WAD 1998

World AIDS Campaign 1998

This call for adult action does not imply that young people should become passive recipients. On the contrary. Young people can spur action and move it in the right direction. They are a powerful force for change in their own households, in the lives of their peers, and in the wider community too.

Worldwide, there are important examples of young people taking an active and even leading part in society, especially where their leadership is encouraged by adults who recognize the tremendous resource they offer. In many countries, young people are encouraged to take on roles as educators and mobilizers in local community groups, religious organizations and the like, including those in the AIDS field. Resilient in the face of profound emotional, economic and physical hardship, some young people are able to survive, thrive, and even take care of others, such as AIDS orphans in Africa who take over responsibility for the care of their many siblings.

There are special reasons why young people's involvement is essential for action on HIV/AIDS. Young people's understanding of life, though often influenced by their parents and other adults, is also developed both with and among their peers. It is groups of close friends that shape young people's understanding of social relationships, teach them about give and take, and enable them to develop a sense of personal competence and responsibility. This kind of peer support is invaluable for AIDS action. With encouragement, it can channel correct information about HIV prevention. It can draw young people into productive activities, such as giving emotional support and bringing practical help and care to those affected by the epidemic.

Peer support, youth to youth, can be aided and encouraged. In an innovative programme of exchange tours, UNDP is bringing young people from Ukraine to Sweden where they visit Youth Clubs that are active in HIV prevention.

Giving young people the space to define what they see as important also brings useful insight and guidance to adults, such as those who are attempting to draw up curricula for AIDS education or to develop policies on human rights protection. When young people explore sex and sexuality, or experiment with drugs, they have their own interpretation of what they are doing. Behaviour that adults may label "risky, to be avoided" may be engaged in by young people not only for entertainment but to show solidarity, to express and receive love, or for comfort and security. When there is mutual respect, rather than attempts solely to influence young people from above, adults can learn to understand these perceptions and, in partnership with young people, develop far more creative and relevant policies and programmes. Partnerships can also draw on young people's immense reservoir of energy.

Young people are a force for change because they are young. They are resilient, open to change, creative and often idealistic --- many of them have not yet encountered failures and the disappointments of time. Capitalizing on this force for change calls for young people to work in partnership with adults who encourage their participation and are receptive to their ideas.

The Campaign's main objectives

Force for Change, the 1998 World AIDS Campaign with young people, provides an opportunity for the social and private sectors to mobilize along with young people to promote their highest state of well-being. When young people can work with each other and with the support and strong commitment of the adults in their lives (such as parents, teachers, religious leaders, health care providers and politicians) there is an opportunity to create a social environment that protects young people's rights and enables them to develop to their full potential.

The campaign has five objectives, all of which aim to reduce the spread of HIV, and to strengthen support for young people infected and affected by HIV/AIDS. The objectives are:

  1. To promote young people's genuine participation.

  2. To promote policies and action for young people's health and development using a human rights framework.

  3. To increase awareness of the impact of HIV/AIDS on young people and young people's impact on the course of the epidemic.

  4. To mobilize social and private sectors to work in partnership on young people's health and development.

  5. To monitor the campaign.

Young people deserve priority attention in the ever-growing HIV/AIDS epidemic. The numbers and the characteristics of the epidemic among young people differ by region: Africa and Asia show more transmission through heterosexual sex, Latin America through homosexual sex, and Eastern Europe and the Newly Independent States through drug injection. But unless all regions develop effective means of reducing young people's vulnerability to HIV and their risk for infection, entire populations of young people will be lost, the epidemic will keep gaining momentum, and the human and economic costs will become intolerable.

In creating culturally sensitive policies and action, it is important to look "beyond AIDS" to the larger picture of young people's health and development. If we do not remedy the underlying causes—including human rights violations—that make young people vulnerable and put them at risk of HIV infection, there is little hope of reversing infection trends durably. There are no shortcuts.

At the same time, policies and initiatives must move beyond viewing young people simply as a "target group" whose problems must be addressed and fixed. It is critical to recognize the tremendous resource which young people represent. Initiatives that combine the strengths of both young people and adults, from the planning stage all the way to implementation and evaluation, will be the ones that will make a difference. The creativity, energy and charisma of young people have brought insight and inspiration to programmes that listen to what young people have to say.

