USAID Programs: Youth and HIV/AIDS
About one-half of all new HIV infections occur among youth aged 15 to 24. In countries in Africa where AIDS is widespread, early and risky sexual activity increases young people's vulnerability to HIV. In other regions, HIV is concentrated in high risk groups which often include significant numbers of young people. Yet youth also represent a window of opportunity for reversing HIV rates, especially when effective prevention programs can reach them before they engage in risky behavior. Accordingly, the U.S. Agency for International Development is committed to helping developing countries provide young people with the knowledge, skills, support and services they need to protect themselves from HIV.
The President's Emergency Plan for AIDS Relief reinforces this commitment to HIV prevention. It seeks to avert seven million new infections, and includes a special emphasis on youth prevention through abstinence and behavior change interventions. Beginning in 2004, USAID is expanding support for activities that reflect this focus.
What Factors Affect Young People's Risk of Contracting HIV?
The environment in which young people live profoundly influences their behaviors. USAID seeks to strengthen protective factors in society that help youth make healthy choices. In particular, close relationships with parents and other adults, school attendance and supportive community norms are associated with positive youth behaviors. Conversely, young people who experience family instability, practice other risk behaviors, and have negative peer role models are more likely to engage in early and unsafe sex. Poverty, including the impact of AIDS on family income, forces many young people out of the protective environments of home and school, increasing their risk of exploitation and unsafe sexual behavior. Street youth, displaced and orphaned youth are at particular risk. Young people may also fail to recognize their own personal risk because of a lack of knowledge and understanding of HIV.
Young women are at considerably higher risk of HIV infection. In some African settings, young women aged 15 to 19 have HIV rates six times higher than young men the same age. Poverty and vulnerability to sexual exploitation and coercion puts girls at risk; economic factors also influence girls to trade sex for money and have relationships with older, more sexually experienced men. USAID helps communities recognize and address social norms that put young women -- as well as youth more generally -- at risk.
What is USAID's Strategy for HIV Prevention Among Youth?
Behavior change is the cornerstone of HIV prevention. USAID endorses the "ABC" model, made famous by its success in Uganda. A stands for abstinence (including delayed sexual initiation among youth), B for being faithful, and C for correct and consistent condom use. The ABC approach can be adapted to a particular country context or target population. For youth specifically, USAID gives primary emphasis to "A" and "B." In order to empower youth to change their behavior, USAID supports skills-based HIV education to provide young people with a basic understanding of HIV, help them personalize risk, and develop the self-esteem, communication and decision-making skills they need to make positive life choices.
Learn more about USAID's The ABCs of HIV Prevention
What other types of HIV programs for youth does USAID support?
While prevention is paramount in working with youth, programs must include the continuum of HIV services including care and treatment. USAID supports expanding access to youth-friendly services for sexually-active youth, including education on correct and consistent condom use, HIV testing, and treatment for sexually transmitted infections. HIV-positive youth need an array of services including psycho-social support, prevention of mother-to-child transmission, palliative care, and antiretroviral therapy (when medically appropriate).
What are Some Examples of USAID's HIV/AIDS Programs for Young People?
Mass media campaigns involve the creative use of theater, music videos, concerts, radio and television programs that appeal to young people. In Zambia, where there was an apparent reduction in HIV prevalence among urban youth in the 1990s, a USAID-supported media campaign disseminates messages such as "virgin power, virgin pride," and "abstinence is cool." This campaign has contributed to an increase in age at first sex and in secondary abstinence, as well as to more consistent condom use among sexually active young adults.
HIV testing is important for youth to learn their status and adopt safer behaviors. In Zimbabwe, USAID supports 14 New Start centers that provide high quality HIV counseling and testing services. These services are promoted to individuals at risk of HIV, including young couples and adolescents. For both HIV-positive and -negative clients, New Start provides counseling to encourage risk-avoidance and risk-reduction behaviors.
Peer education builds on existing youth-oriented networks to provide a safe and comfortable environment for adolescents to explore sensitive issues. In Kenya, USAID supports the national Girl Guides Association to raise HIV awareness among its membership by holding HIV contests and having Guides work towards merit badges relating to various aspects of HIV and AIDS. The program provides a forum for girls and young women -- a group at high risk -- to discuss HIV and support each other in avoiding risky behaviors.
Multi-country central agreements promoting abstinence and healthy behaviors for youth are a new USAID initiative under the Emergency Plan. One new faith-based partner will work with over 1.8 million youth in Haiti, Kenya, Mozambique and Rwanda, as well as with parents, churches, schools and other local partners, to support youth in choosing abstinence as the best means of HIV prevention. Another new partner will collaborate with Red Cross branches and volunteer networks in Guyana, Haiti and Tanzania to reach over 760,000 youth with an interactive peer education curriculum. It will also mobilize communities in support of healthy behaviors through theatrical, sports and musical events. Other new partners will soon be added under this central program.
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March 2004
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