Printable Version

JHU/CCP

Contents

• Editors' Summary
• Credits

1. The Invisible Epidemic
2. How Young People Become Infected
3. Why So Vulnerable?
4. Addressing the Epidemic
5. Reaching Out
6. Consequences of Inaction
7. HIV/AIDS: What Young People Want to Know
8. Profiles
9. Youth at the Center

• Figures
• Tables
• Side-bars
• Bibliography

• Why young women face more risk
• Culture can hurt
• Profile: Going public
• Education should start early
• Condoms for dual protection
• Orphans: A new challenge
• What can parents do?
• Reaching street children
• Putting youth at the center

• POPLINE
• Other Issues
• To order copies
• CCP Home Page

Published by the Population Information Program, Center for Communication Programs, The Johns Hopkins University Bloomberg School of Public Health, 111 Market Place, Suite 310, Baltimore, Maryland 21202, USA.

Youth and HIV/AIDS

Can We Avoid
           Catastrophe?

Today's young people are the AIDS generation. They have never known a world without HIV. Millions already have died. Yet the HIV/AIDS epidemic among youth remains largely invisible to adults and to young people themselves. Stopping HIV/AIDS requires comprehensive strategies that focus on youth.

Of the over 60 million people who have been infected with HIV in the past 20 years, about half became infected between the ages of 15 and 24. Today, nearly 12 million young people are living with HIV/AIDS. Young women are several times more likely than young men to be infected with HIV. In nearly 20 African countries 5% or more of women ages 15 to 24 are infected. Such statistics underscore the urgent need to address HIV/AIDS among youth.

Physical, psychological, and social attributes of adolescence make young people particularly vulnerable to HIV and other sexually transmitted infections (STIs). Adolescents often are not able to comprehend fully the extent of their exposure to risk. Societies often compound young people's risk by making it difficult for them to learn about HIV/AIDS and reproductive health. Moreover, many youth are socially inexperienced and dependent on others. Peer pressures easily influence them—often in ways that can increase their risk.

Recent declines in incidence of HIV/AIDS in a few countries, accompanied by signs that young people are changing their risk-taking behavior, give hope. AIDS today is widely seen as a social crisis as well as a problem of individual behavior. The AIDS epidemic is complex, and thus only a combination of approaches can succeed. It is increasingly clear, however, that youth must be at the center of strategies to control HIV/AIDS.

Building support for AIDS prevention. Until more leaders speak out about the AIDS crisis among youth and give it top priority for funding and action, there is little hope of a solution.

Offering education and communication. Young people need help to become aware of risks for HIV/AIDS and how to avoid them. Education and communication programs must go beyond merely offering information to fostering risk-avoidance skills as well, such as delay of sexual debut, abstinence, and negotiation with sex partners. HIV/AIDS education should begin early, even before children become sexually active.

Addressing cultural and social norms. Many traditions and cultural practices increase risks for young people more than adults and for young women even more than young men. Efforts to involve communities and to change social norms are as crucial as efforts to reduce individual risk-taking.

Promoting condoms for dual protection. Condoms—the only contraceptive method that can protect against HIV as well as against pregnancy—are vital to controlling HIV/AIDS among youth. Condoms should be widely accessible, and their use promoted among sexually active people of all ages.

Making services youth-friendly. To serve young people better, health care providers must do more to make young people feel welcome and comfortable. Services, including treatment of STIs and voluntary HIV counseling, testing, and referral, should be provided confidentially and sensitively.

Reaching out. Programs need to reach out to street children, sex workers, and other vulnerable youth, including the millions of young people orphaned by AIDS. Most programs for youth work better when young people help plan and run them. Programs must also find more effective ways to reach parents and other adults who can influence young people's lives.

All countries can and must develop strategies to address HIV/AIDS. The health sector alone cannot overcome this epidemic. Now is the time to act. It is already too late for many youth. Even if HIV risk were cut in half by 2015, in some countries 20% to 80% of today's 15-year-old boys still would die of AIDS. In some places the prospects for youth who survive are declining as teachers and other leaders die of AIDS and as productivity slows. Only acting decisively now to control HIV can ensure that today's young people will have a future as adults.