Voices of Youth on HIV/AIDS

UNITED NATIONS, New York—To win the battle against HIV and AIDS, it is crucial that young people be seen as actors, rather than spectators, and as part of the solution, rather than part of the problem. This was the message of young activists from 12 countries who came to the UN General Assembly’s High Level Meeting on HIV/AIDS on June 2, as it reviewed progress on the goals it adopted in 2001 at its Special Session on HIV/AIDS.

Members of the Global Youth Coalition on HIV/AIDS and Global Youth Partners presented to delegates the findings of a report they researched and wrote, Our Voice, Our Future, published by the United Nations Population Fund. It reports on progress in their countries—Bangladesh, Cameroon, the Dominican Republic, Egypt, Gambia, Ghana, India, Kenya, Nigeria, Pakistan, Peru and Sudan—towards the targets set in 2001 to reduce HIV/AIDS prevalence among young people.

Young people are at the epicentre of the AIDS pandemic. Ten million young people are currently living with HIV, and over half of the 4.9 million people newly infected worldwide each year are between the ages of 15 and 24. Yet the international community is falling short in its commitments to provide the information and services young people need to prevent HIV and AIDS, and to enlist them fully in efforts to stem the epidemic, the report says.

" Youth participation is getting better, but often young people are not involved from the start but are used as rubber stamps after a plan or report is written. "

--Eunice Aghete, 20, HIV/AIDS activist from Nigeria

In its Declaration of Commitment four years ago, the United Nations Member States agreed that by 2005, they would reduce HIV prevalence among young people in the most affected countries by 25 per cent. They also promised that by 2005, at least 90 per cent of young people would have access to the youth-specific education, counselling and health care required to reduce their vulnerability to infection.

These global targets for 2005 will not be met. Currently, only 20 per cent of young people have meaningful access to comprehensive HIV/AIDS information and services.

What needs to be done to turn the corner on the pandemic? “Young people must be involved from start to finish,” and involved on a higher level, said Eunice Aghete, 20, a youth activist on HIV/AIDS from Lagos, Nigeria, and an author of the report. “Young people are affected by HIV and AIDS; they understand the issues better and they know how to reach their peers better than adults do.”

Political commitment to stopping the spread of the pandemic among young people has increased markedly since 2001, and some governments are making them a priority in national AIDS plans, the report says. But current funding, particularly for youth-led initiatives, is not enough. Young people are often ignored when governments develop policies and programmes and allocate budgets, and life-saving prevention measures are still not reaching those who are most at risk.

“Youth participation is getting better,” Ms. Aghete said, “but often young people are not involved from the start but are used as rubber stamps after a plan or report is written.” It is particularly important that young people play a decision-making role, Our Voice, Our Future reports, as adults acting on young people’s behalf often design and implement programmes that are unsuitable or ineffective. “Often these decisions ignore the fact that young people are not a homogenous group and that their needs differ according to gender, sexual orientation, religion, culture, nationality and socio-economic status.”

Young women, for example, are three times more vulnerable than young men to HIV infection and represent 62 per cent of young people living with HIV. To ensure that the root causes of young people’s vulnerability are effectively addressed, programmes need to be designed to meet the special needs of each group.

The report recommends that governments focus on young people in their national AIDS strategies, step up funding for youth-oriented programmes, especially those that are led by youth, and work in full partnership with them in policymaking. It urges governments to expand availability of comprehensive, youth-friendly information and services, including life-skills-based education; voluntary and confidential counselling and testing; and condoms.

“One of the reasons we are vulnerable is that we don’t have access to information and services targeted to youth and tailored to their needs,” said Alaa Abdel Halim Abdel Salam Salem, 24, from Mansoura, Egypt, a medical-school graduate and member of Global Youth Partners. She pointed to hostility and discrimination against young people with HIV and AIDS in Egypt as the largest impediment to their receiving information, testing, counselling and treatment. “Youth-friendly services don’t stigmatize or discriminate,” she said. “They offer confidentiality and private counselling and are affordable and accessible to young people.”

Our Voice calls on governments to rely less heavily on donor funds that mandate “abstinence only” education. Young people in Zambia, where life expectancy has dropped below age 40 because of AIDS deaths, reported that programmes that distributed condoms or provided sexual and reproductive health education could not receive funding from certain donors because of “conservative agendas”.

“Interventions for young people should not be based solely on abstinence,” said Ms. Aghete. “They should be comprehensive and should involve the “ABCs”—abstinence, be faithful and use condoms—because some young people are not abstaining and are already sexually active.”

The report points to some policies and programmes that are good examples of what works. The Dominican Republic has included sexual and reproductive health education, with an emphasis on HIV/AIDS and life-skills education, in the national primary and secondary school curricula, and developed its national youth policy with the participation of young people, including those living with HIV.

In Zambia, Family Life Education Clubs have been set up in schools and communities and “Youth Friendly Corners” created at some health centres. Anti-AIDS Clubs established by the non-governmental organization (NGO) Caritas in 25 schools in Alexandria, Egypt, have provided a safe space for information and counselling on HIV.

A media campaign on AIDS prevention in India by BBC World Service in partnership with India’s national broadcaster, Doordarshan, and the National AIDS Commission has reached an audience of 125 million people through an award-winning TV detective drama series. Young people in several countries cited creative use of the media for HIV prevention as an area where governments have been successful in reaching out to them.

“Education and knowledge are the most powerful weapons to fight this epidemic,” said Ms. Salem. “The message of our report is that there is not enough political commitment, not enough financial commitment, not enough access to youth services and information and not enough youth participation.”

“We recognize our own responsibility in fighting the spread of the pandemic,” say the authors of Our Voice, Our Future. We are “driving grassroots initiatives in our own countries and are expanding the network of young people committed to working in partnership with our governments and civil society to reduce the vulnerability and risk behaviours of our peers. We ask to be heard and to be involved.”

—Margaret Bald