This article is part of a series on global AIDS issues to be published
by RH Reality Check throughout December. To find other articles in this series, search "global AIDS 2009."
Last week I attended a World AIDS Day event that was hosted at the World Bank, with prominent global HIV/AIDS stakeholders on a panel, including Ambassador Eric Goosby, the US Global AIDS Coordinator; Michel Kazatchkine, Executive Director of the Global Fund to Fight AIDS, TB and Malaria; Joy Phumaphi, Former Minister of Health of Botswana; Julian Schweitzer, Acting Vice President of the Human Development Network at the World Bank, and Beldina Atieno, a teacher and mother living with HIV in Kenya.
While the event was focused on linking HIV/AIDS, food security and maternal and child health, it surprised me that not once during the 1hour and 45 minute presentation did anyone mention young people.
It is no secret that 45 percent of all new HIV infections globally are among young people 15-24 years of age. It is also no secret that complications due to pregnancy and childbirth are the leading cause of death among young women ages 10-19 around the world. And it is no secret that infants of adolescent mothers are 1.5 times more likely than those of older mothers to die before their first birthday.
Or wait: Are these facts in fact still secrets?? You might think so.
It wasn’t until index cards were collected with questions from the audience that anyone (the moderator reading the question on my index card) mentioned youth—and in answering the question, abstinence was the only strategy put forward by one of the panelists as working to prevent HIV, without any rebuttal or inquiry from other panelists.
This, at the World Bank, with prominent leaders on the stage. This despite the release of the 2009 UNAIDS Report stating:
A central weakness of many prevention initiatives for young people is that they do not speak frankly or provide the accurate, comprehensive information that young people need. Many countries that require HIV education in schools have curricula that prioritize abstinence-focused programming, discouraging forthright discussions about condoms and safer sex. However, no study in low- and middle-income countries has found this approach to be effective.
In fact, studies have shown that providing comprehensive information about HIV that is linked with sexual and reproductive health and includes honest, accurate information about condoms is a proven strategy for reducing HIV infection in young people. So, if the United States is supposedly supporting evidence-informed HIV prevention through the President’s Emergency Plan for AIDS Relief, then why is comprehensive HIV prevention for young people not being mentioned?
And speaking of comprehensive approaches, I also found it noteworthy that the word "condom" was not mentioned until 15 minutes prior to the end of the program. In the context of the limited discussion on prevention (except by the World Bank’s Julian Schweitzer who managed to squeeze in emphasis on prevention on a few occasions), mention of condoms came after multiple references to Anti-Retroviral Therapy as prevention, prevention of mother-to-child transmission (where the mother herself already has HIV, by the way) and male circumcision (which does not preclude needing to use condoms). This is not to say that these approaches are not critical to the fight against HIV/AIDS, but why do we keep excluding one of the most important viable and proven approaches when we have so much at stake?
So, what does this all mean? It clearly must mean that we have to keep raising our voices to put young people on the radar and unequivocally demand policies that support comprehensive, evidence-informed HIV prevention programming for youth. There are, after all, 3 billion people under the age of 25 on the planet today. This is not fiction, this is not hyperbole–this is about public health and this is about human rights.