The global impact of HIV/AIDS on young people.This article provides an overview of the impact of HIV/AIDS HIV/AIDS Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome on young people around the world, generally defined as those between the ages of 10 and 24. It uses a variety of sources and studies. Readers are cautioned that global data sets and studies specific to young people are in short supply; therefore, country- or community-specific information is often used to illustrate key points.
Because of its focus on young people, this article does not discuss mother-to-child transmission mother-to-child transmission Vertical transmission, see there (MTCT MTCT Mother to Child Transmission
MTCT Manipulator/Teleoperator Control Technology
MTCT Memphis Through Cairo Terms (barge freight on cargo originating on this stretch of the Mississippi River)
MTCT Modified Truncated Cone Target ); however, MTCT remains a major route of transmission in some parts of the world and contributes to the number of young people living with HIV HIV (Human Immunodeficiency Virus), either of two closely related retroviruses that invade T-helper lymphocytes and are responsible for AIDS. There are two types of HIV: HIV-1 and HIV-2. HIV-1 is responsible for the vast majority of AIDS in the United States. or at increased risk of infection.
HIV/AIDS prevalence among young people is already high in many hard-hit countries around the world, and young people continue to make up a significant proportion of new infections.
Prevalence and incidence. There are an estimated 40 million people living with HIV/AIDS worldwide, more than a third of whom (38 percent) are under the age of 25. (1) They account for 33 percent of adults ages 15 to 49 estimated to be living with HIV/AIDS.
Of the five million people newly infected in·fect
tr.v. in·fect·ed, in·fect·ing, in·fects
1. To contaminate with a pathogenic microorganism or agent.
2. To communicate a pathogen or disease to.
3. To invade and produce infection in. with HIV in 2001, almost six in 10 (58 percent) were under the age of 25. Those 15 to 24 years of age represented four in 10 of these new infections. Young people ages 15 to 24 account for half of all new infections among individuals 15 to 49. This amounts to almost 6,000 infections per day among 15 to 24-year-olds, or approximately one every 15 seconds. When infections among children under the age of 15 are factored in, an estimated 8,000 young people become infected with HIV every day worldwide. (2)
In regions where the epidemic is mostly related to heterosexual heterosexual /het·ero·sex·u·al/ (-sek´shoo-al)
1. pertaining to, characteristic of, or directed toward the opposite sex.
2. one who is sexually attracted to persons of the opposite sex. transmission, new HIV infections occur disproportionately dis·pro·por·tion·ate
Out of proportion, as in size, shape, or amount.
dispro·por among girls and young women. In regions where injection drug use and male-to-male sexual contact are primary modes of transmission, rates of new infections among young men exceed or are equal to those among young women. (3)
Overall, most people newly infected with HIV or already living with HIV/AIDS are in sub-Saharan Africa. Among young people, approximately three quarters (76 percent) of those already infected live in this region, (4) as do over 90 percent of the world's AIDS orphans (some 12.1 million children). Children orphaned or·phan
a. A child whose parents are dead.
b. A child who has been deprived of parental care and has not been adopted.
2. A young animal without a mother.
3. by AIDS are more likely to become or remain impoverished im·pov·er·ished
1. Reduced to poverty; poverty-stricken. See Synonyms at poor.
2. Deprived of natural richness or strength; limited or depleted: and to become infected themselves. (5)
In sub-Saharan Africa, as many as 11 percent of young women and six percent of young men age 15 to 24 are estimated to already be living with HIV/AIDS. Within the region, Botswana and Lesotho have the highest proportions of infected youth. In Botswana, for example, up to 45 percent of young women and 19 percent of young men age 15 to 24 are estimated to be living with HIV. (6) In Lesotho, up to 51 percent of young women and 23 percent of young men are estimated to be living with HIV. (6)
Countries in other regions of the world also have high HIV/AIDS prevalence rates among youth. Approximately 15 percent of young people living with HIV/AIDS are in the East/South Asia and Pacific region of the world. (7) In Cambodia, as many as three percent of young women are estimated to be infected, as are one percent of young men. In Haiti, HIV prevalence is as high as seven percent for young women and five percent for young men. (8)
Even in developed countries that have had important successes in prevention and treatment leading to reductions in new infections, morbidity, and mortality, such as the United States United States, officially United States of America, republic (2005 est. pop. 295,734,000), 3,539,227 sq mi (9,166,598 sq km), North America. The United States is the world's third largest country in population and the fourth largest country in area. , recent data indicate a rise in incidence among some young populations. Young people under the age of 25 continue to represent as many as half of new infections. (9)
Nations with young populations hard hit. High rates of HIV infection among young people are, for the most part, occurring in countries with very young populations. Sub-Saharan Africa is one of the youngest regions of the world. Over half of its population is estimated to be under the age of 18 (with one in four people between the ages of 10 and 19). (10) In Zambia, Malawi, Kenya, and Mozambique, over half of the population is below the age of 18. In South Africa South Africa, Afrikaans Suid-Afrika, officially Republic of South Africa, republic (2005 est. pop. 44,344,000), 471,442 sq mi (1,221,037 sq km), S Africa. , more than 40 percent of the population is below the age of 18.
Hard-hit countries in other regions of the world also have young populations. Almost half of Haiti's population is below 18. By comparison, about a third of the world's population is below the age of 18, and slightly more than one quarter of the U.S. population is below 18. (11) The confluence confluence /con·flu·ence/ (kon´floo-ins)
1. a running together; a meeting of streams.con´fluent
2. in embryology, the flowing of cells, a component process of gastrulation. of high HIV/AIDS prevalence and disproportionately young populations results in a concentration of infections among young people that has vast and long-term consequences for the course of the epidemic and for the future of many highly-affected countries.
The National Intelligence Council, part of the Central Intelligence Agency, has identified a number of countries with "youth bulges" (defined as those in which the ratio of 15- to 29-year-olds to 30- to 54-year-olds exceeds 1.27.) (12) Most of these are in sub-Saharan Africa and correspond to those countries with already-high prevalence of HIV among young people. Of the 25 sub-Saharan countries with youth bulges, over half have prevalence rates of HIV among young males and/or females higher than 10 percent. (13)
Analysis of data from the U.S. Census Bureau Noun 1. Census Bureau - the bureau of the Commerce Department responsible for taking the census; provides demographic information and analyses about the population of the United States
Bureau of the Census (14) indicate that the youth bulges will increase in many highly affected countries, including Botswana, Burundi, Lesotho, and Mozambique, due in part to the effects of the epidemic (as those in slightly older cohorts die prematurely).
The HIV/AIDS epidemic is expected to have far-reaching demographic impacts on many nations, affecting the population structures of hard-hit countries. (15) Teens and young adults will be increasingly affected.
Prevalence among young people. The U.S. Census Bureau estimates that HIV/AIDS prevalence rates among adults age 15 to 49 will continue to rise at least through 2010 in many hard-hit countries in Africa, Asia, and Latin America Latin America, the Spanish-speaking, Portuguese-speaking, and French-speaking countries (except Canada) of North America, South America, Central America, and the West Indies. . (16)
The number of young people living with HIV/AIDS is also expected to grow over the next decade. Analysis of U.S. Census Bureau data indicates that if current trends persist, the global total of young people living with HIV/AIDS could rise from the current estimate of 12.4 million to 21.5 million in 2010, an increase of more than 70 percent. (17) This estimate is based on analysis of data from 49 highly affected countries in Africa, Asia, and Latin America, which represent approximately 75 percent (or 9.3 million) of the global estimate of young people currently living with HIV/AIDS.
