Young people and HIV/AIDS.

A United Nations report launched July 2, 2002 reveals the alarming extent to which the vast majority of young people are uninformed about how HIV is transmitted or how to protect themselves against the virus. Nonetheless, the report also observes, sexual activity begins in adolescence for most people.

"Young People and HIV/AIDS: Opportunity in Crisis," jointly produced by UNICEF, UNAIDS and the World Health Organization, is the first detailed analysis of the knowledge and behavior of young people aged 15 to 24 regarding HIV/AIDS. The report also includes current statistics on HIV prevalence in every country by age group.

Carol Bellamy, UNICEF Executive Director, goes straight to the heart of the matter, identifying two trends that contribute to the HIV/AIDS crisis: young people have sexual relations -- a fact that the world must recognize in order to establish effective prevention programs -- and young people lack the knowledge to protect themselves. As a result, young people are disproportionately affected by HIV.

"Global success in combating HIV/AIDS must be measured by its impact on our children and young people," Bellamy insists, "Are they getting the information they need to protect themselves from HIV? Are girls being empowered to take charge of their sexuality? Are infants safe from the disease, and are children being orphaned by AIDS being raised in loving supportive environments? These are the hard questions we need to be asking. These are the yardsticks for measuring our leaders. We cannot let another generation be devastated by AIDS."

The report stresses that young people are at the center of the pandemic: they are the most affected by HIV/AIDS, and they are also the key to overcoming this crisis. But despite this reality, most strategies for combating the pandemic fail to take into account this sector of the population.

The UN organizations that published the report demand an unparalleled political commitment to provide the financial and human resources so urgently needed in the fight against HIV/AIDS. As the report explains, this effort should concentrate on young people, providing them with the knowledge and skills they need to prevent HIV infection.

According to the report, young people overwhelmingly lack information on HIV/AIDS. Surveys from 40 countries indicate that more than 50% of young people aged 15 to 24 harbor serious misconceptions about how HIV/AIDS is transmitted. In some of the countries with the highest rates of transmission, only one in five young people knows how to protect themselves from HIV infection. As a result, half of all new infections today occur among young people aged 15 to 24.

While stressing that young people frequently lack both the knowledge and the means to protect themselves from HIV, Peter Piot, UNAIDS Executive Director, argues that "according special priority to young people will change the future course of the epidemic." Every day, he explains, 6,000 young people become infected, but all these infections could be avoided for only eight U.S. dollars per young person, an extremely worthwhile investment. "Changing behaviors and expectations early results in a lifetime of benefit -- both in HIV prevention and in overcoming HIV-related stigma. The challenge is to promote effective programs that engage young people in all aspects of the response to HIV/AIDS... In every country where HIV transmission has been reduced, it has been among young people that the most spectacular reductions have occurred." Among the report's most significant conclusions are the following:

* Young people lack information about HIV/AIDS. In countries with generalized HIV epidemics, such as Cameroon, Central African Republic, Equatorial Guinea, Lesotho and Sierra Leone, more than 80% of young women aged 15 to 24 do not have sufficient knowledge about HIV. In Ukraine, although 99% of girls had heard of AIDS, only 9% could correctly identify the three primary ways of avoiding sexual transmission.

Among the report's most significant conclusions are the following:

* Young people have sexual relations. In many countries, unmarried girls and boys are sexually active before the age of 15. Recent surveys of boys aged 15 to 19 in Brazil, Hungary and Kenya, for example, found that more than a quarter reported having sex before they were 15.

* The appropriate use of condoms and other prevention options, such as abstinence, must be taught to young people from early on. In Burkina Faso, only 45% of boys aged 15 to 19 reported using a condom with a non-marital partner, compared to 64% of young men aged 20 to 24. In Malawi, 29% of boys aged 15 to 19 used a condom, compared to 47% of the men aged 20 to 24. Another study in Ukraine found that just 28% of young women aged 15 to 24 had used a condom at first sexual intercourse.

* Adolescent girls are at very high risk of getting infected, especially in sub-Saharan Africa, the region must severely affected by HIV/AIDS. More than two-thirds of newly-infected 15-to-19-year-olds in this region are female. In Ethiopia, Malawi, United Republic of Tanzania, Zambia and Zimbabwe, for every 15-to-19-year-old boy who is infected, there are five to six girls infected in the same age group.

Young People are the Key to Overcoming the Pandemic

The report stresses that in countries in which HIV/AIDS rates have declined, such as Thailand or Uganda, the primary reason is serious sustained efforts to ensure that young people have the knowledge, skills and services to protect themselves. The authors of the report clearly identify the close correlation between what young people know and how they behave. In this respect they insist that a supportive environment is essential if young people are to learn the skills that will allow them to protect themselves from HIV. The report also emphasizes the need to take special measures to reach the most vulnerable sectors of young people, such as those who inject drugs or work in the sex trade.

While Gro Harlem Bruntland, Director General of the World Health Organization, agrees that young people are able to make responsible decisions to protect themselves from HIV/AIDS, she also maintains that "young people need adult assistance to deal with thoughts, feelings and experiences that accompany physical maturity... Evidence from around the world has clearly shown that providing information and building skills on human sexuality and human relationships help to avert health problems and create more mature and responsible attitudes."

In this effort, the report advocates a ten-step strategy to prevent HIV/AIDS:

* End the silence, stigma and shame;

* Provide young people with knowledge and information;

* Equip young people with life skills to put knowledge into practice;

* Provide youth-friendly health services;

* Promote voluntary and confidential HIV counseling and testing;

* Work with young people, promote their participation;

* Engage young people who are living with HIV/AIDS;

* Create safe and supporting environments;

* Reach out to young people most at risk;

* Strengthen partnerships, monitor programs.

A Statistical Basis for a Rapid Response

The report is based on two essential statistical tables. The first offers information on almost every country in the world, addressing transmission rates, school enrollment, levels of education and sexual behavior. A second table provides even more detailed information on knowledge and behavior in 60 countries where HIV prevalence is 1% or higher. The statistics are very recent, from 1999 or later.

This up-to-date information will allow those fighting HIV/AIDS to more accurately measure results regarding the objectives established during the June 2001 United Nations General Assembly Special Session on HIV/AIDS and reaffirmed in the Special Session on Children in May 2002.

At these important meetings, Heads of State and Government committed themselves to meeting a number of key goals to diminish HIV prevalence among young people. These include:

* Reducing HIV prevalence among young people aged 15 to 24 by 25% in the most affected countries by 2005, and by 25% worldwide by 2010.

* Ensuring that young people have the information, education, services and life skills to reduce their vulnerability to HIV, reaching 90% by 2005 and 95% by 2010.

Source: Information distributed by the Argentine network Red RIMA, courtesy Laura Alves, e-mail: [e-mail]. For more information on the report, contact Alfred Ironside, UNICEF, tel.: [phone]; e-mail: aironside @ unicef.org; website: www.unicef.org