Preventing HIV Infections in Young People
	Condom Programming in the Context of STI/HIV Prevention
	Preventing HIV Infections in Pregnant Women

Preventing HIV Infections in Young People⁴

Young people are at the centre of the HIV/AIDS epidemic. More than half of new HIV infections worldwide – between 6,000 and 7,000 daily — occur among young people, essentially through sexual intercourse or through drug injecting.

In countries with high HIV prevalence rates, young people are at risk of contracting the infection as soon as they become sexually active. In many communities, because of such cultural practices as early marriage and sexual violence against women, and because adult men are searching for HIV-free sexual partners, the risk for adolescent girls and young women of being infected with HIV is high. In certain regions young women are as much as six times more likely than young men to be infected.

Many lessons have been learned about educating young people early in life about reproductive and sexual health, and equipping them with life skills. Evidence shows that young people who are provided with information and have access to counselling and services are more likely to delay their sexual activity and practice safer sex if sexually active, thereby reducing their risk of acquiring HIV infection or unintentionally getting pregnant.

Yet, many parents as well as political, religious and community leaders around the world still show reluctance to the idea, thereby putting the younger segments of their population at a higher risk of HIV infection.

The ICPD+5 review document specifically emphasizes the needs of young people. It calls on all Governments to ensure "that by 2005, at least 90 per cent, and by 2010 at least 95 per cent of young men and women aged 15 to 24 have access to information, education and services necessary to develop the life skills required to reduce their vulnerability to HIV infection."

Governments should further ensure that "by 2005 [HIV] prevalence in this age group is reduced globally by 25 per cent in the most affected countries, and that by 2010 [HIV] prevalence in this age group is reduced globally by 25 per cent" (paragraph 70).

Repeated commitment to these targets have been reiterated in many international consensus documents including the Declaration of Commitment of the United Nations General Assembly Special Session on HIV/AIDS (UNGASS) of June 2001.

UNFPA activities to prevent HIV infection in young people should pursue three broad directions, each of which reinforces the other:

• Create a supportive and enabling policy environment for programming for HIV prevention for young people;



• Strengthen HIV/AIDS and sexual and reproductive health education programmes for young people both in- and out-of-school; and



• Incorporate HIV-prevention strategies into “youthfriendly” sexual and reproductive health information, education and services.

Creating a supportive environment.

Based on UNFPA’s experience in the area of population and demographic data collection and analysis, an important role for UNFPA would be to support the collection of genderspecific health and demographic data on young people through population and community-based surveys like the demographic health surveys and the design, implementation and analyses of qualitative sexual behaviour studies.

These surveys and analysis would provide evidence- based information needed to:

a) sensitize policy makers, communities and significant gate-keepers on issues related to sexuality, HIV and young people;

b) ensure national policies recognize and appropriately address the epidemic among young people;

c) develop situation-specific preventive and behavioural change messages; and

d) advocate for up scaling of successful sexual and reproductive health and rights programmes for young people.

Recognizing that in many parts of the world the provision of sexuality education and reproductive health services for young people is still viewed with scepticism, concern and fear, UNFPA should support advocacy and awareness creation activities that promote dialogue and partnerships between young people, parents, community and religious leaders, and policy makers that can result in youth-friendly, gender-responsive policies and programmes which build on positive social norms and encourage open and frank discussion of young people’s concerns and needs.

Strengthening in-school and out-of-school programmes.

Whether the rates of infection are low or high in a given country, integrating HIV/AIDS into education programmes dealing with family life, population and reproductive and sexual health issues are an important way to ensure long-term preparedness for young people.

UNFPA should continue to support specific actions for the integration of HIV prevention and reproductive and sexual health information and education into the school sector, including the:

• Development of policies and programmes that strengthen the capacity of relevant education sectors in the provision of HIV prevention activities;



• Development of HIV/AIDS curricula content in the context of reproductive and sexual health for integration into mainstream educational curricula as well as into extracurricular activities and non-formal vocational programmes; and the



• Development of pre- and in-service teacher training packages on HIV/AIDS education and life skills.

School-based and out-of-school life skills education should promote positive attitudes and skills, including the promotion of self-esteem, negotiation, coping, and critical thinking, decision-making, communication and assertiveness skills.

Additional support could be provided to strengthen parent education programmes that include parent-child communication skills.

Particularly for out-of-school youth and youth in especially difficult circumstances, support should be provided for initiatives that serve to empower young people (e.g., girls and boys empowerment initiatives) and that link reproductive health and HIV prevention with other specialized and social services, livelihood opportunities, skills building and vocational training.

To complement HIV/AIDS education programmes, UNFPA should consider supporting multilevel and multimedia communication efforts that encourage positive and healthy lifestyles, good social norms and safer sexual options.

The development, production and dissemination of behaviour change communication (BCC) materials and messages must be mindful of the heterogeneity of young people; be sensitive to age, culture and gender factors; and, as much as possible, be based on audience segmentation and audience research to allow messages to be more tailored to specific attitudes, practices and needs.

This is particularly important when addressing the adolescence age group 10 to 19 years where within this age cohort, the 10 to 14 age group and the 15 to 19 age group would require different strategies and messages.

The process should encourage young people to actively participate and explore innovative, entertaining and popular ways of reaching young people with information and educational messages. These include radio, television, drama, folk theatre and other traditional media, comic strips and youth magazines, videos, interactive computer games, the Internet, telephone hotlines/help lines, music and dynamic talk shows.

Positive role models including celebrities and peers are extremely useful in developing self-esteem. UNFPA should expand its support to peer education programmes for in-school and out-of-school youth, in which young people serve as role models and the carriers of positive and culturally relevant messages.

Incorporating HIV prevention strategies into youth friendly sexual and reproductive health services.

Awareness creation and preventive education need to be complemented with institutional services especially for young people who are already sexually active, are in difficult circumstances, or who are susceptible to engaging in risky behaviours including substance abuse (particularly drug injecting).

To this end, UNFPA should advocate and support the introduction and/or expansion of youth-friendly sexual and reproductive health services including those that integrate: reproductive and sexual health and HIV/AIDS information, education and counselling; the diagnosis and management of STIs; confidential and voluntary HIV counselling, testing and support; and access to male and female condoms including information and education to ensure proper and consistent use.

Efforts should be made to ensure that young people have access to information and services through a range of service delivery settings including multi-purpose youth centres, youth corners, public and private health clinics, hotlines/ help lines, outreach/mobile services and school-based clinics.

Where resources are limited, UNFPA should consider prioritizing its support to preventing HIV infections among young people most vulnerable, while advocating with partners for additional resources to address young people in general.

Among young people as well, HIV disproportionately affects the poor and the marginalized. Marginalized young people including street children, are equally important in preventing unwanted because of their situations — exposure to unprotected sex, sexual violence, stigma and discrimination resulting in poor access to information and services.

Consideration may also be given to supporting HIV-prevention initiatives in settings such as the workplace for migrant youth workers, the street or street children and in camps for refugee youth.

In support to this core area, UNFPA will need to assist Governments in training programme managers and service providers from a broad spectrum of youth and youth-serving organizations and related sectors, particularly health, education and youth. Training will need to ensure knowledge and skills to effectively integrate HIV prevention activities into ongoing sexual and reproductive health programmes for young people.

In addition, capacity-building activities will need to address and clarify service providers’ and educators’ values and attitudes, which many times serve as barriers to access to services and information by young people.

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