AIDS-related deaths. One of the most direct measures of the epidemic's impact is mortality. In countries where 15 percent or more of all adults are estimated to be infected with HIV--nine countries as of the end of 2001--it has been projected that at least one-third of boys now aged 15 will die of AIDS unless treatment improvements or a vaccine is introduced. (18) In Botswana, where prevalence is particularly high, a 15 year-old now has about an 80 percent chance of dying of AIDS. (19)
Deaths due to HIV/AIDS are premature deaths Premature Death occurs when a living thing dies of a cause other than old age. A premature death can be the result of injury, illness, violence, suicide, poor nutrition (often stemming from low income), starvation, dehydration, or other factors. , and many who die from AIDS-related causes were infected as teens and young adults. (20) UNAIDS UNAIDS Joint United Nations Programme on HIV/AIDS estimated that the survival time from HIV infection to death in sub-Saharan Africa is approximately eight to nine years. (21) As such, most of those who die from AIDS-related causes between the ages of 20 and 34 were infected an average of eight to nine years earlier, as teens or younger adults. U.S. Census Bureau data from 50 highly affected countries were analyzed to assess this impact. (22)
In these 50 countries, it is projected that, between 1990 and 2010, a total of 26.7 million people age 20 to 34 will have died from AIDS-related causes. The majority (59 percent) of these deaths will be among young women. In addition, most of these deaths will occur in the current decade (78 percent or 20.7 million between 2000 and 2010).
Population growth rates Growth Rates
The compounded annualized rate of growth of a company's revenues, earnings, dividends, or other figures.
Remember, historically high growth rates don't always mean a high rate of growth looking into the future. . In addition to the direct measures of HIV/AIDS prevalence and HIV-related mortality, the epidemic will also have broader population affects. Growth rates for populations in many countries have already been reduced. The U.S. Census Bureau estimates that AIDS will result in negative population growth in several countries before the year 2010, including Botswana, Lesotho, Mozambique, South Africa, and Swaziland. Several other countries are estimated to experience flat growth rates by the year 2010, including Namibia and Zimbabwe. Population growth rates are also expected to be affected in Latin America, the Caribbean, and Asia. (23)
Life expectancy Life Expectancy
1. The age until which a person is expected to live.
2. The remaining number of years an individual is expected to live, based on IRS issued life expectancy tables. . HIV/AIDS has also affected life expectancy, the average age to which a person born today can be expected to live. Due to HIV/AIDS, life expectancy in many hard-hit countries has already been reduced and could drop below age 30 in some countries by the year 2010, reversing steady gains over the last century. (24)
Life expectancy in Botswana, for example, is projected to decrease to 27 years by 2010, a net decrease of 47 years due to AIDS. In Zimbabwe, life expectancy is projected to be 35 years in 2010, a net decrease of 36 years. (25)
Several factors make youth particularly vulnerable to HIV infection, including their biological and emotional development and their financial dependence. In many parts of the world, young people have limited access to health care services and reliable information about sexual activity and its implications. They are often unlikely or unable to protect themselves appropriately as they demonstrate an inclination to sexual experimentation, often with multiple partners. (26)
These sexual behaviors sexual behavior A person's sexual practices–ie, whether he/she engages in heterosexual or homosexual activity. See Sex life, Sexual life. , and sex in conjunction with drug and/or alcohol use, may increase the likelihood of becoming infected with HIV. In addition, young people's sense of invulnerability in·vul·ner·a·ble
1. Immune to attack; impregnable.
2. Impossible to damage, injure, or wound.
[French invulnérable, from Old French, from Latin ("it can't happen (programming) can't happen - The traditional program comment for code executed under a condition that should never be true, for example a file size computed as negative. Often, such a condition being true indicates data corruption or a faulty algorithm; it is almost always handled to me"), combined with lack of experience, may leave them unaware of the consequences of their actions and therefore less likely to take precautions precautions Infectious disease The constellation of activities intended to minimize exposure to an infectious agent; precautions imply that the isolation of an infected Pt is optional, but not mandatory. against risk of infection. (27)
Awareness and knowledge. Surveys indicate that although many young people across the world have now heard about the HIV/AIDS epidemic, awareness is not universal. UNICEF UNICEF (y`nĭsĕf'), the United Nations Children's Fund, an affiliated agency of the United Nations. reports that in more than a dozen countries, over half of young people had never heard of AIDS. (28)
In addition, awareness does not necessarily translate into practical knowledge: a significant percentage of at-risk young people may still be unaware of how to protect themselves or harbor misconceptions Misconceptions is an American sitcom television series for The WB Network for the 2005-2006 season that never aired. It features Jane Leeves, formerly of Frasier, and French Stewart, formerly of 3rd Rock From the Sun. about HIV transmission. Surveys in 17 countries found that one in two adolescents could not name a single method of protecting themselves from HIV infection (with girls knowing less than boys in all instances). (29) Researchers working in Mozambique found that 74 percent of young women and 62 percent of young men (age 15 to 19) were unaware of any way to protect themselves from HIV. (30) A recent survey of young South Africans This is a list of notable South Africans with Wikipedia articles. Academics, Medical and Scientists
Awareness of HIV/AIDS among young people may also not translate into a perception of personal risk, even among those in countries with very high prevalence. (32) This may be in part due to a lack of visibility of HIV-positive youth, with most young people living with HIV not even knowing they are infected. (33)
Health experts note that the availability of appropriate youth-targeted information varies across regions and within nations and communities. Social, religious, and economic influences lead to widely-varying opinions on how and what to provide to young people concerning HIV prevention. (34) In some places, therefore, young people may be more vulnerable because they are less likely to know enough about HIV to protect themselves. (35)
Lack of information, particularly when it relates to sexual behavior, can bring unintended and potentially dangerous results. For example, some heterosexual youth, to avoid pregnancy and maintain virginity Virginity
See also Chastity, Purity.
patron saint of virgins. [Christian Hagiog.: Brewer Dictionary, 16]
Indian maiden learns too late she can be released from her vow to remain a virgin. [Fr. Lit. , may engage in alternatives to vaginal vag·i·nal
1. Of or relating to the vagina.
2. Relating to or resembling a sheath.
pertaining to the vagina, the tunica vaginalis testis, or to any sheath. intercourse such as anal or oral sex, believing these practices are not "having sex" (and therefore carry no risk, even though anal sex Noun 1. anal sex - intercourse via the anus, committed by a man with a man or woman
anal intercourse, buggery, sodomy
sexual perversion, perversion - an aberrant sexual practice; is one of the most efficient ways to transmit HIV, and oral sex, not as risky, is not entirely safe). (36)
Other sexually transmitted diseases Sexually transmitted diseases
Infections that are acquired and transmitted by sexual contact. Although virtually any infection may be transmitted during intimate contact, the term sexually transmitted disease is restricted to conditions that are largely . Being infected with another sexually transmitted disease sexually transmitted disease (STD) or venereal disease, term for infections acquired mainly through sexual contact. Five diseases were traditionally known as venereal diseases: gonorrhea, syphilis, and the less common granuloma inguinale, (STD (Subscriber Trunk Dialing) Long distance dialing outside of the U.S. that does not require operator intervention. STD prefix codes are required and billing is based on call units, which are a fixed amount of money in the currency of that country. ) also increases the likelihood of both acquiring and transmitting HIV. (37) The prevalence of STDs other than HIV among youth is high. (38) A broad, cross-national survey of STD data among developed countries (North American North American
named after North America.
North American blastomycosis
see North American blastomycosis.
