Background

Young people are especially vulnerable to HIV and other sexually transmitted diseases (STDs). They are also vulnerable as regards drug use (and not just injected drugs). Even if they are not engaging in risk behaviours today, they may soon be exposed to situations that put them at risk. Very often they cannot talk easily or at all about AIDS, or about the risk behaviours that can lead to HIV infection, at home or in their community. However, most of them do attend school at some point, and school is an entry point where these topics - often difficult to discuss elsewhere - can be addressed.

The potential strengths of a school setting are that children there have a curriculum, teachers, and a peer group. And school teaches them not only information, but also skills and attitudes.

Young people who are sexually active are generally not in a stable sexual relationship and may have frequent changes of partner. They are often ignorant of the health risks of sexual behaviour, and they may have poor access to health care services. In addition, they are sensitive to peer pressures and messages from the media, and some are sexually exploited by adults. Those who engage in drug use (including alcohol) may become more vulnerable to sexual or injection-related HIV transmission. These facts help explain why in many countries 60% of all new HIV infections are among 15-24 year-olds. The highest rates of STDs are usually found in the age range of 20-24 years, followed by 15-19 years.

Young people generally find it difficult to reach services where they can discuss questions related to sexual health or sexuality. Counselling is rarely available, and family planning clinics are mostly restricted to married women and couples. Young people are usually reluctant to talk to doctors or nurses about sex, either out of embarrassment or because they consider that confidentiality will not be respected. They may feel equally uncomfortable talking to their parents about sexual matters, and the parents in turn may also be embarrassed or lack the confidence to discuss the subject with their children.

At the same time, young people can be a positive asset in helping prevent HIV and STDs. As they are still developing behaviour and experimenting in sexual matters, they can adopt safer practices from the outset - or switch to them - more easily than adults. Their attitudes are also usually less rigid, and they have less entrenched taboos (see Baggaley R, “Young people talk about HIV: summary of findings from 45 focus group discussions”, UNICEF, Lusaka, 1996).

Young people can exert a strong influence on one another. This can be negative, with young people encouraging each other to engage in risk behaviours, but equally it can be channelled positively in AIDS education programmes, to spread messages on what is safe and what is not as regards AIDS. Young people have great energy and commitment. Since they have had less time to develop prejudices, young people can also learn to adopt non-discriminatory behaviour and attitudes towards people with HIV/AIDS far more easily than adults can.

Given the vulnerability of young people to STDs and HIV, society needs to do more to help children protect themselves, primarily by educating them - in schools, at home and through the mass media. Leaving education on matters relating to sexuality to parents alone is a haphazard policy. For the growing number of children attending school, school teachers can take on this task.

A study across a range of cultures has shown that good AIDS education among adolescents does not lead to increased sexual activity, but on the contrary delays the age of first sexual intercourse. The study has also confirmed that when the same adolescents become sexually active, they tend to avoid sexual risk behaviour (see Impact of HIV and sexual health education on the sexual behaviour of young people, 1997).