Young people and adults working together can create the FORCE FOR CHANGE in the 1998 World AIDS Campaign with Young People.

Why a campaign with young people?

UNAIDS and its partners have chosen to carry out its 1998 World AIDS Campaign for and with young people—for three reasons. One is the special vulnerability of young people to the epidemic. Of all those infected after infancy, at least half are young people under 25. Another reason is that young people aged 10-24 account for more than 30% of all people in the developing world, where the epidemic is concentrated. If HIV prevention in this huge youthful population fails, developing countries will have to face the staggering human and economic costs of vast numbers of adult AIDS cases. Most important, working with young people makes sense because they are a force for change. They are still at the stage of experimentation and can learn more easily than adults to make their behaviour safe or to adopt safe practices from the start. But the role of young people does not stop there. They can help take the sting and shame out of AIDS where it is still stigmatized; they can bring kindness and practical help to those already infected with HIV or living in a household touched by AIDS. If they get support from the adults in their lives and from society at large, young people can change the course of the epidemic.

Important human rights in the AIDS era

Like adults over 25, young people have a right to information, life-skills (see box on page 10) and services that enable them to protect themselves against HIV/AIDS. They have a right to freedom from coerced sex, rape and other forms of exploitation. More broadly, young people have a right to develop in a supportive environment, with the solid backing of caring adults in their family, school and community. They have a right to education, skills, employment, health, confidentiality, and protection from discrimination, including discrimination on the grounds of HIV status, sexual practice, sex and age.

Research shows that these rights help protect health and development. Conversely, when they are not respected and promoted young people become vulnerable—that is, they have little or no control over their HIV/AIDS-related risks. Vulnerability can be created by violations of the rights to education, health care, participation, and safety, among others.

This is why action to prevent HIV infection must extend "beyond AIDS" to the broad social and economic rights that protect young people's health and development. This means grounding policies and programmes in the Universal Declaration of Human Rights, the UN Convention on the Rights of the Child, and the UN Convention on the Elimination of all Forms of Discrimination against Women.

Boys, risk and vulnerability

In the era of HIV/AIDS, boys raised with certain expectations of "masculine behaviour" can contribute to the vulnerability of their female sex partners and put themselves at risk at the same time. To complement the traditional focus on girls, WHO is launching a project aimed at reducing unsafe sex, sexual abuse and violence through work with boys. In the first instance, the project will try to identify successful approaches already being used with male adolescents. In the second phase, strategies will be developed to improve the quality of work with adolescent boys and to expand the scale of successful programmes.

Some help for young drug injectors

As part of the Programme of Youth Development in Odessa , which UNICEF is helping to implement, a project for HIV/AIDS prevention and harm reduction in injecting drug users has reached the pilot stage. Three outreach posts have been set up where former injecting drug users provide current users with medical aid, counselling and new syringes. An estimated 200 drug injectors visit these posts daily. These and other young people in Odessa can also benefit from the Youth-Friendly Clinics project, where they can get confidential, free or inexpensive general medical assistance and counselling as well as consultations with gynaecologists, psychologists and STD specialists.

Sexual health education translates into lower risk

Young people have a right to information and education that affects their health. But what impact does sexual health education have? Is it helpful, or can it be harmful?

A WHO review of programmes around the world, recently updated by UNAIDS, found that sex education does not lead to earlier or increased sexual activity, contrary to what many parents feared. The review concluded, instead, that:

  • the life skills needed for responsible and safe behaviour can be learned

  • good-quality educational programmes help delay first intercourse and protect sexually-active young people from HIV, STDs and pregnancy.

Anecdotal evidence, too, suggests that sex education encourages safer sexual behaviour. "When I first came to this school in 1994, we had several drop-outs from girls who fell pregnant", says Patience Ruyeko-Miengamero, a teacher at a rural school in Zimbabwe , an hour's drive from the capital Harare . "But last year following sex education programmes in 1995 we never experienced that, and for this year as yet there are no reports of pregnancies."