North American cattle tick
see boophilusannulatus. , European, and Scandinavian countries Noun 1. Scandinavian country - any one of the countries occupying Scandinavia
European country, European nation - any one of the countries occupying the European continent plus Russia and Romania) found that syphilis syphilis (sĭf`əlĭs), contagious sexually transmitted disease caused by the spirochete Treponema pallidum (described by Fritz Schaudinn and Erich Hoffmann in 1905). , gonorrhea gonorrhea (gŏnərē`ə), common infectious disease caused by a bacterium (Neisseria gonorrhoeae), involving chiefly the mucous membranes of the genitourinary tract. , and chlamydia chlamydia (kləmĭd`ēə), genus of microorganisms that cause a variety of diseases in humans and other animals. Psittacosis, or parrot fever, caused by the species Chlamydia psittaci, disproportionately affect adolescents and young adults, with generally higher incidence among females than males. (39)
In the United States, it is estimated that two-thirds of the 12 million cases of STDs diagnosed annually are among people under the age of 25. (40) In England and Wales England and Wales are both constituent countries of the United Kingdom, that together share a single legal system: English law. Legislatively, England and Wales are treated as a single unit (see State (law)) for the conflict of laws. , cases of gonorrhea and syphilis-again documented disproportionately among young people-have hit their highest levels in more than a decade. (41)
Data from developing countries are more limited. The World Health Organization (WHO) reports that age-specific data from developing countries show peak incidence of STDs among those 15 to 29. Studies of gonorrhea in several African and Middle Eastern nations found the highest levels of infection among those in this same age group, with the highest among those aged 15 to 19. (42)
Of or involving both social and economic factors.
of or involving economic and social factors
Adj. 1. factors. Most young people at risk for HIV infection or already living with HIV/AIDS reside in the world's poorest regions. Their vulnerability to HIV operates within a broader context of poverty, which may include lack of access to education, economic opportunities, and health-related services.
Formal educational systems can contribute directly and indirectly to the impact of HLV HLV Heavy Lift Vehicle
HLV Hessischen Leichtathletik-Verbandes (German)
HLV Heavy Lift Vessel
HLV Hasta La Vista
HLV HTML Link Validator
HLV Human Living Vampire
HLV Hazard Limiting Value
HLV Helensville on young people. Teachers and schools can improve awareness of risk and teach strategies for protection through good-quality sexual health education programs, which help delay initiation of sexual behavior and protect sexually active youth from HIV, STDs, and pregnancy. (43)
However, educational systems in many countries, already struggling before the spread of AIDS, have been significantly affected by the epidemic. About one million African children and young people are estimated to have lost their teachers to AIDS in 2001. (44) Prior gains in school enrollment, resulting from increased investments by many developing countries, have been adversely affected as teachers succumb suc·cumb
intr.v. suc·cumbed, suc·cumb·ing, suc·cumbs
1. To submit to an overpowering force or yield to an overwhelming desire; give up or give in. See Synonyms at yield.
2. To die. to AIDS or leave to seek health care. (45) Students who are infected may be stigmatized and/or pressured to leave. (46) Students orphaned by AIDS are often unable to pay educational fees and, if forced to leave school, face increased risk of poverty and HIV infection. (47) Girls may be particularly affected by this phenomenon because they are often the first to be taken from school when sick parents need help or their families need income. (48)
Lack of economic opportunity is also an important contributor to HIV-related vulnerability This is particularly true of girls and young women, who have less access to and control over income, property, land, and credit. (49) Though the extent of gender disparities in economic opportunity vary from country to country, they are ubiquitous. (50)
Without options, young women may exchange sex for money, shelter, or safety-often under threat of violence. (51) Studies of unmarried adolescents in several sub-Saharan countries have found that 13 to 38 percent of girls have received or been given money or gifts in exchange for sex. (52)
Alternatively, because they have nowhere else to go, they may be forced to remain in relationships with partners who are violent or are believed or known to be infected with HIV. (53) Young women often lack the power to insist on the use of condoms. (54)
Lack of economic opportunity is not just a problem for women. Gay and bisexual bisexual /bi·sex·u·al/ (-sek´shoo-al)
1. pertaining to or characterized by bisexuality.
2. an individual exhibiting bisexuality.
3. pertaining to or characterized by hermaphroditism.
4. (and sometimes heterosexual) boys and young men in many countries trade sex for money, drugs, or shelter with wealthier men--both for survival and to enhance income. (55)
HEALTH CARE ACCESS
Systemic disparities in access to health care for young people can heighten height·en
v. height·ened, height·en·ing, height·ens
1. To raise or increase the quantity or degree of; intensify.
2. To make high or higher; raise.
v.intr. vulnerability to HIV. Many of the countries hardest hit by HIV/AIDS lack sufficient infrastructure and resources to deliver needed HIV-related services, including prevention and treatment services, HIV counseling and testing, and mental health care. (56) In addition, there are some persistent barriers to these health services health services Managed care The benefits covered under a health contract for youth in developing and developed nations alike--lack of privacy and confidentiality, staff insensitivity in·sen·si·tive
1. Not physically sensitive; numb.
a. Lacking in sensitivity to the feelings or circumstances of others; unfeeling.
b. to young people's special needs and perspectives, lack of affordable services, and lack of services geared toward adolescents ("teen friendly"). (57) Health care access may worsen wors·en
tr. & intr.v. wors·ened, wors·en·ing, wors·ens
To make or become worse.
to make or become worse
worsening adjn as the burden of caring for so many millions of people suffering from AIDS-related illnesses takes an increasing toll on health infrastructures. (58)
Stigma stigma: see pistil.
mark of Cain
God’s mark on Cain, a sign of his shame for fratricide. [O. T.: Genesis 4:15]
scarlet letter may also play a role in young people's willingness to seek services. (59) Young women and girls, for example, may avoid health care services, including HIV testing HIV test Various tests have been used to detect HIV and production of antibodies thereto; some HTs shown below are no longer actively used, but are listed for completeness and context. See HIV, Immunoblot. and treatment for STDs, because of fear of stigmatization stigmatization /stig·ma·ti·za·tion/ (stig?mah-ti-za´shun)
1. the developing of or being identified as possessing one or more stigmata.
2. the act or process of negatively labelling or characterizing another. or even of violence--particularly if it becomes known that they're sexually active (before or outside of marriage) or infected with HIV. (60)
THE MOST VULNERABLE
Certain subpopulations of youth have been identified as bearing a disproportionate dis·pro·por·tion·ate
Out of proportion, as in size, shape, or amount.
dispro·por share of HIV's proliferation proliferation /pro·lif·er·a·tion/ (pro-lif?er-a´shun) the reproduction or multiplication of similar forms, especially of cells.prolif´erativeprolif´erous
n. and/or are at increasing risk: young women and girls, young men who have sex with men Men who have sex with men (MSM) is a term used mostly in the United States to classify men who engage in sex with other men, regardless of whether they self-identify as gay, bisexual, or heterosexual. , injecting drug users, sex workers, and children who have been orphaned by AIDS. (61)
Young women and girls. Women comprise an increasing proportion of adults living with HIV/AIDS, rising from 41 percent in 1997 to 50 percent in 2001. (62) In sub-Saharan Africa, women represent more than half of all people living with HIV/AIDS. (63)
Prevalence of HIV is typically higher among young women in sub-Saharan Africa, (64) who represent the majority of young people living with HIV/AIDS in that region and in Asia. (65) Among women, peak HIV prevalence is around age 25, while in men it occurs 10 to 15 years later and generally at lower levels. (66) Infections among South African girls, for example, peak at age 15 to 19; among boys they peak at age 20 to 24. (67)
In some of the most affected countries, the rates of new HIV infections among girls are as much as five to six times higher than those among boys. (68) In Botswana, for example, up to 45 percent of women age 15 to 24 are estimated to be HIV positive, about twice the proportion of HIV-positive men in the same age group. (69)
Although it is most pronounced there, this trend is not unique to the developing world. In the United States, women now represent 30 percent of new HIV infections and an increasing proportion of new AIDS cases as well (rising from seven percent in 1985 to 25 percent in 2001). (70)
Biologically, the risk of becoming infected with HIV during unprotected vaginal intercourse is greater for women than men. (71) The immaturity im·ma·ture
1. Not fully grown or developed. See Synonyms at young.
2. Marked by or suggesting a lack of normal maturity: silly, immature behavior. of young women's reproductive organs Reproductive organs
The group of organs (including the testes, ovaries, and uterus) whose purpose is to produce a new individual and continue the species.
