UNFPAState of World Population 2003
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State of World Population
Overview of Adolescent Life
Gender Inequality and Reproductive Health
HIV/AIDS and Adolescents
Promoting Healthier Behavior
Meeting Reproductive Health Services Needs
Comprehensive Programmes for Adolescents
Giving Priority to Adolescents
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HIV/AIDS and Adolescents

Contributing Factors
Regional Differences
Impact of AIDS on Young People
Social Marketing of Contraceptives
Services for HIV/AIDS Prevention and Care

Services for HIV/AIDS Prevention and Care

Voluntary counselling and testing (VCT) services are a vital part of HIV prevention, treatment and care programmes. Regardless of the result, young people tested often change to less risky behaviour. Studies show that many young people need and want access to VCT so they can learn whether they are infected—provided the services are confidential and affordable and that they are given the results honestly.(41)

However, a barrier to testing is the lack of treatment and support for those who test positive. Few young people in the developing world have access to antiretroviral drugs (ARVs) to treat HIV. In fact, of the people in the developing world who would benefit from ARVs, fewer than 5 per cent currently get them.(42) Botswana and Brazil have pledged to provide ARVs to all who need them, but other hard-hit countries lack the resources to follow suit.

As countries expand access to HIV treatment, use of VCT services should increase.

Even where treatment is not available, VCT can lead young people to change their behaviour. In a study in Kenya and Uganda, VCT was offered to young people aged 14 to 21. Most sought the test of their own accord and when they were healthy. In interviews, most of those tested said they intended to abstain, keep to one partner, have fewer partners or use condoms. Most had disclosed their results, mainly to partners and spouses, rather than to parents whom they did not want to disappoint. Most who had not been tested indicated that they would like to be tested in the future. Subjects said they valued the counselling aspect of the VCT, but most providers felt ill-prepared to counsel young people.

Counselling the young requires special training, particularly to reach those who have been raped, threaten suicide, plan to harm their partners, or plan to leave home or school.


Research and experience have identified qualities of effective, youth-friendly VCT programmes:

  • Service providers trained to counsel youth about HIV.
  • Use of a separate room or alternate site so youth will not encounter family members or adults they know when seeking VCT.
  • Free or reduced price of tests for young people.
  • Referral system for young clients.
  • Outreach to schools and youth groups.
  • Multimedia campaigns to inform youth about VCT.
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