Young people's knowledge in Asia on consistent condom use and the prevention of HIV.

More than half of the world's young people--almost 850 million between the ages of 10 and 24--live in the Asia-Pacific region. This demographic surge of people entering their productive and reproductive years offers great potential for development, but it also signals an urgent SRH challenge, as research demonstrates that new adult HIV infections are increasingly occurring among 15-24 year olds, with a disproportionate number of young women being infected and affected. (1)

Thus far in Asia and the Pacific, HIV prevalence in most countries has been restricted to vulnerable groups, particularly injecting drug users and sex workers; but without appropriate and effective interventions, the virus could spread rapidly, becoming more mainstream. The large number of sexually active young people has the potential to fuel the epidemic, especially when the SRH needs and concerns of young people have historically been overlooked. (2) The situation demands a scaling up of HIV and AIDS advocacy, prevention and treatment efforts directed at youth, but reaching youth is not easy. The same factors that increase young people's vulnerability to infection (e.g. increased mobility, trafficking, sex work, poverty, level of education, limited access to health services, and illiteracy) are also significant barriers to the impact of prevention activities. Young women are particularly difficult to reach, given gender beliefs and roles that can limit their exposure to prevention efforts.

The United Nations Population Fund and Reference Bureau in their effort to track the extent to which national information and education programmes on HIV and SRH have succeeded, have recently begun tracking the percentage of young people aged 15-24 who know whether a person can protect her- or himself from HIV by consistent condom use. (3) Data are currently available for Cambodia, India, Indonesia, Mongolia, Nepal, the Philippines, and Vietnam. Taking the average between these countries, only 54.1% of young women know that a condom can offer effective protection against infection, suggesting national HIV and SRH efforts are generally weak and ineffective. This is concerning given that the median age for first sexual intercourse for women is quite young: 19.9 (Cambodia); 18.6 (Indonesia); 16.9 (Nepal); and 21.9 (Philippines). For three countries--India, Indonesia and Nepal--there are data on whether young men know that a condom can offer protection against infection. The average between the countries is 74%, which suggests that while not good, young men have greater access to comprehensive HIV prevention information.

Indonesia and Nepal demonstrate pronounced differences between young women and men in their knowledge. Indonesia presents the most extreme example, with a percentage point difference of 55 between women and men. This suggests that those designing and implementing prevention programmes and campaigns need to specifically target young women and take into careful consideration influences, whether cultural, religious, political, or economic, which result in gender-based differences in access to comprehensive information.

A comprehensive, gender-sensitive and rights-based approach to the delivery of HIV and SRH information is crucial for young women--an approach that stresses women's empowerment in this process and identifies and challenges personal and structural barriers to women's ability to negotiate for the use of condoms. (4) Although reaching young women with the knowledge that condoms can protect them from infection is an important, and oftentimes difficult, first step, it is simply not enough. It is critical that education must include increasing young women's self esteem, confidence to take action, decision-making skills, and ability to communicate concerns and needs. (5) At the same time, male responsibility must be focused on, which includes improving young men's potential to listen to and respect their partner.

Endnotes

(1) United Nations Population Fund and Population Reference Bureau. 2005. Country Profiles for Population and Reproductive Health: Policy Developments and Indicators 2005. http://www.unfpa. org/upload/lib_pub_file/524_filename_country_profiles_2005.pdf

(2) Ooi, Chye Pei; Kabir, Sandra; and Satia, Jay. 2006. Innovative Approaches to Population Programme Management: Linked Response to Reproductive Health and HIV/AIDS. Volume Ten. Kuala Lumpur, Malaysia: International Council on Management of Population Programmes (ICOMP).

(3) All percentages on this indicator are taken from United Nations Population Fund and Population Reference Bureau. 2005. Country Profiles for Population and Reproductive Health: Policy Developments and Indicators 2005.

(4) UNAIDS Inter-Agency Task Team on Gender and HIV/AIDS. HIV/AIDS and Gender: Fact Sheet. http://www.genderandaids.org/downloads/events/Fact%20Sheets.pdf

(5) UNAIDS; UNFPA; UNIFEM. 2004. Women and HIV/AIDS: Confronting the Crisis. http://www.unfpa.org/hiv/women/docs/women_aids.pdf

                Women 15-24 who          Men 15-24 who
                  know that a         know that a person
               person can protect     can protect himself
              herself from HIV by         from HIV by
               consistent condom          consistent
                     use, %                 condom
                                            use, %

Cambodia               64                     N/A
India                  62                     63
Indonesia              23                     78
Mongolia               77                     N/A
Nepal                  39                     81
Philippines            54                     N/A
Vietnam                60                     N/A