communities, and nations, and they must be at the centre of prevention actions. Where young people are well informed of HIV risks and prevention strategies, they are changing their behaviour in ways that reduces their vulnerability. For example, in several countries, targeted education has led to delayed sexual debut and increased use of condoms resulting in a decrease in HIV prevalence in young people. Yet efforts to increase HIV knowledge among young people remain inadequate.
Young people are diverse. Interventions must be tailored to meet their individual characteristics and circumstances, such as age, sex, religion, socioeconomic and marital status and domestic arrangements, among other factors. Interventions should specifically address the needs of vulnerable and high-risk groups of young people, including injecting drug users (IDUs), whose high-risk behaviour has been identified as a driving force behind HIV transmission in Eastern Europe and Central Asia.
UNFPA strives to build on and expand rights-based policies and programmes that promote healthy adolescent development and provide them with age-appropriate knowledge and tools to make informed choices. UNFPA-supported programmes emphasize behaviour change, including abstinence or delay in sexual debut, reduction in the number of sexual partners, monogamy, and correct and consistent condom use for those who are sexually active. However, young people's needs are not limited to prevention alone. Those who are HIV positive, some of whom do not know they are infected, need care, treatment and support, includign sexual and reproductive health services.
As part of the UNAIDS division of labour, UNFPA takes the lead in the provision of information and education, condom programming, prevention for out-of school young people and prevention efforts targeting vulnerable groups.' Guided by its mandate to protect reproductive health, UNFPA also plays a lead role in ensuring that young people are dually protected against sexually transmitted infections, including HIV, and unwanted pregnancies.
Forging genuine partnerships with young people themselves is an overarching strategy. Other areas of special focus for UNFPA include evidence-based interventions, very young adolescents and out-of-school youth.
Youth-adult partnerships and programmes are an innovative way of involving young people in HIV prevention efforts. They are based on the understanding that young people have a right to partcipate in programmes that affect them and on the experience that programmes are more sustainable and more effective when youth are treated as partners. Because youth are often less powerful, articulate and knowledgeable than their adult partners, youth-adult partnerships focus on technical assistance and training that empower young people to make their voices heard.
Provided with necessary means and skills training, young people can be important advocates for their specific sexual and reproductive health needs. Given the possibility to speak up, they can introduce more youth sensitive perspectives to policy-making processes. For example, in 2005, a UNFPA-supported pilot project recruited young people in Botswana to contribute to the Ntional AIDS Coordinating Agency through a midterm review of the National Strategic Framework for HIV/AIDS. In Thailand, young people were recruited to contribute to the the national development frameworks that guide all UN programming in those countries.
UNFPA's commitment to youth participation is reflected in a wide range of initiatives from peer education to advocacy work. These initiatives build on and utilize the skills, knowledge and enthusiasm of young people. Increasingly, young people are participating in important events that help shape the global response to HIV/AIDS, such as the UN General Assembly Special Session on HIV/AIDS and the International AIDS Conference.
A number of major, regional programmes focusing on HIV prevention among young people were initiated with support from UNFPA and others since 2000, and the final reports from these programmes offer a number of lessons and good practices to be incorporated into future efforts. These include the African Youth Alliance, AfriYAN, the Reproductive Health Initiative for Youth in Asia, and a major OPEC-Fund supported initiative to prevent HIV among vulnerable populations in Central America and the Caribbean.
Young people are at the centre of the global AIDS epidemic. Of the 1.7 billion young people worldwide, 5.4 million are estimated to be living with HIV (2007). About 40 per cent of new HIV infections are among young people. This age group also has the highest rates (over 500,000 infections daily) of sexually transmitted infections excluding HIV. Young people are particularly vulnerable to HIV infection for social, political, cultural, biological, and economic reasons.
Whatever their circumstances, in order to protect themselves against HIV, young people need:
The importance of preventing HIV infections among young people has been a consistent message in all HIV/AIDS related commitments to date, particularly ICPD+5, the Millennium Development Goals, the Declaration of Commitment made at the 2001 United Nations General Assembly Special Session on HIV/AIDS (UNGASS), and the General Assembly Political Declaration on HIV/AIDS in 2006 (see box below). HIV prevention among young people is also one of the 'Essential Programmatic Actions for HIV Prevention' in the UNAIDS Policy Position Paper Intensifying HIV prevention.
The Declaration of Commitment set specific targets for HIV prevention among youth. It calls on all Governments to ensure:
HIV infection rates in persons 15 to 24 years of age should be reduced by 25 percent in the most-affected countries by 2005, and by 25 percent globally by 2010.
Six of 11 heavily affected African countries have reported a decline of 25 per cent or more in HIV prevalence among young people in capital cities, according to the 2006 Report on the Global AIDS Epidemic. However, surveys indicate that fewer than 50 per cent of young people have achieved comprehensive knowledge levels about HIV prevention in 2005.
“We, Heads of State and Government and representatives of States and Governments…Commit ourselves to addressing the rising rates of HIV infection among young people to ensure an HIV-free future generation through the implementation of comprehensive, evidence-based prevention strategies, responsible sexual behaviour, including the use of condoms, evidence- and skills-based, youth specific HIV education, mass media interventions, and the provision of youth friendly health services.” -- Paragraph 26 of the Political Declaration on HIV/AIDS