Young people around the world are not receiving clear messages or support to use condoms to prevent HIV infection, according to delegates at the AIDS 2014 conference in Melbourne, Australia (20-25 July).
Health experts and youth organisations have pointed to inadequate sex education and stigma facing young people who are sexually active as factors in rising rates of sexually transmitted infections among adolescents.
“If you look at the number of new cases of sexually transmitted diseases in the US, 25 per cent of them are in the adolescent population. This is a major public health issue that needs to be addressed,” says Dr David Kaplan, chief of adolescent medicine at the University of Colorado School of Medicine.
When used consistently and correctly, latex condoms are highly effective in preventing the sexual transmission of HIV. They are also effective in preventing pregnancy and other sexually transmitted infections (STIs) and lower women’s risk of developing cervical cancer. But in many countries, these messages are simply not getting through to young people.
Lack of sex education
“We are saying that we are fighting to end AIDS, yet we are leaving the measures to prevent it behind, especially among the youth,” says Consolata, a woman who works with young people who are living with HIV in Nairobi, Kenya.
“In some countries, we know that sex education is not the order of the day. Youths are sexually active and, at the same time, they do not know how to go about it safely. This leads to unwanted pregnancies, HIV and other sexually transmitted diseases.”
According to Daisy, who works with an organisation representing sex workers in Uganda, many HIV prevention strategies for African youth, such as encouraging condom use, have been ineffective because barriers within the community have rarely been addressed.
Opposition to condoms
Qualitative research in rural Western Kenya, on the attitudes of different segments of society towards youth condom use, found that about half of community members strongly opposed youth condom use, with many advocating punishment such as beatings and expulsion. The research revealed significant differences in attitudes by gender, with females generally more opposed to youth condom use.
These attitudes are not limited to African countries. “I use condoms illegally because I have to, but my religion and parents don’t allow condoms and they don’t talk about it at home. They always say that sex is for older people so we should not involve ourselves in that act,” says Rajiv a young transgender woman from Myanmar.
A panel discussion at AIDS 2014 among a group of young people further highlighted the issues they face over taking control of their sexual and reproductive health. One panelist said: “Look at the young sex workers – both boys and girls – they don’t know how to use condoms and yet they practice sex every day. When you ask them why they don’t know how to use condoms, they always respond that no one educated them. We are here busy saying that we are ending AIDS by 2030, yet we don’t educate people on basic safe sex practices.”
Young people and sexual health rights
Lack of knowledge among adolescents not just about condoms, but also wider sexual and reproductive health issues and how to access services remains a huge barrier to preventing new HIV infections and other STIs, as well as unwanted pregnancies.
Link Up is a project led by the International HIV/AIDS Alliance with a consortium of partners, which is improving the sexual and reproductive health and rights of one million young people affected by HIV in Bangladesh, Burundi, Ethiopia, Myanmar and Uganda.
Young people account for 40 per cent of all new HIV infections and the project recognises the urgent need to prioritise and involve young people in efforts to tackle HIV.
Zungu Theresa is a young male sex worker from Tanzania, speaking at the conference, he said: “I came out to advocate for condom use among young people after seeing my two friends dying of AIDS because they had unprotected sex and they didn’t know about AIDS.”
Nim, a transgender woman from Myanmar, added: “We have to take condoms seriously by letting every young person know how to use a condom. We want to make sure that people love them – and we are going to do this by introducing romantic ways on how to both use and put on a condom. Our brothers and sisters from Myanmar did this through beautiful pictures that describe how to wear a condom.”
It is clear from the conference discussions that young people themselves are increasingly demanding better sex education. An end to AIDS is possible by supporting young people along this path.
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