Worldwide, more than half of all people who become infected with the human immunodeficiency virus - HIV - acquire the virus when they are under 25 years old.
It is tragic that HIV should single out a youthful and otherwise relatively healthy population group. But it is hardly a coincidence, given the daily circumstances of many young people's lives. As we have learnt from two decades of experience with this epidemic, the path of HIV is eased by poverty, lack of skills, violence, and harmful social norms such as machismo and early sexual debut.
This briefing paper takes a look at the young people of Latin America and the Caribbean in the era of AIDS. How exposed are they to HIV? In the context of their everyday lives, what factors tend to make them more vulnerable to the virus? Finally, how can communication build up the protective factors in their environment and break down the harmful ones?
In 1997 the World AIDS Campaign highlighted the challenges facing children living in a world with HIV/AIDS. In 1998 the Campaign focused on young people as a force for change.
The 1999 World AIDS Campaign aims to build on the activities and awareness created in preceding years by turning the world's attention more broadly to communication:
In Latin America and the Caribbean, an estimated 1.3 million adults (aged 15-49) and children (0-14) were living with HIV at the end of 1998. Men who have sex with other men, and those-often men as well - who inject drugs are disproportionately affected in many countries of the region. However, rising infection rates in women show that heterosexual transmission is gaining in importance. Systematic surveillance is limited, but HIV prevalence in pregnant women attending antenatal clinics reportedly reaches 1% in Honduras and exceeds 3% in Porto Alegre, Brazil. HIV rates in pregnant women are significantly higher in the Caribbean-by 1993 a rate of 8% was seen in Haiti and in 1996 a similar rate was reported from one surveillance site in the Dominican Republic.
Altogether, from the limited surveillance data available, UNAIDS estimates that more than 65,000 15- 24-year-olds became infected during 1998 alone in this region. In addition, 8000 children ranging from infants up to 14-year-olds became infected in 1998. Most of these infections were in children who acquired the virus from their HIV-positive mother during pregnancy or birth or through breast feeding.
Because HIV surveillance systems generally take age 14 as the cut-off point for child infections, and because the overwhelming majority of these occur through mother-to-child transmission, relatively little is known about the magnitude of sexual transmission among youngsters aged 10-14.
Data from Brazil suggest that some early spread of this kind does occur. For example, in 1998 almost 10% of AIDS cases in youngsters aged 12 or younger were not the result of mother-to-child transmission. In addition, 13% of Brazil's cumulative total of AIDS cases since the start of the epidemic were in 15- 24-year-olds, and fully 82% were in people under 44. It is important to bear in mind that AIDS is the severe end-stage of infection with the human immunodeficiency virus.
In developing countries, people typically develop AIDS 8-10 years on average after initial infection with HIV. This means that a 30-year-old with AIDS might well have become infected in his or her early twenties.
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.
Like adults over 25, young people have a right to information, life-skills (Important life-skills in the HIV/AIDS era) 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.
If HIV infection rates among 13- 19-year-old girls are often higher than in teenage boys - the difference in Uganda, for instance, is as big as three-fold, according to estimates by the Medical Research Council Programme on AIDS in Uganda - the reason lies in their greater biological and social vulnerability. Compared with males, the female reproductive tract is more susceptible to infection with HIV and other STDs, a susceptibility that is particularly great in young girls. And girls often run this biological risk very early. In a study conducted for the International Center for Research on Women, a quarter of adolescent girls in Brazil reported having first experienced sex before age 13; in Malawi the mean age was 13.6 years; and in Papua New Guinea first intercourse occurred as early as age 11.
Compounding the biological vulnerability of girls are complex and unhealthy gender expectations which mean that young women have less control over their lives and bodies than their male counterparts, and that boys and young men are tacitly or openly encouraged to adopt aggressive, even predatory sexual behaviour.
In many cases, a girl's first sexual experience is forced. More than half the young women in a Malawi study reported coercion; over 20% of young women surveyed in Nigeria reported being forced to have sex; in Papua New Guinea over half the young women questioned said they had been coerced, often violently.
