AIDS in the adolescents group is a similar biosocial problem, which has taken form of a crisis in some parts of the world. The root causes of this are almost all the aforementioned factors that sum up to spell AIDS!
Who are 'youth'?
This is a tricky question. Various studies and reports take various ages as ‘youth’ medical textbooks describe boys between 12-20 years and girls between 10-18 years as adolescents. WHO refers to persons between age of 10 and 19 as adolescents and those between 10 and 24 as ‘young people’. Most of the international data of HIV/AIDS studies are for age group 15-24 years. For general consideration, it is safe to consider all persons between 10-25 years as young people. And they are the focus here.
Prepubescent 12-14 (male) 10-12 (female)
Pubescent 14-16 (male) 12-14 (female)
Post-pubescent 16-20 (male) 14-18 (female)
Table 1 Adolescents (years)
This group comprises about 20% of the world’s population. In developing countries where fertility rates are higher, they can form even greater part – up to 40% sometimes. This age group is the most healthy and active age group. This is going to be the economically productive group just at the age when effects of HIV contracted in teen-years would manifest as fully blown aids. This age group is clinically considered the least vulnerable for death and various chronic illnesses. Infection contracted in youth is also likely to be ignored because of apparent healthy state and therefore its chances of spreading to others in the same group are higher.
Vulnerability
Young people are much more vulnerable to HIV/AIDS than older people are. Because of the stage of their social, emotional, psychological and physical development they tend to experiment with risky behavior. What is more dangerous is the lack of awareness and a confidence that ‘it can’t happen to me.’
Risk-taking behavior is seen in:
▪ Sexual experimentation
▪ Experimentation with injectable prohibited drugs
▪ Smoking
▪ Alcoholism
A young person's environment is also a big stimulus, which drives them towards various habits. Taking alcoholism as an example, it was estimated that one in four US children (19 million in all), before age of 18 lived in a family with a member who was an alcoholic or abused alcohol. There is no reason to believe that situation is better in other parts of the world. The other condition perplexing this situation is lack of knowledge on part of young people about what constitutes a risky behavior. Having multiple sexual partners or experimenting with various drugs or alcohol is a matter of fun for them. In fact sometimes it is seen as a matter of boasting in front of peers. They fail to understand adverse impact of such things on their health and even if they do understand, it shows their carelessness about those things – a characteristic of the age group!
Sometimes the cause behind risk-taking behavior is not with the youth but with the society. In a large part of the world, sexuality is still a matter of embarrassment and shame; young people in such societies do not get a chance during their puberty and adolescence of the exact understanding of the biophysical changes they are undergoing. Similarly they don't have reliable sources which can explain to them facts about sexuality and safe sexual practices.
This results in the person feeling uncomfortable about one's sexuality, resulting in channeling it the wrong way, with wrong partners. These people, even if they know about the risks of various STDs, AIDS, or of pregnancy as a result of unprotected intercourse, do not use condoms. They just can't go and buy it because of buying condom from a third person means revealing one's sexuality to an unknown agent of the society. To relieve young people from such embarrassment, state and central governments in India have tried to find a solution. Open boxes of condoms are put in public hospitals and other public places. They are meant to be taken away for free and whoever wants condoms can take away them from those boxes in any quantity. But still the fear of someone seeing them taking a packet from the box and resultant embarrassment, is too much for them to even look at those boxes!
The result
All these factors affecting behavior have resulted in an apparently disastrous condition. A creeping death of a whole generation in many sub-Saharan African nations is now as clearly visible as a lighthouse in the darkness of ocean - it is at a distance but at one moment, we have to reach there.
Statistics from the Joint United Nations Programme on HIV/AIDS (UNAIDS) has shown some of the glimpses of disastrous effects of AIDS among young people:
- In 1998 over 2.5 million young people became infected with HIV, half of all new HIV infections that year.
- Every day over 7000 more young people become infected - about 5 per minute.
- Worldwide, people ages 15 - 24 account for about 30% of all people living with HIV/AIDS.
- just 10% of world's young people live in countries of sub-Saharan Africa, but these countries have almost 75% of the world's HIV infected youth (8.6 million)
Is there any solution?
