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.
Why So Vulnerable?
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.
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.
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.
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.
Using condoms—the only contraceptive method that can protect against HIV as well as against pregnancy—is vital to controlling HIV/AIDS among youth. Condoms should be widely accessible, and their use promoted among sexually active people of all ages.
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.
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.
Act Now
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 risks were cut in half by 2015, in some countries 20% to 80% of today's 15-year-old boys still would still 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 the spread of HIV/AIDS, can ensure that today's young people will have a future as adults.
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