Inter Press Service - December 10, 2001
Susan Lee

In effect, many die because of embarrassment, according to the report, "Youth and HIV/AIDS: Can We Avoid Catastrophe?", published by the Bloomberg School of Public Health at Johns Hopkins University.

The document recommends more targeted prevention strategies and encouraging an atmosphere of open discussion in which young people feel comfortable asking potentially embarrassing sex-related questions.

Researchers also assail the United States for stifling discourse on abortion and sexually transmitted diseases, saying U.S. policy has hindered access to resources and information in many countries - with disastrous consequences in places like sub-Saharan Africa, where an estimated 8 million young people - mostly women - are infected with HIV.

Underscoring the urgency of the situation, the researchers note that although 15 to 24 year olds make up only one-fifth of the world's population, they have accounted for half of the more than 60 million new human immunodeficiency virus (HIV) infections over the past two decades.

Some 11.8 million young people are living with HIV/AIDS, compared with 10.3 million at the end of last year, according to the Joint United Nations Programme on HIV/AIDS.

Youth advocates long have said that AIDS prevention starts with education in schools, in communities, and among families, peers, and partners. Young people practice unsafe sex, they say, because they have little information about safe sex practices and because they feel intimidated about asking sex-related questions.

"There's a misconception that the youth don't get involved and would not like to work out their problems," said Jane Norman of the Washington-based Youth Empowerment Initiative.

"The underlying fact is that young people don't get a lot of respect and so sometimes they do not act out in the healthiest way," she said. "Sexuality is a natural and normal part of being a human being. When we make young people feel guilty, it makes them less likely to come forward and get information."

Iain Guest of the Washington-based Advocacy Project, which paid for a group of youth activists to travel to six African countries last summer to lobby governments and meet other young activists, said youth should be active in strategies to reduce HIV rates.

"Young people, the material shows, are in fact extremely good at networking and connecting with their peers," Guest said. "We need to remember that they can be trusted, and their actions are not dependent on some characteristic behaviour but rather on the social conditions present."

The U.S. policy of denying funding to foreign non-governmental organisations deemed to perform, facilitate, or provide information about abortions, has "hamstrung reproductive health services abroad that need all the support they can get," said Norman. Even where the "global gag rule" does not silence discourse, she added, it "censors information by emphasising the failure rate of contraceptives."

The report cites urbanisation, more liberal attitudes toward sexuality, and the breakdown of extended families as factors that have increased vulnerability to high-risk behaviour.

In Bangladesh, surveys found that 96 percent of young women aged 15 to 19, and 88 percent of young men, did not know a single way to protect themselves against HIV/AIDS.

The report also notes that some adult men in parts of Africa believe - incorrectly - that having sex with a virgin will cure them of the disease, or that sleeping with young girls will minimise their chances of contracting HIV.

In consequence, women in some regions contract the disease 10 years earlier than men.

Besides young women, high-risk groups include young drug users, homeless children, sex workers, and the poorest. The report says prevention strategies targeted at these groups would have the same impact in reducing AIDS as a national campaign, at 20 percent of the cost.

Unless immediate action is taken, it warns, life expectancy in countries including Botswana, Mozambique, Namibia, Swaziland, and Zimbabwe will fall to around 30 years by 2010.

"It may already be too late to avoid catastrophic numbers of AIDS deaths," said Hopkins researcher Karungari Kiragu.

The report urges political and financial institutions to support youth programmes in developing countries. It notes that although 95 percent of people living with AIDS reside in developing countries, 95 percent of AIDS prevention money is spent in industrial countries.
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