Mentioned in: Choriocarcinoma makes them even more vulnerable than mature women to HIV infection by providing enhanced opportunity for exposure and infection. (72)
Cultural and economic factors also contribute to increased vulnerability of young women and girls. For example, lack of economic autonomy may induce young women to partner with older men for protection and support. (73) Growing evidence suggests that sexual relationships between older men and younger women are responsible for much of the gender disparity dis·par·i·ty
n. pl. dis·par·i·ties
1. The condition or fact of being unequal, as in age, rank, or degree; difference: "narrow the economic disparities among regions and industries" between young women's and men's infection rates and for the increasing numbers of infections among younger girls. (74)
Young women who have sex with older partners are at greater risk for infection because these older partners are more likely to be infected than age-equivalent partners would be. (75) In some countries, younger and younger girls are put at risk because some men are seeking partners who are not infected, fueled in part by an expectation that younger girls are less likely to be infected or by a misguided mis·guid·ed
Based or acting on error; misled: well-intentioned but misguided efforts; misguided do-gooders.
mis·guid belief that having intercourse with a virgin will cure or prevent AIDS. (76)
Condoms, though effective in reducing the risk of HIV transmission, require that the male partner agree to their use. Insisting that a partner (or husband) wear a condom 1. condom - The protective plastic bag that accompanies 3.5-inch microfloppy diskettes. Rarely, also used of (paper) disk envelopes. Unlike the write protect tab, the condom (when left on) not only impedes the practice of SEX but has also been shown to have a high failure might be interpreted as a challenge to long-accepted rules, and could raise questions about loyalty, fidelity, and trust. (77)
As mentioned previously, sexual violence and coercion coercion, in law, the unlawful act of compelling a person to do, or to abstain from doing, something by depriving him of the exercise of his free will, particularly by use or threat of physical or moral force. put women at risk of infection and may keep those already HIV-positive from seeking available care. UNAIDS reports that some new cases of HIV infection among women are caused by gender-based violence in their homes, schools, work places, and social spheres. (78) In South Africa, for example, a woman who made her HIV infection public was stoned to death by neighbors who felt she had brought shame upon their community. (79)
Young gay and bisexual men. Because of the efficiency of anal intercourse Noun 1. anal intercourse - intercourse via the anus, committed by a man with a man or woman
anal sex, buggery, sodomy
sexual perversion, perversion - an aberrant sexual practice; as a mode of transmitting HIV, men who have unprotected sex Unprotected sex refers to any act of sexual intercourse in which the participants use no form of barrier contraception. Sexually transmitted infections
Specifically, unprotected sex with men are at a relatively high risk for HIV Worldwide, approximately five to 10 percent of all HIV infections are due to sexual transmission between men. (80) UNAIDS estimates that male-to-male sexual transmission is a predominant risk factor for HIV in several countries, including the United States, Brazil, Costa Rica Costa Rica (kŏs`tə rē`kə), officially Republic of Costa Rica, republic (2005 est. pop. 4,016,000), 19,575 sq mi (50,700 sq km), Central America. , and Mexico, and may be playing an increasing role in Eastern Europe Eastern Europe
The countries of eastern Europe, especially those that were allied with the USSR in the Warsaw Pact, which was established in 1955 and dissolved in 1991. . (81) The U.S. Centers for Disease Control and Prevention Centers for Disease Control and Prevention (CDC), agency of the U.S. Public Health Service since 1973, with headquarters in Atlanta; it was established in 1946 as the Communicable Disease Center. (CDC See Control Data, century date change and Back Orifice.
CDC - Control Data Corporation ) estimates that half of new AIDS cases reported in the United States in 2000 among males age 13 to 24 were among men who have sex with men (MSMs). (82)
Stigma, social exclusion social exclusion
Sociol the failure of society to provide certain people with those rights normally available to its members, such as employment, health care, education, etc. , and lack of information can result in increased risk-taking among MSMs. (83) These factors make it difficult to obtain accurate data on the extent of MSM MSM - Micronetics Standard MUMPS behaviors and related risks. (84) Many societies outlaw homosexual behavior or in some way officially condemn or ignore its existence. In Vietnam, for example, AIDS cases among MSMs are simply not reported. (85)
Many young MSMs may also be sexually involved with women, acting as "viral bridges" by introducing HIV into the larger population. A UNAIDS survey in Cambodia found that 40 percent of self-identifying MSMs also reported having sex with women in the month before being surveyed. (86) Research in Budapest found that the percentage of men who identified themselves as gay or bisexual but who had sex with a female at least once was high (77 percent), with 26 percent reporting sex with a female within the last year. (87) This same group reported a low rate of condom use for vaginal intercourse (23 percent). (88) Similar rates of bisexual behavior were found in Russian (89) and Brazilian (90) studies.
Despite encouraging reductions in unsafe sex practices in the early 1990s, risky behaviors and HIV infection rates among young MSMs may be on the rise again in the developed world. A recent survey of 23- to 29-year-old MSMs in six U.S. cities found high HIV prevalence rates among Whites (seven percent), Hispanics (14 percent), and particularly Blacks (32 percent). (91) An earlier sample of younger MSMs (15 to 22) in seven U.S. cities found a seven percent overall HIV prevalence rate, with higher rates among Black (14 percent) and Hispanic (seven percent) youth than among Whites (thee percent). (92) Public health experts have expressed concern that recently-noted outbreaks of STDs among MSMs may signal a resurgence of risk-taking among older MSMs and a lack of awareness or concern among younger MSMs. (93)
Young injection drug users. Intravenous injection Noun 1. intravenous injection - an injection into a vein
fix - something craved, especially an intravenous injection of a narcotic drug; "she needed a fix of chocolate" is the quickest and most efficient route of HIV transmission because infected blood is delivered directly into a user's blood stream. Approximately 10 percent of HIV infections globally are due to injection drug use. (94) Eastern Europe and Central Asia are experiencing a rapid spread of HIV due largely to high numbers of youth injecting drugs. (95)
In the Russian Federation Russian Federation: see Russia. , where HIV is predominantly transmitted through injection drug use, HIV is concentrated largely among 18 to 30 year-olds; the average HIV-infected drug user is 24. A 1999 survey of 15 to 16 year-olds in Moscow found that six percent admitted to having used heroin at least once in their lives; also in 1999, 40 percent of clients of a St. Petersburg drug treatment program were young people, up from 13 percent two years earlier. (96)
In Central Asia, 70 percent of injection drug users are under age 25. (97) Canada, China, Latvia, Malaysia, Moldova, Russia, Ukraine, and Vietnam reported that more than half of all new HIV infections in 1998 to 1999 occurred among injection drug users, an increasing percentage of whom are young people. (98)
Children and youth orphaned by AIDS. Children orphaned by AIDS present a significant challenge. Since the epidemic began, an estimated 13.2 million children--most of whom live in the developing world--have lost their mothers or both parents to AIDS. (99)
Prior to the onset of the AIDS epidemic, approximately two percent of children in developing countries were orphans. By 1999 in some African countries the rate was more than 10 percent. In 2000, one child every 14 seconds became an orphan orphan: see adoption; foundling hospital; guardian and ward.