A separate study of an AIDS prevention programme among high school students in the Philippines found that, though there had been little impact on condom use during sex, the programme had led to a delay in the age of first sex and increased students' understanding of HIV/AIDS. The same trend toward postponement of first sexual intercourse is now being observed in Uganda and the USA .

The UNAIDS review found that effective programmes share certain features:

  • they have as specific aims both delayed first intercourse and protected intercourse

  • they encourage the learning of life skills (the same skills that also help build self-confidence and avoid unwanted pregnancy, sexual abuse and substance use)

  • they discuss clearly the result of unprotected sex and the ways to avoid it

  • they help young people "personalize" the risk through role-playing

  • they reinforce group values against unsafe behaviour, both at school and in the community.

UNESCO, UNFPA, WHO and the World Bank, alongside UNAIDS, are all engaged in helping countries translate these findings into action. A few examples illustrate the breadth of this work. With UNESCO's help, decision-makers in West Africa and elsewhere are working together to develop effective educational programmes based on the WHO/UNESCO publication School health education to prevent AIDS and STD: a resource package for curriculum planners. This publication and the two companion volumes intended for teachers and for students were translated into French by UNESCO. UNFPA, which collaborates with countries on school population programmes, has already introduced the subject of AIDS into these in more than 100 countries, and the World Bank is also using and promoting the 3-volume WHO/UNESCO school package. WHO is providing technical assistance and training to educational and health authorities in China in order to introduce STD/AIDS education into the school system in two provinces with high HIV prevalence rates.

Important life skills in the HIV/AIDS era;

  • How to make sound decisions about relationships and sexual intercourse, and stand up for those decisions.

  • How to deal with pressures for unwanted sex or drugs.

  • How to recognize a situation that might turn risky or violent.

  • How and where to ask for help and support.

  • When ready for sexual relationships, how to negotiate protected sex or other forms of safer sex.

  • How to show compassion and solidarity towards people with HIV/AIDS.

  • How to care for people with AIDS in the family and the community.

Young people demand a say

At the 1995 International Conference on STD/AIDS in Kampala , a "delegation" of young Africans from 11 countries, ranging in age from 14 to 24, issued a declaration of their needs and priorities. The declaration put forward a series of principles that UNAIDS endorses as essential for effective AIDS action:

  • Youth participation: involve us in programme planning, implementation and evaluation and policy development in community decision-making processes.

  • Youth-friendly services: support the provision of services, including centres where we can access information, support and referral.

  • Parental involvement: strengthen the capacity of parents and other significant persons in our lives to better communicate with us and provide guidance and support to us, our brothers and sisters.

  • Education about HIV/AIDS and sexuality: promote skills-based education on physical development, reproductive health and sexuality for both in and out of school youth.

  • Protection of girls and young women: prevent the sexual abuse and exploitation of girls in vulnerable situations; emphasise the sensitization of boys, young men and elder men.

  • Partnership with people with HIV and AIDS: build networks between young people with HIV/AIDS and other youth to promote prevention of HIV/AIDS, protection of human rights and acceptance of people with HIV/AIDS in society.

  • Young people's commitments: commit ourselves to responsible decision making about our own sexual behaviour and positively influence our peers.

Along the same lines, the Commonwealth Youth Forum held in Edinburgh , in October 1997 put forward a statement of sexual and reproductive rights. The young people recognized "the responsibilities that these rights entail both to individuals and to states" and urged Commonwealth governments to protect those rights pursuant to the Programme of Action they had endorsed in Cairo at the International Conference on Population and Development in 1994. The Youth Forum's declaration states:

All young people of the world regardless of sex, religion, colour, sexual orientation, or mental and physical ability have the following rights as sexual beings:

  1. The right to be yourself—free to make your decisions, to express yourself, to enjoy sex, to be safe, to choose to marry (or not to marry) and plan a family.

  2. The right to know—about sex, contraceptives, STDs/HIV and about your rights.

  3. The right to protect yourself and be protected—from unplanned pregnancies, STDs/HIV and sexual abuse.

  4. The right to have health care—which is confidential, affordable, of good quality, accessible to all, and given with due respect.

  5. The right to be responsible for one's own actions and those that affect others.

  6. The right to be involved—in planning programmes with and for youth, attending meetings/seminars etc. at all levels, and trying to influence governments through appropriate means.