The reasons for unwanted sex range from social pressure - girls often have sex because refusing would mean ending a relationship - through coercion by older men in authority (e.g. schoolteachers) to outright violence. Young girls are often targeted because they are believed "safe" and uninfected with HIV. Rape, reported from every continent, has become lethal with the advent of HIV.
Unwanted pregnancies can be seen as an indicator of sex over which women have little control. A study in Jamaica found that 47% of girls under 20 had had a pregnancy, and that over four-fifths of those pregnancies were unwanted. In Tanzania, according to a publication in the Strategies for Hope series, 71% of patients admitted to hospital for abortion complications were teenage girls.
Girls, and boys as well, can be infected through sexual abuse by relatives, family friends, teachers and strangers. Girls and young women in domestic service, often exploited for their labour, are especially vulnerable to sexual abuse by males in the employer's family. Young boys serving as apprentices in the construction trade or helpers on long-haul trucks are sometimes abused by the older men.
Forced prostitution is another form of abuse and exploitation known to fuel the HIV epidemic. Around 30% of 13- 19-year-old sex workers (some of whom were forced into prostitution) in Cambodia are infected, and even higher rates have been reported from elsewhere.
Many thousands of girls, but also boys, enter the sex trade every year. In Myanmar, a national HIV survey reported in 1994 found higher HIV prevalence rates in young women than young men and ascribed this to the demand for very young girls in the sex industry, primarily across the border in Thailand. Some farm families take their daughters out of the fields at age 12 or 13 as field work might ruin their main asset for the sex trade - beauty.
While many young people are abducted or sold into the sex industry by parents, relatives or family friends, some are coerced simply by circumstances. Poverty is a key factor, though the commercial sex trade also has links with growing consumerism, violence and crime.
-Woman social worker, southern Africa Children and adolescents who work or live on the streets sometimes engage in an informal trade of sex for money, protection, a meal or a place to sleep. HIV has now been added to the panoply of risks and dangers they face daily, including violence and abuse at the hands of other street kids or adults and authority figures.
Like street children and those in the sex trade, many other young people live on the margins of society in especially difficult circumstances. These include young residents of urban slums or remote rural areas, refugees, and migrants. Reaching these groups with AIDS education is a major challenge. Many are poor, have little access to education and so cannot read and write, may not know the language of the country they are living in, and have little control over the circumstances of their lives.
Another group of young people who tend to be marginalized, and who may be exposed to a high risk of infection because of their sexual practices, are young men who have sex with men. (Young lesbian women are also marginalized but their same-sex practices are thought to expose them to little HIV risk.) Especially in developing countries, these young people are ignored in youth programmes which tend to assume that all sex is heterosexual - despite evidence that same-sex relations occur around the world, even in societies with the strictest taboos against them. Because this kind of sexuality is misunderstood and stigmatized, essential educational messages about AIDS prevention fail to be targeted at this group.
Young people who inject drugs are exposed to high HIV risks if they share needles. In a number of Eastern European countries, crumbling health and social service infrastructures combined with high unemployment are contributing to a sense of hopelessness about the future among some young people. Drug injecting with shared needles is reaching explosive levels in cities such as Mykolayev and Odessa. Not surprisingly, HIV rates are skyrocketing as a result. As the world has seen repeatedly in cities from New York to Bangkok, Geneva and Santos (Brazil), once the virus finds its way into a population of drug injectors the spread is explosive. In Manipur, India, the proportion of young drug injectors (median age: 25) infected with HIV zoomed from virtually zero in 1989 to 56% within six months, and to over 67% by 1992.
In the Newly Independent States, as in much of Asia and the Americas, young people engaged in unsafe drug injecting often get little or no counselling, support for stopping substance use, or practical help in switching to less harmful forms of drug use. Discrimination against them magnifies their vulnerability.