See widow & orphan.
See also Abandonment.
finally, at middle age, discovers origins. [Am. Lit. because of AIDS. (100) This impact is expected to worsen. The United States Agency for International Development The United States Agency for International Development (or USAID) is the U.S. government organization responsible for most non-military foreign aid. An independent federal agency, it receives overall foreign policy guidance from the U.S. (USAID USAID United States Agency for International Development
USAID Agencia de los Estados Unidos para el Desarrollo Internacional (Spanish) ) has estimated that as many as 44 million children will be orphaned by AIDS by 2010. (101)
The impact of HIV/AIDS on children begins well before the death of their parents. Children living in households headed by HIV-positive parents face increased risk of hunger, malnutrition malnutrition, insufficiency of one or more nutritional elements necessary for health and well-being. Primary malnutrition is caused by the lack of essential foodstuffs—usually vitamins, minerals, or proteins—in the diet. , material deprivation, reduced access to school and health care, and increased emotional distress emotional distress n. an increasingly popular basis for a claim of damages in lawsuits for injury due to the negligence or intentional acts of another. Originally damages for emotional distress were only awardable in conjunction with damages for actual physical harm. . (102)
After parents die, in much of the world the burden for caring for orphans falls on families and communities--and particularly on young women. However, these care networks are being overwhelmed o·ver·whelm
tr.v. o·ver·whelmed, o·ver·whelm·ing, o·ver·whelms
1. To surge over and submerge; engulf: waves overwhelming the rocky shoreline.
a. by the magnitude of the needs put upon them, leaving many children vulnerable to malnutrition, exploitation, and abandonment. (103) UNAIDS reports that orphans living with extended families or in foster care are more prone to discrimination, including limited access to health, education, and social services social services
welfare services provided by local authorities or a state agency for people with particular social needs
social services npl → servicios mpl sociales . (104) As alternatives, some children maintain their own households or assume other adult burdens; others take to the streets. (105) Without support systems and resources, they are at substantially increased risk of malnutrition, abuse, illness, and HIV infection. (106)
Communities and societies are impacted as well. The U.S. National Intelligence Council notes that the large number of children orphaned by AIDS, located largely in countries that are already disproportionately young, will strain family systems and contribute to crime and political instability. (107)
Sexually exploited children. The sexual exploitation of children also contributes to increased incidence of HIV transmission. Prostitution prostitution, act of granting sexual access for payment. Although most commonly conducted by females for males, it may be performed by females or males for either females or males. , trafficking, child pornography Child pornography is the visual representation of minors under the age of 18 engaged in sexual activity or the visual representation of minors engaging in lewd or erotic behavior designed to arouse the viewer's sexual interest. , and forced marriages all heighten risk of HIV infection for children and communities within which such practices occur. (108)
Approximately one million children enter the world's sex trade every year, (109) placing them at greater risk for HIV infection. (110) Rates of HIV infection among young sex workers can be high. For example, studies have found HIV prevalence of 17 percent among sex workers in urban Nepal, 72 percent for sex workers under 18 in Mumbai, India, and 30 percent for sex workers age 13 to 19 in Cambodia. (111) Younger sex workers may be particularly vulnerable because of their inexperience Inexperience
See also Innocence, Naïveté.
Bowes, Major Edward
(1874–1946) originator and master of ceremonies of the Amateur Hour on radio. [Am. in negotiating condom use and, as previously mentioned, because their clients may assume that sex with a child or virgin decreases their risk of infection or may even have preventive or curative curative /cur·a·tive/ (kur´ah-tiv) tending to overcome disease and promote recovery.
1. Serving or tending to cure.
2. powers against HIV. (112)
Sexual exploitation of children is exacerbated by the large number of children orphaned by AIDS. These children, parentless and in poverty, increase the pool of those young people vulnerable to exploitation or, in some cases, dependent upon trading sex for survival. (113)
Trafficking in children may also serve to increase the spread of HIV. Reports of children trafficked across continents and oceans to meet "demand" suggest the consistency with which the practice occurs and the potential it brings of increasing the spread of HIV In one case, over 1,000 children were sent from China, Laos, Malaysia, Thailand, and Vietnam to Atlanta, GA, to work as prostitutes. (114)
Several recent prevention reviews demonstrate effectiveness in reducing risky behaviors and HIV transmission. (l15) Few large-scale prevention efforts, however, have been geared toward youth, and youth may need different prevention strategies than older adults. Where they do exist, such efforts have been shown to lead to increased knowledge about HIV/AIDS, delays in sexual activity, and increased condom use among those having sex for the first time. Prevention efforts have also led to reductions in HIV transmission among some populations. (116)
The impact of the epidemic on young people is expected to grow, particularly in hard-hit countries that already have very young populations. Therefore, the level of available resources and how those resources are used will continue to challenge global and national leaders. (117)
Projections of demographic shifting over the next decade and beyond show that-absent significantly enhanced prevention and treatment efforts, and perhaps the introduction of new technologies including microbicides and vaccines-the combination of young populations and the spread of HIV will result in the continued growth of the HIV/AIDS pandemic pandemic /pan·dem·ic/ (pan-dem´ik)
1. a widespread epidemic of a disease.
2. widely epidemic.
Epidemic over a wide geographic area.
Prevention interventions directed at youth will therefore be critical to altering the future course of the pandemic. (118) In fact, where national prevention efforts have been most successful-in Uganda and Thailand-young people are often the first to respond to prevention interventions and to show positive results. (119) In Uganda, for example, HIV prevalence declined significantly among pregnant women, with the greatest decline among those in the youngest age group (15 to 19 years old). In Thailand, HIV prevalence rates declined among young military recruits (a proxy of national success for Thailand's HIV prevention campaign).
A new analysis of the potential impact of different prevention interventions, including increased condom use and a reduction in the number of sexual partners, among young people 15 to 19 years old in South Africa projects significant reductions in HIV incidence and prevalence over time. (120) In addition, projection models demonstrate that even modest changes in behavior-such as increased condom use and STD treatment-can significantly reduce HIV/AIDS prevalence. (121)
This article was excerpted and adapted for the SIECUS SIECUS Sexuality Information and Education Council of the United States Report with permission of The Henry J. Kaiser Henry John Kaiser (May 9, 1882—August 24, 1967) was an American industrialist who became known as the father of modern American shipbuilding. Early life
Beginning as a cashier in a dry-goods shop in Utica, New York, Kaiser moved many times as he pursued the Family Foundation from a report on tile status of the HIV/AIDS epidemic titled Tip of the Iceberg tip of the iceberg
n. pl. tips of the iceberg
A small evident part or aspect of something largely hidden: afraid that these few reported cases of the disease might only be the tip of the iceberg. : The Global Impact of HIV/AIDS on Youth. The foundation is an independent national health philanthropy philanthropy, the spirit of active goodwill toward others as demonstrated in efforts to promote their welfare. The term is often used interchangeably with charity. dedicated to providing information and analysis on health issues to policymakers, the media, and the general public. Go to the Kaiser web site at www.kff.org for tile complete report.
(1.) UNAIDS, AIDS Epidemic Update, December 2001.
(2.) UNAIDS, "UNAIDS Executive Director Calls for Action to Protect Youth from HIV/AIDS," Press Release, May 10, 2002. Available at: www.unaids.org/whatsnew/press/eng/pressarc02/SSyouth100502.html; UNAIDS, AIDS Epidemic Update, December 2001; P. Piot, "Testimony to a Hearing on 'Halting the Global Spread of HIV/AIDS: The Future of U.S. Bilateral and Multilateral mul·ti·lat·er·al
1. Having many sides.
2. Involving more than two nations or parties: multilateral trade agreements. Responses," Committee on Foreign Relations of the United States This article or section has multiple issues:
* Its neutrality is disputed.