The only preventive method for controlling HIV spread among youth is to induce behavioral change among individuals. This is a mammoth task which needs intersectoral co-ordination among governments, international agencies and non-governmental organizations. Participation of the youth themselves is indeed the most important component. A healer can heal only that patient who wants to be cured! Combating a disease with such huge dimensions needs constant scientific research as well as clinical monitoring and evaluation of changing clinical features and emerging microbiological and genetic changes. While preventing the disease, we cannot forget those unfortunate persons who have acquired the Immunodeficiency Syndrome.
For all of these things, a very large share of financial support is needed. In fact, a preventive effort for HIV/AIDS is a cheaper option than managing the disease in other ways. For instance, in India, the cost of treating one AIDS patient for one year even without expensive therapies equals the annual cost of providing primary school education for 10 students. A multipronged approach is suggested here for prevention of youth AIDS pandemic.
1) Information, education and communication activities through all communication channels:
- 'Edutainment' and 'infotainment' are the keys to reach and teach the youth what they are supposed to do! An attractive advertisement about AIDS prevention by a successful sports personality or movie-actor will have a better impact than an hour-long lecture by a university professor.
- Use of all means of media channels to reach youth at every corner: establishing AIDS telephone hotlines, SMS by mobiles, POP-UP on internet, advertisement on FM radios, special advertisements in CD/Cassettes of popular songs, contests of various types with attractive rewards, etc.
2) Enhancing community participation:
- Special training to all primary and high school teachers about AIDS and prevention
- Informing parents about their role in prevention
- Encourage parents and teachers to talk to the youth about sex and pregnancy
10 TIPS TO HELP PARENTS COMMUNICATE WITH THEIR ADOLESCENT CHILDREN ABOUT SEX
1. Be clear about your own sexual values before you talk to your children about sex.
2. Talk to your children early and often about sex
3. Be sure to have a two-way discussion and not a lecture.
4. Supervise and monitor your children.
5. Know your children’s friends and their families
6. Discourage early, frequent and steady dating in favor of group activities
7. Discourage dating where the age difference is large, especially for young girls.
8. Know what programmes your children are watching on TV, listening to on the radio and what they are reading.
9. Let your children know that you value education.
10. Let your children know that you value them.
3) Challenging high-risk behavior through education to young people about:
- Hazards of high risk behavior
- What is a high risk behavior
- Alternate ways
- How to wean off from high risk habits
4) Making condoms available
- Easy access at multiple places
- Should be very cheap/free of cost
- Seller must not make the buyer feel uncomfortable
- Consistent use of condoms should be emphasized
- Correct methods to use condoms should be taught to users
5) Enforcement of laws on drug prohibition:
- Drug dealers/sellers/carriers should be caught and sent to prisons with heavy monitory punishments
- Organized criminal networks in drug trafficking must be destroyed.
- All those known to be addicted to drug abuse should be sent to rehabilitation centers without any delay.
- Creating awareness in the society about harms of drugs and taking help of citizens in dealing with the menace.
6) Introduction of AIDS education in school curriculum at early stages
-Providing education about anatomical, biological and social aspects of sex and sexuality to adolescents undergoing pubertal changes.
-Exploring what constitutes a high-risk behavior and how to save oneself from it.
-Dealing with peer pressure and other social pressures on young people to be sexually active.
-Using teaching methods and materials appropriate to students’ age, sexual experience and culture.
-Selecting as teachers those who can understand adolescents and their needs and who can help their needs and who can help them deal with those needs in safer ways.
7) Promoting voluntary counseling, HIV testing and referral. Such a facility should:
-Respect teens
-Offer free testing
-Offer a broad array of teen oriented services
-Assure confidentiality
-Not require parental consent
-Offer a choice between oral or blood-drawn tests
-Be convenient with access to public transportation
-Ask few questions.
-Require little paperwork.
8) Promoting voluntary blood donation among young people…
- will help maintain adequate stores of blood unite in banks.
- will reduce practice of dependence on professional blood donors
- will increase awareness among young people about importance of blood donation as a form of social service.
9) Strengthening financial support
- There should be a definite amount of national, state and district budgets earmarked for anti-AIDS activities
- A minimum fixed share of any nation’s GDP should go to preventive activities.
- International agencies should have enough funds from various governmental and private donations.
- Of the total funds, a fixed share should go to youth AIDS prevention activities.
10) Improving socio-economic environment
- Providing young people enough opportunities of education, employment and technical skills.
- Loans and grants to initiate economic activities to young people at cheaper interests
- Developing training institutes for underprivileged youth so as to enable them to have good living standards.
- Introducing policy changes and social modifications to absorb the young people in its main stream.
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