Beth Fredrick is Executive Vice President of the International Women's Health Coalition.
The session starts simply: eight young men stand at the front of a room in Minna, Nigeria. Each young man holds up a large piece of paper with a word written on it, each word a type of sexual activity.
From there it becomes more complicated.
First, the youngest boys are asked to leave. This is not a lesson on birds and bees and community leaders, though supportive, need to be reassured that this workshop is only for those who are mature enough. The 50 or more young men, ranging in age from 16 to 19, are learning how to stay safe from HIV. That will require frank conversation about what will put them at risk and what they can do to protect themselves and their sexual partners. In other words, this is a life-saving conversation.
Three professionals in the room stand back and observe as each card is raised. Idris, Rose, and Helena are there from the International Centre for Reproductive Health and Sexual Rights (INCRESE), a six-year-old Nigerian organization that works to protect and promote sexual and reproductive health and rights. They want the questions and concerns of the young men themselves to drive the conversation.
In Hausa, the common language of this village in a largely Muslim State in Nigeria, the young men discuss what they learned about preventing HIV transmission in previous lessons and whether the activity on the card places them at any health risk, including HIV infection.
Their misconceptions are understandable. At first, the young men define oral sex as a conversation between a boyfriend and girlfriend. But it soon becomes clear that some of the young men are well aware of what oral sex really is. What they don't know – and I hadn't fully appreciated – is that lack of oral hygiene in much of the developing world means bleeding gums and persistent sores. Both can facilitate transmission of HIV/AIDS, if one or both people are infected.
For over two hours, the young men [img_assist|nid=1205|title=Beth Fredrick with class|desc=|link=none|align=right|width=275|height=182]discuss a range of similar issues and Idris, Rose and Helena field a battery of questions:
"When blood leaves a person's body, does the breeze kill HIV?"
"I cut myself when I shave; am I at risk of getting HIV?
"Is masturbation dangerous?"
"If I want to be intimate with a girl, what will keep us from becoming infected?"
When Idris, Rose and Helena were teenagers, Nigeria was only beginning to awake to the realities of HIV and AIDS. Nigerian leaders increasingly face challenges in tracking and preventing new HIV infections and ensuring care and treatment. Nigeria ranks second only to South Africa in the number of people living with HIV among countries in Africa.
The need for programs such as the one that INCRESE has pioneered is acute. According to UNAIDS, one in five Nigerian young women (aged 15 to 19) had her first sexual experience before age 15. Though young men begin later, 8% of them will have had sex before they turn 15. Schools are one avenue for learning about HIV/AIDS and prevention, yet only one in five primary or secondary schools have teachers who have been trained in life skills-based HIV education and who taught it within the last year.
Last month, the World Bank released its World Development Report. Rightly, it focuses on young people and the challenges they face in reaching their full potential to spur healthy development – for themselves and their communities. The Bank goes far in prescribing some fundamentals to protect and empower young people. Implementing prescriptions like these – and bolder – will require coordinated action at all levels, from governments to parents and families, including young people themselves.
First, we must invest in programs like INCRESE, which educate and empower boys and young men to understand their sexual responsibility, listen to their partners, and use condoms. Change requires more men like Idris and the young men in the INCRESE program.
Second, we must empower young women to share equally in the knowledge and agency needed to determine when, where, and under what circumstances to have sex. The healthiest exchanges will be open exchanges, with input from both partners.
Finally, we must provide all young people with information and services. In too many places, marriage is a prerequisite for health services or knowledge. Community leaders need to embrace and encourage any means of starting a dialogue with youth about gender equality, life skills and sexuality.
When you look into the eyes of a young person, for a moment, you see the future – theirs and ours. Working with them, we can make that future healthier and happier. We have an obligation to them from which the world can no longer shrink away.