* Its neutrality or factuality may be compromised by weasel words.
Please help [ improve the article] or discuss these issues on the talk page. Senate, 2002.
(3.) UNAIDS, AIDS Epidemic Update, December 2001; UNICEF, Progress of Nations, 2000.
(4.) UNICEF, Progress of Nations, 2000; Population Reference Bureau The Population Reference Bureau is a non-governmental organization in the United States, founded in 1929 by Guy Irving Burch, with support of Raymond Pearl. It provides information about demography. , Youth in Sub-Saharan Africa: A Chartbook on Sexual Experience and Reproductive Health Within the framework of WHO's definition of health as a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity, reproductive health, or sexual health/hygiene , April 2000. Available at: www.prb.org/Template.cfm?Section=PRB&template=/Content Management/ContentDisplay.cfm?&ContentID=2821
(5.) UNAIDS. Children and Young People in a World of AIDS, August 2001; S. Hunter and J. Williamson, "Children on the Brink" USAID. 2000. Available at: http://www.dec.org/pdf_docs/PNACJ284.pdf
(6.) UNAIDS (Unpublished data; 2002).
(7.) UNICEF, Progress of Nations, 2000.
(8.) UNAIDS (Unpublished data; 2002).
(9.) CDC. Young People at Risk: HIV/AIDS Among America's Youth, March 11, 2002.
(10.) UNICEF, Progress of Nations, 2000; Population Reference Bureau, Youth in Sub-Saharan Africa: A Chartbook on Sexual Experience and Reproductive Health, April 2000. Available at: www.prb.org/Template.cfm?Section=PRB&template/ContentManagement/Conte ntDisplay.cfm&ContentID=282l
(11.) UNICEF, Progress of Nations, 2000.
(12.) National Intelligence Council (Central Intelligence Agency), "Global Trends 2015: A Dialogue About the Future with Nongovernmental Experts," December 2000. Available at: www.cia.gov/nic/pubs/index.htm.
(13.) UNAIDS (Unpublished data; 2002).
(14.) U. S. Census Bureau. Unpublished data, 2002.
(15.) K. A. Stanecki, U. S. Census Bureau, "The AIDS Pandemic Acquired Immune Deficiency Syndrome (AIDS) has led to the deaths of more than 25 million people since it was first recognized in 1981, making it one of the most destructive epidemics in recorded history. in the 21st Century: The Demographic Impact in Developing Countries." (Paper presented at the 13th International AIDS Conference Education, networking and the promotion of best practice are essential to enhancing the response to HIV/AIDS. IAS conferences provide opportunities to share experience, and increase the knowledge and expertise of professionals working in HIV/AIDS. , July, 2000, Durban, South Africa.); U. S. Census Bureau. Unpublished data, 2002; U. S. Census Bureau. Unpublished data, 2002.
(16.) U. S. Census Bureau. Unpublished data, 2002.
(17.) This projection is based on U.S. Census Bureau estimates of HIV/AIDS prevalence and population size in 49 countries among those ages 15 through 49 through 2010. These data were used to calculate the number of people ages 15 through 49 estimated to be living with HIV/AIDS in each year between 1990 and 2010. The proportion of young people ages 15 through 24 living with HIV/AIDS of those ages 15 through 49, currently estimated at one third, was used to derive an estimate of the number of young people living with HIV/AIDS in these 49 countries in 2010. UNAIDS estimates that there were 12.4 million young people ages 15 through 24 living with HIV/AIDS at of the end of 2001. These 49 countries represented 75 percent of this global estimate (or 9.3 million) in 2001. This proportion was used to extrapolate extrapolate - extrapolation a global estimate of the number of young people living with HIV/AIDS currently and through 2010. Several factors make this global estimate of youth prevalence in 2010 uncertain, but also suggest that it may be conservative. First, this analysis assumes that young people, ages 15 through 24, will continue to make up one third of HIV/AIDS prevalence among those ages 15 through 49 through 2010, and that this proportion is representative of the epidemic in the 49 countries analyzed. Many of these highly affected countries, however, already have very large proportions of young people, proportions that are expected to increase due in part to the effects of AIDS, as those in slightly older cohorts die at disproportionately higher rates. Therefore, teens and young adults may comprise an increasingly greater proportion of those living with HIV/AIDS over time--a number which itself is projected to grow. In addition, this analysis assumes that these 49 countries will continue to represent 75 percent of the global total of youth living with HIV/AIDS in 2010, as they are estimated to represent today Not included in the 49 countries are India, China, and other countries that are projected to have substantial numbers of affected individuals over time. Therefore, this subset of 49 countries may well represent less than 75 percent of global youth with HIV/AIDS prevalence over time, which would result in a higher 2010 projection.
(18.) UNAIDS (Unpublished data; 2002); UNAIDS, Report on the Global HIV/AIDS Epidemic, June 2000; UNAIDS. AIDS and Population, (fact sheet), 2002. Available at: www.unaids.org/fact_sheets/files/Demographic_Eng.html
(19.) P. Piot, "Testimony to a Hearing on 'Halting the Global Spread of HIV/AIDS"; Henry J. Kaiser Family Foundation. The Impending im·pend
intr.v. im·pend·ed, im·pend·ing, im·pends
1. To be about to occur: Her retirement is impending.
2. Catastrophe: A Resource Book on the Emerging HIV/AIDS Epidemic in South Africa, May 2000. Available at: www.kff.org/content/2000/20000515a/; UNAIDS, Report on the Global HINT/AIDS Epidemic, June 2000.
(20.) UNAIDS. AIDS and Population, (fact sheet), 2002. Available at: www.unaida.org/fact_sheets/files/Demographic_Eng.html
(21.) UNAIDS. (Personal communication, 2002.)
(22.) U. S. Census Bureau. Unpublished data, 2002.
(23.) K. A. Stanecki, U. S. Census Bureau, "The AIDS Pandemic in the 21st Century"; U. S. Census Bureau. Unpublished data, 2002.
(25.) U. S. Census Bureau. Unpublished data, 2002.
(26.) K. Kiragu, "Can We Avoid Catastrophe?," Population Reports, vol. 12, 2001.
(27.) Population Reference Bureau, Youth in Sub-Saharan Africa. Available at: www.prb.org/Template.cfm?Section=PRB&template=/ContentManagement/Cont entDisplay.cfm&ContentID=2821
(28.) UNICEF, Progress of Nations, 2000.
(29.) UNAIDS, Together We Can: Leadership in a World of AIDS, June 2001.
(30.) UNAIDS. Children and Young People in a World of AIDS, August 2001.
(31.) Henry J. Kaiser Family Foundation, Hot Prospects, Cold Facts: National Survey of South African Youth, March, 2001. Available at: www.kff.org/content/2001/20010314/
(32.) Population Reference Bureau, Youth in Sub-Saharan Africa. Available at: www.prb.org/Template.cfm?Section=PRB&template=/ContentManagement/Cont entDisplay.cfm&ContentID=282l
(33.) UNAIDS, AIDS Epidemic Update, December 2001.
(34.) UNAIDS, Report on the Global HIV/AIDS Epidemic, June 2000; Henry J. Kaiser Family Foundation, Hot Prospects, Cold Facts: National Survey of South African Youth, March, 2001. Available at: www.kff.org/content/2001/20010314/; H. BlaMe, "My Voice Counts Too," Progress of Nations 2000 (UNICEF, New York New York, state, United States
New York, Middle Atlantic state of the United States. It is bordered by Vermont, Massachusetts, Connecticut, and the Atlantic Ocean (E), New Jersey and Pennsylvania (S), Lakes Erie and Ontario and the Canadian province of , 2000) pp. 2-3.
