|Adolescent Sexuality and the HIV Epidemic (UNDP, 1999, 24 p.)|
Approximately one-third of the world's population is between 10-24 years of age, and four out of five young people live in developing countries, a figure which is expected to increase to 87% by the year 2020 (Friedman, 1993; Ainsworth and Over, 1997). In many countries the majority of young people are sexually experienced by the age of 20 and premarital sex is common among 15-19 year-olds. For example in recent surveys it was found that 73% of young men and 28% of young women in this age group in Rio de Janeiro reported having had premarital sex, compared with 59% and 12% respectively in Quito, and 31% and 47% respectively in Ghana (Population Council, 1996)
Sexually transmitted infections (STIs) including HIV are most common among young people aged 15-24 and it has been estimated that half of all HIV infections worldwide have occurred among people aged under 25 years (World Health Organisation, 1995). In some developing countries, up to 60% of all new HIV infections occur among 15-24 year-olds. Yet, vulnerability to STIs including HIV is systematically patterned so as to render some young people more likely to become infected than others. Gender, socio-economic status, sexuality and age are important factors structuring such vulnerability. Unequal power relations between women and men, for example, may render young women especially vulnerable to coerced or unwanted sex, and can also influence the capacity of young women to influence when, where and how sexual relations occur (Rivers & Aggleton, 1998).
The consequences of HIV/AIDS can be far-reaching for young people. Not only does HIV disease have terrible consequences for the individual, causing serious illness and eventual death, it has the potential to trigger negative social reactions. Across the world, people with HIV/AIDS routinely experience discrimination, stigmatization and ostracization (Auer, 1996; Malcolm et al, 1998). Children and young people who are orphaned by the epidemic, and who themselves may be infected, are sometimes left without the support of adults (Levine, Michaels & Back, 1996). For women and adolescent girls, the consequence of AIDS can be particularly dire. There is strong evidence, for example, that in some countries women may be 'blamed' for HIV disease even in circumstances where they have been infected by remaining faithful to their husband or other male partner (Bharat & Aggleton, in press). There is also evidence to suggest that women are less likely to receive the kind of care and support made available to male household members (Warwick et al., 1998). Moreover, where the male head of household has died there may be loss of social support for young women, ostracization from the community, and lack of legal protection to inherit land and property. Some young women may find themselves unwelcome in the extended family and may even be coerced into sex work (Levine, Michaels & Back, 1996).
Given the significant number of young people living in developing countries seriously affected by the epidemic, it is crucial that work is undertaken to ensure that they are able to protect themselves. This involves providing them with access to information and resources, as well as promoting a climate which is understanding of young people and their sexual and reproductive health needs. In recognition of the enhanced risks faced by young people, UNAIDS and its cosponsoring organisations including UNDP, has identified young people as a key group for HIV-related prevention activities. World AIDS Day 1998 gives special emphasis to this fact in its identification of young people as a key group with which to work.