A 10-step strategy to prevent HIV/AIDS among young people.

This "10-Step Strategy" was released during the International AIDS Conference in Barcelona to help countries as well as communities develop their own HIV/AIDS program guidelines based on individual situations and needs.

1. End the silence, stigma, and shame

National and community leadership must break the silence, challenge the stigma, and eliminate the shame associated with HIV/AIDS. They must have the courage to talk openly and without judgment about adolescent sexuality, about violence against girls and women, and about drug use.

Policymakers must ensure that adolescents have the information, services, and support they need. Leaders must marshal the necessary financial resources for the fight against AIDS and develop strategies based on thorough analysis of the local situation.

In countries where strong political leadership has fostered openness about the issues and wide-ranging responses--such as Brazil, Senegal, Thailand, and Uganda--the tide is turning.

2. Provide knowledge and information

Young people cannot protect themselves if they do not know the facts about HIV/AIDS. Adolescents must learn the facts before they become sexually active, and the information must be regularly reinforced both in the classroom and beyond.

Increasing knowledge through schools. Good-quality education fosters analytical thinking and healthy habits. Better educated young people are more likely to acquire the knowledge, confidence, and social skills to protect themselves from HIV. Prevention education should be timely, age-appropriate, and relevant to the situations and culture of the young people and their families.

Increasing knowledge through communities. Parents as well as community and religious leaders need to recognize the importance of their own roles in providing life-saving information and skills.

For example, health workers in Masaka, Uganda, have taken on the role of traditional sengas (usually paternal aunts) who give guidance to adolescent girls. In rural Zambia, birth attendants and traditional chiefs travel in teams to deliver the facts about HIV and lift the taboo on providing sexuality education to young adolescents.

Increasing knowledge through the media. The media is a powerful weapon against HIV/AIDS. Good programming can counter popular misconceptions about adolescents, reveal the discrimination and abuse young people face, and highlight the contributions they make to their communities.

Different types of theater and entertainment have also been used to break the silence surrounding HIV/AIDS. In Brazil, for example, street theater is part of a program for young people that helps increase their condom use. In South Africa, the weekly television drama Soul Buddyz runs in tandem with a radio series.

3. Provide life skills to put knowledge into practice

Young people cannot change their behavior by knowledge alone. They need skills to put what they learn into practice.

Life skills--involving negotiation, conflict resolution, critical thinking, decision-making, and communication--are vital for young people. These skills will help them learn to relate to one another as equals, work in groups, build self-esteem, peacefully resolve disagreements, and resist both peer and adult pressure to take unnecessary risks. They can be taught in many creative and innovative ways, both in and out of school.

In Bangladesh, life skills training is linked to. other training programs related to developing marketable skills and employment opportunities. Over 20,000 young women have received such training through the Bangladesh Centre of Mass Education and Science.

4. Provide youth-friendly health services

The services to help prevent HIV and other sexually transmitted diseases include access to condoms as well as access to voluntary HIV counseling and testing. For young women who are preguant and HIV positive, the clinics can provide information and services to help them avoid transmitting HIV to their infants.

In Thailand, "health corners" for adolescents are part of many health clinics. Teams of nurses and social workers provide counseling on sexual health and arrange referrals for young people requiring medical care.

5. Promote voluntary and confidential HIV counseling and testing

Nine out of 10 people living with HIV/AIDS do not know they are infected. Yet studies show that young people have a strong interest in knowing their HIV status.

Voluntary and confidential HIV counseling and testing is an important tool for preventing HIV. This allows adolescents to evaluate their behavior and its consequences. For example, a negative test result offers a key opportunity for a counselor to reinforce the importance of safety and risk-reduction behaviors. Young people who test positive for HIV must receive referrals for medical care and must talk to individuals who can help them understand what their HIV-positive status means as well as the responsibilities they have to themselves and others.

Despite the importance of such counseling and testing, fewer than 50 percent of young people in many countries know where they can receive such help. For example, only 16 percent of girls 15 to 19 years of age in Cambodia know where to go for tests.

6. Work with young people and promote participation

Energetic, enthusiastic, and creative young people are a tremendous resource in all areas of HIV prevention and care. Their input is invaluable in developing program design and outreach, ensuring that prevention and care efforts are meaningful to their peers, and making certain that information is communicated through effective channels.

Involving young people in prevention efforts educates them about HIV and gives them a sense of responsibility and pride. With the right skills, young people are extremely effective messengers in reaching high-risk individuals and groups.

7. Engage young people living with HIV/AIDS

A major challenge in HIV prevention, is to convince young people that HIV/AIDS can strike anyone. One of the most effective ways to accomplish this is to get young people living with HIV/AIDS to share their experiences.

Young people living with HIV/AIDS are in a strategic position to reinforce information about the need to adopt and maintain safe behaviors. They, more than anyone else, can convey the message that individuals must make every effort to ensure that no one contracts HIV from them.

They can also reduce the stigma associated with HIV by showing that the virus can infect anyone and can serve as effective role models for living productive lives.

8. Create safe and supportive environments

Providing young people with information and skills without ensuring that they feel safe and supported at home, at school, and in their community severely limits their ability to protect themselves from HIV.

Parents, schools, and social institutions need the knowledge and skills to create an environment in which young men and women are safe from harm, are cared for equally, and are treated with respect.

Schools and communities must condemn sexual violence, abuse, and exploitation. Governments must make sexual violence unacceptable by enacting and enforcing laws that protect young women and men from all forms of sexual violence, inside and outside of marriage, as well as imposing criminal penalties on their abusers. Media and education campaigns must encourage equality between men and women and denounce all forms of violence against women, children, and adolescents.

9. Reach out to young people most at risk

Those young people especially at high risk for contracting HIV--young men having sex with men, children living on the street, child soldiers, young refugees, children orphaned by AIDS, and others--are often on the periphery of society and face enormous difficulties obtaining help.

These individuals need access to livelihoods, education, and services to help them to build their future. Interventions must take into account the range of constraints they face and help to establish an environment marked by respect, acceptance, and stability. This is key to helping them to integrate into society.

10. Strengthen partnerships, monitor progress

Protecting young people from HIV is too big a job for any one sector of society. To make a real and lasting difference, the commitment and resources of all sectors must be mobilized, coordinated, and channeled to families and communities. There must be a commitment to bring people together at every level--community, nation, region, world--to invest in young people.

The partners must include nongovernmental and civil society organizations, including faith-based groups and the private sector; governments; young people; academic and research institutions; private foundations; bilateral donor agencies; and the United Nations and other multilateral agencies.

Defeating HIV/AIDS will also require tracking change, both in the infection rates and in the knowledge, awareness, and behavior of young people. Collecting information on their knowledge and behavior will not only help to monitor progress but will also help to identify which programs are succeeding and why.

These strategies are excerpted and adapted from Young People and HIV/AIDS: Opportunity in Crisis developed by the United Nation's Children's Fund (UNICEF), the Joint United Nations Programme on HIV/AIDS (UNAIDS), and the World Health Organization (WHO).