(35.) UNAIDS, Report on the Global HIV/AIDS Epidemic, June 2000.
(36.) G. Rao Gupta, "Gender, Sexuality, and HIV/AIDS: The What, the Why, and the How," International Center for Research on Women The International Center for Research on Women (ICRW) is a non-profit organization headquartered in Washington, D.C., United States, with a regional office in New Delhi, India, and a project office in Uganda. . (Plenary plenary adj. full, complete, covering all matters, usually referring to an order, hearing or trial.
PLENARY. Full, complete.
2. address, International AIDS Conference, Durban, South Africa, July, 2000.) Available at: www.icrw.org/docs/Durban Speech.pdf; U.S. Centers for Disease Control and Prevention, Preventing the Sexual Transmission of HIV, the Virus that Causes AIDS: What You Should Know about Oral Sex, December 2000. Available at: ftp://ftp.cdcnpin.org/Updates/oralsex.pdf
(37.) UNAIDS, WHO, Sexually Transmitted Diseases: Policies and Principles for Prevention and Care.
(38.) Institute of Medicine, Committee on Prevention and Control of Sexually Transmitted Diseases, T. R. Eng and W. T. Butler, The Hidden Epidemic: Confronting Sexually Transmitted Diseases (Washington, DC: National Academy Press, 1997).
(39.) C. Panchaud, S. Singh, D. Feivelson, and J. E. Darroch, "Sexually Transmitted Diseases Among Adolescents in Developed Countries, Family Planning family planning
Use of measures designed to regulate the number and spacing of children within a family, largely to curb population growth and ensure each family’s access to limited resources. Perspectives, January-February 2000, vol. 32, no. 1, pp. 24-32, 45.
(40.) Henry J. Kaiser Family Foundation, Sexually Transmitted Diseases in the United States (Fact Sheet), February 11, 2000. Available at: www.kff.org/content/2000/3003/STD%20fact%20Sheet.PDF.12
(41.) UNAIDS, AIDS Epidemic Update, December 2001.
(42.) UNAIDS, WHO, Sexually Transmitted Diseases: Policies and Principles for Prevention and Care.
(43.) UNAIDS, Global Crisis--Global Action, June 2001.
(44.) P. Piot, "Testimony to a Hearing on 'Halting the Global Spread of HIV/AIDS"; National Intelligence Council (Central Intelligence Agency), "Global Trends 2015: A Dialogue About the Future with Nongovernmental Experts," December 2000. Available at: www.cia.gov/nic/pubs/index.htm
(45.) UNICEF, Progress of Nations, 2000.
(48.) UNAIDS. Children and Young People in a World of AIDS, August 2001.
(49.) G. Rao Gupta, "Gender, Sexuality, and HIV/AIDS: The What, the Why, and the How," International Center for Research on Women (Plenary address, International AIDS Conference, Durban, South Africa, July, 2000.) Available at: www.icrw.org/docs/DurbanSpeech.pdf; UNAIDS, Gender and HIV/AIDS (Fact Sheet), June 2001. Available at: www.unaids.org/fact_sheets/ungass/pdf/Fsgender_en.pdf
(50.) G. Rao Gupta, "Gender, Sexuality, and HIV/AIDS." Available at: www.icrw.org/docs/DurbanSpeech.pdf
(51.) G. Rao Gupta, "Gender, Sexuality, and HIV/AIDS." Available at: www.icrw.org/docs/DurbanSpeech.pdf; Gender and HIV/AIDS. Available at: www.unaids.org/fact_sheets/ungass/pdf/Fsgender_sn.pdf
(52.) Population Reference Bureau, Youth in Sub-Saharan Africa. Available at: www.prb.org/Template.cfm?Section=PRB&template=/ConrentManagement/Cont entDisplay.cfm&ContentID=2821
(53.) S. Gregson, C. A. Nyamukapa, G. P. Garnett, et al., "Sexual Mixing Patterns Mixing patterns refer to systematic tendencies of one type of nodes in a network to connect to another type. For instance, nodes might tend to link to others that are very similar or very different. and Sex-differentials in Teenage Exposure to HIV Infection in Rural Zimbabwe," Lancet lancet /lan·cet/ (lan´set) a small, pointed, two-edged surgical knife.
n. , June 1, 2002, pp. 1896-1903.
(54.) UNAIDS, Report on the Global HIV/AIDS Epidemic, June 2000.
(55.) Y.A. Amirkhanian, J.A. Kelly, A.A. Kukharsky, et al., "Predictors of HIV Risk Behavior Among Russian Men Who Have Sex with Men: An Emerging Epidemic," AIDS, February 16 2001, vol. 15, no. 3, pp. 407-12; J. A. Kelly, Y.A. Amirkhanian, T. L. McAuliffe, et al, "HIV Risk Behavior and Risk-related Characteristics of Young Russian Men Who Exchange Sex for Money or Valuables from Other Men, AIDS Education Prevention, April 2001, vol. 13, no. 2, pp. 175-88; UNAIDS. AIDS and Men Who Have Sex with Men: UNAIDS Point of View, July 1998; UNAIDS. AIDS and Men Who Have Sex with Men [UNAIDS technical update]. May, 2000. Available at: www.unaids.org/publications/documents/specific/ men/men tue2000.pdf.
(56.) UNAIDS, Report on the Global HIV//AIDS Epidemic, June 2000.
(57.) S. Hunter and J. Williamson, "Children on the Brink," USAID. 2000. Available at: http://www.dec.org/pdf_docs/PNACJ284.pdf; Henry J. Kaiser Family Foundation, Hearing Their Voices: A Qualitative Research Qualitative research
Traditional analysis of firm-specific prospects for future earnings. It may be based on data collected by the analysts, there is no formal quantitative framework used to generate projections. Study on HIT/Testing and Higher-risk Teens, June 1999.
(58.) National Intelligence Council (Central Intelligence Agency), "Global Trends 2015." Available at: www.cia.gov/nic/pubs/index.htm; P. Wehrwein, "AIDS Leaves Africa's Economic Future in Doubt," CNN CNN
or Cable News Network
Subsidiary company of Turner Broadcasting Systems. It was created by Ted Turner in 1980 to present 24-hour live news broadcasts, using satellites to transmit reports from news bureaus around the world. . March 26, 2002. Available at: www.cnn.com/specials/2000/aids/stories/economic.impact
(59.) UNAIDS, Together We Can: Leadership in a World of AIDS, June 2001; U.S. Centers for Disease Control and Prevention, "HIV-related Knowledge and Stigma-United States, 2000," Morbidity and Mortality Weekly Report Morbidity and Mortality Weekly Report (MMWR) is a weekly epidemiological digest for the United States published by the Centers for Disease Control and Prevention. The 5 June 1981 issue of the MMWR published the cases of five men in what turned out to be the first report of AIDS. , December 1, 2000, vol. 49, no. 47, pp. 1062-64; R. O. Valdiserri, "HIV/AIDS Stigma: An Impediment A disability or obstruction that prevents an individual from entering into a contract.
Infancy, for example, is an impediment in making certain contracts. Impediments to marriage include such factors as consanguinity between the parties or an earlier marriage that is still valid. to Public Health," American Journal of Public Health The American Journal of Public Health (AJPH) is a peer reviewed monthly journal of the American Public Health Association (APHA). The Journal also regularly publishes authoritative editorials and commentaries and serves as a forum for the analysis of health policy. , March 2002, vol. 92, no. 3, pp. 341-42.
