|Adolescent Sexuality and the HIV Epidemic (UNDP, 1999, 24 p.)|
A number of principles can be identified for future work to prevent HIV infection among young people in developing countries.
· Prevalent ideologies of masculinity and femininity which prescribe virginity in unmarried girls and promiscuity for boys facilitate the transmission of HIV to young women and young men. These ideologies need to be challenged at policy and programme levels, as well as in the media, family and community.
· Unhelpful stereotypes about young people and adolescent sexuality inform the attitudes of parents, other adults and even those involved with HIV-prevention. Wherever possible, program designers should attempt to challenge these stereotypes, since they serve as an obstacle to the development of appropriate and relevant programs of sex and HIV-related prevention.
· There is evidence to suggest that young people across the world are having sex earlier than in the past. It is important then that sex and HIV-related education are provided in a timely manner.
· The widespread denial of adolescent sexuality leads to attempts by adults to constrain and control young people's sexual behaviour. Since this is often unrealistic, it means that young people are denied access to information, services and resources which help them to protect their health.
· Young people benefit from open and honest communication with adults, and this is absent in many cultural contexts and declining in others. It is important that programs encourage better and more open forms of communication within families, and between families, communities and young people. There is some evidence to suggest that the epidemic of HIV infection may in itself provide increased awareness among parents about the importance of helping young people to protect their sexual health.
· Formal programs of sex education and HIV-related education are most successful when they include messages about safer sex as well as abstinence. Convincing messages which inform parents as well as policy-makers that timely and relevant sex education does not propel young people into premature sexual relationships must be disseminated.
· Teachers also require training in delivering sex education and developing confidence in talking to young people about sex. Supportive environments, including support from policy makers, educationalists and head teachers, are important in helping teachers to deliver effective programs of HIV-related education.
· There is evidence to suggest that peer education programs support young people in making changes to their behaviour.
· Programs might also provide opportunities to address issues relating to gender, social status and sexuality in work to promote young people sexual and reproductive health.
· Program designers and others concerned with HIV-infection must promote a greater awareness of structural issues affecting sexual and reproductive decision making, including rights and protection for young people, as well as improved access to education and health services.
· Young people living in developing countries, particularly girls and those young people living in especially precarious circumstances, need protection from rape, sexual exploitation and coercion. It is important that communities and governments are mobilised to take action to ensure that all young people can enjoy increased safety and freedom from sexual abuse.
· More work with young men is required to enable them to think about their role in relation to both their own sexual health and that of their partners, as well as improving programs for young women. Additionally, work should target adult men and the wider community in order to help adults to reduce the pressures on young men who are developing their masculine identities to behave in ways which jeopardize their own health and the health of others.
· When working with particularly vulnerable young people, including those who live on the streets, it is crucial that programs seek to address the daily risks which they face. As well as acknowledging the need for shelter, food, safety and support, those concerned with the prevention of HIV must work with policy-makers to reduce the hardships faced by street children.
· Work should be undertaken to reduce the marginalisation of young men who have sex with other men, alongside preventive work to ensure that young men are accurately informed and have access to health services and resources such as condoms.
· Improved access to non-judgmental and user-friendly sexual health services is crucial for young people. Training in adolescent health issues should be provided to health workers in the field of sexual and reproductive health.
· Young people need improved access to good quality condoms; it is important that confidential and non-judgmental provision is improved for young people.