Apart from the HIV risk connected with needle-sharing, it is known that alcohol and other drugs can affect sexual behaviour and increase young people's vulnerability to HIV. Excessive drinking, for example, diminishes inhibitions and impairs the ability to use important information that has been learnt about AIDS prevention and to make decisions about protection.
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.
Like older HIV-positive adults, young people living with HIV infection require increasing health care as their immune system weakens and their health declines. However, they may face special obstacles in exercising their right to health. Young people may be too poor to buy care, or too afraid of disclosure by health providers who might not respect their confidentiality. The absence of youth-friendly services is an obstacle.
Even before reaching this stage, young people who know they are HIV positive may find it particularly difficult to reconcile themselves to being infected so early in life. It may be harder for them to deal with feelings of anger and confusion about their sex life and the risk of infecting others. Even where HIV/AIDS support groups exist, there may be none specifically geared to the needs of people their own age.
Young people with HIV infection, as well as those whose relatives are living with or have died of AIDS, may be teased, thrown out of school, or deprived of the company of their friends because the parents of the latter forbid all contact.
Whether infected or affected, young people are probably less well equipped than their older counterparts to confront discrimination, including the painful experience of being rejected by their age peers. They may be more ignorant of their specific rights, including the right to non-discrimination in education and employment, and have little access to lawyers or other advocates to fight on their behalf. Overshadowing all are the economic hardships they endure. All too often, initiatives by extended families and communities to ensure that young people are cared for, educated and employed receive inadequate backing from governments.
As these examples show, action in favour of protecting young people from AIDS cannot focus only on individual behaviour. It must also focus on protecting their human rights so that they can ward off HIV and cope with the burden of AIDS. The goal is to transform the setting in which they live into a supportive environment in which they will have more control over their lives, including their HIV/AIDS risks.
-Young man from Zimbabwe
With the world's power and resources concentrated in adult hands, the onus for AIDS action is on adults - as individuals, groups and governments.
In many industrialized countries and some developing countries, governments and NGOs together have risen to this challenge with considerable success. Through a combination of media campaigns, sexual health education on AIDS for those attending school (see Sexual health education translates into lower risk) and those out of school, the provision of condoms and other prevention services, and the establishment of supportive policies, countries ranging from Australia to Uganda have helped young people adopt safer sexual behaviour, live in more supportive environments, and experience lower HIV infection rates.
In Thailand, sustained prevention efforts were aimed at increasing condom use, boosting respect for women, discouraging men from visiting sex workers, and offering young women better educational and other prospects to discourage their entry or sale into commercial sex. As a result of these measures, carried out by many government departments (including health, education, police and military) in coordination with NGOs and the media, HIV prevalence in 21-year-old men in northern Thailand fell from 7.1% in 1992 to 3.5% - less than half - by 1995, and has decreased even further since then.
In Uganda, again thanks to concerted government and NGO action, pregnant young women attending antenatal clinics have considerably lower infection rates than they used to. Most encouragingly, the biggest decrease is in the youngest age group, those aged 15 to 19. In some clinics, rates have plummeted from 38% in 1991 to 7.3% in 1996. While some of this drop can be explained by increased condom use, some is due to the trend among young people to begin their sexual life later.
Another country in which young people are postponing first intercourse is Switzerland. Interestingly, the proportion of 17-year-olds who had begun having intercourse started to fall in 1987. This is the exact same year in which condoms were made widely available to young people and when condom use among 17- 20-year-olds who were sexually active started rising from 17%, reaching 69% by 1994.
Adult support is not just a question of remote, impersonal action taken by government departments or far-off organizations. One of the biggest needs young people around the world have identified is for understanding on the part of their parents, teachers and community leaders. They need adults they can turn to and trust, adults who will listen as they explain what they are experiencing and coping with.
A major nationwide study in the USA on adolescents has found that the single most important factor in healthy development is a caring adult to whom the young person feels connected - loved by, listened to, cared about. This finding was independent of race, ethnic group and socioeconomic status.