(60.) G. Rao Gupta, "Gender, Sexuality, and HIV/AIDS." Available at: www.icrw.org/docs/DurbanSpeech.pdf
(61.) UNAIDS, AIDS Epidemic Update, December 2001.
(62.) UNAIDS, Children and Young People in a World of AIDS, August 2001; UNAIDS, Global Crisis-Global Action, June 2001; UNAIDS, Gender and HIV/AIDS. Available at: www.unaids.org/fact_sheets/ungass/pdf/Fsgender_en.pdf.
(63.) UNAIDS (Unpublished data; 2002).
(64.) S. Gregson, C. A. Nyamukapa, G. P. Garnett, et al., "Sexual Mixing Patterns and Sex-differentials in Teenage Exposure to HIV Infection in Rural Zimbabwe," Lancet, June 1, 2002, pp. 1896-1903.
(65.) UNICEF, Progress of Nations, 2000.
(66.) K. A. Stanecki, U. S. Census Bureau, "The AIDS Pandemic in the 21st Century."
(67.) Henry J. Kaiser Family Foundation. The Impending Catastrophe. Available at: www.kff.org/content/2000/20000515a/
(68.) P. Piot, "Testimony to a Hearing on 'Halting the Global Spread of HIV/AIDS"; UNAIDS, Global Crisis--Global Action, June 2001; UNAIDS, Gender and HIV/AIDS (Fact Sheet), June 2001. Available at: www.unaids.org/fact_sheets/ungass/pdf/FSgender_en.pdf
(69.) UNAIDS (Unpublished data; 2002).
(70.) U.S. Centers for Disease Control and Prevention, "HIV/AIDS Update: A Glance at the HIV Epidemic," 2002. Available at: www.cdc.gov/nchstp/od/news/At-a-Glance.pdf. Accessed June 28, 2002; U.S. Centers for Disease Control and Prevention, "HIV/AIDS Surveillance Reports," Available at: www.cdc.gov/hiv/stats/hasrlink.htm
(71.) UNAIDS, Report on the Global HIV/AIDS Epidemic, June 2000; K. Kiragu, "Can We Avoid Catastrophe?," Population Reports, vol. 12, 2001;T.A. Peterman Pe´ter`man
n. 1. A fisherman; - so called after the apostle Peter. , R. L. Stoneburner, J.R. Allen, H.W. Jaffe, and J. W. Curran, "Risk of Human Immunodeficiency Virus human immunodeficiency virus
Human immunodeficiency virus (HIV)
A transmissible retrovirus that causes AIDS in humans. Transmission from Heterosexual Adults with Transfusion Transfusion Definition
Transfusion is the process of transferring whole blood or blood components from one person (donor) to another (recipient). Associated Infections, Journal of the American Medical Association JAMA: The Journal of the American Medical Association is an international peer-reviewed general medical journal, published 48 times per year by the American Medical Association. JAMA is the most widely circulated medical journal in the world. , January 1, 1988, vol. 259, no. 1, pp. 55-58.
(72.) K. Kiragu, "Can We Avoid Catastrophe?," Population Reports, vol. 12,2001.
(73.) S. Gregson, et al., "Sexual Mixing Patterns and Sex-differentials in Teenage Exposure to HIV Infection in Rural Zimbabwe."
(74.) UNAIDS. Children and Young People in a World of AIDS; UNAIDS, Global Crisis--Global Action; S. Gregson, et al., "Sexual Mixing Patterns and Sex-differentials in Teenage Exposure to HIV Infection in Rural Zimbabwe."
(75.) UNAIDS, Report on the Global HIV/AIDS Epidemic, June 2000.
(76.) Human Rights Watch, "Scared scare
v. scared, scar·ing, scares
To strike with sudden fear; alarm. See Synonyms at frighten.
To become frightened: a child who scares easily. at School: Sexual Violence Against Girls in South African Schools, March 2001. Available at: www.polity.org.za/govdocs/reports/nongov/sexviolence; "Here's How We Can Fight AIDS," The Sunday Times, Johannesburg, South Africa, November 25, 2001.
(77.) G. Rao Gupta, "Gender, Sexuality, and HIV/AIDS. Available at: www.icrw.org/docs/DurbanSpeech.pdf
(78.) UNAIDS, Report on the Global HIV/AIDS Epidemic, June 2000; UNAIDS, Global Crisis--Global Action, June 2001.
(79.) Associated Press Associated Press: see news agency.
Associated Press (AP)
Cooperative news agency, the oldest and largest in the U.S. and long the largest in the world. , "HIV Positive South African Women Murdered," December 19, 1998.
(80.) UNAIDS. AIDS and Men Who 1-lave Sex with Men [UNAIDS technical update]. May, 2000. Available at: www.unaids.org/publications/documents/specific/men/men tue2000.pdf
(81.) UNAIDS, AIDS Epidemic Update, December 2001; UNAIDS, Global Crisis--Global Action, June 2001.
(82.) U.S. Centers for Disease Control and Prevention, HIV/AIDS Surveillance Reports: U.S. HIV and AIDS Cases Reported through December 2000, Year- End Edition, 2001, vol. 12, no. 2.
(83.) UNAIDS, Report on the Global HIV/AIDS Epidemic, June 2000; UNAIDS. AIDS and Men Who Have Sex with Men [UNAIDS technical update]. May, 2000. Available at: www.unaids.org/publications/documents/specific/men/men tue2000.pdf; U.S. Centers for Disease Control and Prevention, "HIV-related Knowledge and Stigma--United States, 2000$' Morbidity and Mortality Weekly Report, December 1, 2000, vol. 49, no. 47, pp. 1062-64.
(84.) UNAIDS, Report on the Global HIV/AIDS Epidemic, June 2000.
(85.) UNAIDS, WHO, Vietnam. Epidemiological epidemiological
emanating from or pertaining to epidemiology.
the associative relationships between the frequency of occurrence of a disease and its determinants, its predisposing and precipitating Fact Sheets on HIV/AIDS and Sexually Transmitted Infections: 2000 Update (revised), 2000.
(86.) UNAIDS, AIDS Epidemic Update, December 2001.
(87.) P. Csepe, Y.A. Amirkhanian, J.A. Kelly, T. L. McAuliffe, and L. Mocsonoki, "HIV Risk Behaviour Among Gay and Bisexual Men in Budapest, Hungary, International Journal of STD/AIDS, March 2002, vol. 13, no. 3, pp. 192-200.
(89.) Y. A. Amirkhanian, J.A. Kelly, A.A. Kukharsky, et al., "Predictors of HIV Risk Behavior Among Russian Men Who Have Sex with Men: An Emerging Epidemic," AIDS, February 16 2001, vol. 15, no. 3, pp. 407-12.
(90.) UNAIDS, Report on the Global HIV/AIDS Epidemic, June 2000.
(91.) U.S. Centers for Disease Control and Prevention, "HIV Incidence Among Young Men Who Have Sex with Men-Seven U.S. Cities, 1994-2000," Morbidity and Mortality Weekly Report, June 1, 2001, vol. 50, no. 21, pp. 440-44.
(92.) U.S. Centers for Disease Control and Prevention, "HIV Incidence Among Young Men Who Have Sex with Men"; U.S. Centers for Disease Control and Prevention, "Need for Sustained HIV Prevention Among Men Who Have Sex with Men," March 11, 2002. Available at: www.cdc.gov/hiv/pubs/facts/msm.htm
(93.) U.S. Centers for Disease Control and Prevention, "Resurgent re·sur·gent
1. Experiencing or tending to bring about renewal or revival.
2. Sweeping or surging back again.
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