Youth and the HIV/AIDS Crisis

(August 2000) About half of all people infected with HIV are under age 25, according to World Health Organization estimates, and in less developed countries, up to 60 percent of all new infections are among 15-to-24-year-olds. In this age group of newly infected people, there are twice as many young women as young men.

Adolescents are at high risk of contracting HIV and other STIs because, among other reasons, they often have multiple short-term sexual relationships and do not consistently use condoms. They also tend to lack sufficient information and understanding of HIV/AIDS: their vulnerability to it, how to prevent it, and the self-confidence necessary to protect themselves. STIs other than HIV (such as chlamydia and gonorrhea) are also a serious threat to adolescents. Worldwide, the highest reported rates of STIs are found among young people ages 15 to 24. In more developed countries, two-thirds of all reported STI infections occur among men and women under age 25, and in less developed countries, the proportion of infected young people is even higher.

Young people face special obstacles in obtaining diagnosis and treatment of HIV/AIDS and other STIs, even where services are available. They usually lack information about STIs, their symptoms, the need for treatment, and where to obtain services. They are also reluctant to seek care, and providers may be hesitant to treat them. Because females with chlamydia and gonorrhea, the most common STIs, often do not show symptoms, and because having another STI increases an individual’s susceptibility to HIV, young people are at high risk of contracting and spreading these infections. They may also face legal and/or institutional obstacles to using services, such as negative provider attitudes or requirements for parental, spousal, or partner consent before testing or treatment. Additionally, young people often believe (incorrectly) that STIs will simply go away if untreated or that they will not recur if treated.

Young women are particularly vulnerable to STIs for both biological and cultural reasons. Adolescent women have fewer protective antibodies than do older women, and the immaturity of their cervixes increases the likelihood that exposure to infection will result in the transmission of the disease. Sexual violence and exploitation, lack of formal education (including sex education), inability to negotiate with partners about sexual decisions, and lack of access to contraception and reproductive health services work together to put young women at especially high risk. Additionally, women in many societies are not accustomed to discussing issues of reproductive health and sexuality with others, which further increases their vulnerability.

A Call for HIV/AIDS Education

Policymakers are giving greater attention today to the need for AIDS education, prevention, and treatment. It is estimated that over 30 million adults and children worldwide are living with HIV or AIDS, but most do not know they are infected. An overwhelming majority, 95 percent of people with HIV, live in less developed countries. In 1999, at the five-year review of the ICPD, governments established the goal of giving at least 90 percent of young men and women ages 15 to 24 access to preventive methods by 2005 in order to reduce vulnerability to HIV infection. These methods include female and male condoms, voluntary testing and counseling, and follow-up.

Despite the urgent need for raising public awareness, cultural and institutional barriers stand in the way of educating people about the risks of HIV and ways to prevent it from spreading. Many parents and educators have long been concerned that sex education may increase sexual activity among young people. However, a recent assessment by the Joint United Nations Programme on HIV/AIDS (UNAIDS) reveals that HIV and sexual health education promotes safer sexual practices and does not increase sexual activity. According to the report, effective programs help delay first intercourse and protect sexually active youth from STIs, including HIV, and from unintended pregnancy. UNAIDS also reports that sexual health education is most effective when started before the onset of sexual activity.