Some of the communication needs to focus on sexuality. According to a report by the International Center for Research on Women, ''Despite numerous barriers documented... young women and men want increased communication with adults on sexual matters. For example, nearly 80 percent of female adolescents in the Mexico study said that they would like to talk more about sexuality with their mothers, and 60 percent would like more communication with their fathers. The Khon Khaen, Thailand, school-based study also found that adolescents wanted access to trusted adults.''
Research with young people in the Pacific has highlighted the same appeal for communication and connection. As a young Samoan put it, ''Parents and kids just don't know each other. They don't know what they're like. They don't know their habits. They don't know when they're hurt''.
Young people can communicate with trusted adults through the written word, too. In Uganda, a newspaper called Straight Talk with a circulation of around 100,000 a month is targeted at 14- 19-year-olds. Breaking new ground, the paper gives ample space to comments and questions from its young readers, and the advice provided by the adult editor is forthright. In reply to one question from a male reader, the paper wrote, ''If you are afraid of having sex with your girlfriend, then you are not ready yet. Sexual feeling at your age is normal, but you don't have to have sex. Masturbation could help you relieve these tense feelings.'' Despite the unusually frank views expressed, the paper is flourishing.
-14-year-old girl addressing the International Conference, on STD/AIDS in Africa, Kampala, 1995. 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:
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:
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.
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.
-Youth delegate to the 4th International Congress on AIDS in Asia and the Pacific, Manila, October 1997.
Whatever the adult world does for the health and development of young people, experience shows that it is best done not by manipulating the young or using them as tokens, but with their genuine participation. This means listening to young people, understanding how they think and act, offering assistance and support without dictating the outcome, and engaging them as active participants in activities and decision-making.
The following highly effective HIV/AIDS-related programmes are examples of approaches that value and fully integrate young people as participants.
The Asian Red Cross and Red Crescent AIDS Task Force (ART) was established in 1994 by professionals and young volunteers from 10 national Red Cross and Red Crescent Societies in Asia to promote HIV/AIDS activities at grass-roots level.
In its first two years, ART trained 1,000 young people as peer educators using a life-skills approach (see Important life-skills in the HIV/AIDS era. Teams of Red Cross/Red Crescent staff worked with young people in each country to develop culturally sensitive training manuals on sexual and reproductive health and HIV/AIDS. The manuals were pre-tested with groups of young people in each of the ten countries.
Following this, Red Cross/Red Crescent staff met with young people from national Societies to discuss cultural differences reflected in each manual, to finalize the texts, and to develop principles for conducting sexual and reproductive health training to help young people protect themselves and their peers.
In 1994 a group of NGOs in Lusaka, Zambia, realized that existing primary health clinics were not meeting the health needs of young people. The NGOs joined with the Ministry of Health and the district council in organizing an informal working group to identify these needs and develop a strategic plan. The working group meetings were attended by young people, health staff and NGO representatives.
One of the priorities identified was the need to increase the direct involvement of young people in the provision of services. Consequently, 52 young people were trained over a period of two weeks to provide counselling on pregnancy, sexually transmitted diseases, substance use, financial matters, and communication with partners. Once trained, these peer counsellors provided counselling and condoms to young people who came to the clinic for them. If a young person required medical care, the peer counsellor also served as a link between the young person and the medical staff.
Involving young people as peer counsellors had the double effect of (a) increasing attendance at the clinic because services were more suited to the needs of young people, and (b) creating strong links between the adults and young people in the community. Young people felt more comfortable talking first with their peers and then, if necessary, with an adult health care provider.
Jornal Radical is a monthly magazine for young people developed and published by the Athos Bulcâo Foundation in Brasilia, Brazil. The magazine attracts young people's attention by using bright colours, photographs and modern layout, and by discussing issues that interest them. The magazine, written in easy-to-understand language, covers cultural issues such as literature and music, social concerns such as human rights and politics, and personal matters such as sex and relationships.
The magazine has an interactive approach, whereby young people are asked to contribute articles, poems and drawings. Jornal Radical also interviews young people about their beliefs and aspirations. One of the magazine's more radical innovations is to arrange for young people to interview government ministers, teachers, artists and musicians.
Jornal Radical has been distributed to over 1.1 million young people in schools over the past year and is immensely popular. Radical serves as an informal educational tool to raise young people's social and cultural consciousness as well as to raise adults' awareness of young people's concerns. One young woman wrote in to say, ''Radical offers us the opportunity to express what we desire and feel, and motivates us to read because the materials are super-interesting.''
The Clear Skies Project was created in a rural district outside Chiang Mai, Thailand, to provide emotional and practical support for people with HIV infection or AIDS. The project is entirely run by people who are themselves living with HIV/AIDS, many of them under the age of 25. The project arranges weekly meetings where HIV-positive people come together to discuss common concerns such as health problems and community discrimination. They discuss possible solutions and work in partnership with various institutions, government offices, and health care centres. The project has also worked with other groups to draw up a document outlining the rights of people living with HIV/AIDS.
One of the project's main activities is to provide home care for people with AIDS who are too ill to leave their homes. Volunteers train families to look after sick family members. The project also conducts workshops on meditation and yoga, maintains a herbal medicine garden, and facilitates access to health clinics and hospitals. The project works closely with health care providers to increase their sensitivity to the need of people living with HIV/AIDS for caring, sensitive, and confidential care.
Many of the newest staff members at Clear Skies Project are young men and women. They are vocal advocates of prevention efforts, speaking out at conferences and in schools on the realities, risks and pains of HIV infection. They have been particularly effective in raising school youth's awareness of the difficulties faced by people living with HIV/AIDS. In classrooms where they have spoken, they have often changed young people's attitudes from discrimination and fear to feelings of compassion and solidarity.
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:
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.
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:
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:
UNAIDS is happy to acknowledge the significant contributions to this document made by PANOS.
© Joint United Nations Programme on HIV/AIDS (UNAIDS) 1999. All rights reserved. This document, which is not a formal publication of UNAIDS, may be freely reviewed, quoted, reproduced or translated, in part or in full, provided that the source is acknowledged. The document may not be sold or used in conjunction with commercial purposes without prior written approval from UNAIDS (contact: UNAIDS Information Centre).
Joint United Nations Programme on HIV/AIDS (UNAIDS)
Introduction
LISTEN, LEARN, LIVE!
HIV/AIDS, children and young people: the threat is real
Boys, risk and vulnerability
Important human rights in the A I D S era
Young women's vulnerability
Abuse and exploitation
"I have several teenagers I'm counselling. [One HIV-positive 13-year-old] got hounded out of school because she was raped, she was raped by quite a well-known figure where she lives. The kids got to know about it because she ran to the police station - the guy died before he got to court. She ended up Ward 12 suicidal; she said "I didn't know anything. I didn't know what he was going to do. I didn't know about sex."
Life on the margins
Drugs, sex and HIV/AIDS
Some help for young drug injectors
Special needs of young people living with or affected by HIV / AIDS
"I go about telling people of my status. Some will actually not believe, but some will just feel pity, or they mock me, or they accuse me of being promiscuous. But this sexual act that left me HIV positive was only my second."
Support from the adult world
Adults to trust and talk to
"In my country, Botswana, there is a serious problem of communication between parents and their children. This is a cry from our hearts. Parents - talk to us. Without your communication, guidance, dialogue, we are a lost generation. Come to our aid."
Sexual health education translates into lower risk
Young people: a force for change
"You have to start from the ground [children and youth] with education, so the youth will grow fruitfully and be protected from AIDS. If not, the tree will die."
What young people's participation can achieve
The Asian Red Cross and Red Crescent AIDS Task Force (ART)
Youth-friendly health services, Lusaka, Zambia
Jornal Radical, Brasilia, Brazil
Clear Skies Project, Doi Saket, Thailand
Important life-skills in the HIV/AIDS era
The Campaign's main objectives
Young people demand a say
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