Hopkins Report: Youth Crucial to Stopping HIV/AIDS
--------------------------------------------------

To stop the HIV/AIDS epidemic from becoming a catastrophe, prevention
strategies must do much more to reach young people right away, ac-
cording to a new report from the Johns Hopkins University Bloomberg
School of Public Health. The Hopkins call for a youth-centered strat-
egy follows grim new United Nations statistics that show almost 12
million young people are now living with the deadly disease.

Furthermore, roughly half of the more than 60 million people infected
with HIV over the past 20 years became infected between the ages of
15 and 24, according to the latest issue of Population Reports,
"Youth and HIV/AIDS: Can We Avoid Catastrophe?" published by the
Population Information Program at the School's Center for Communica-
tion Programs:
http://www.jhuccp.org/pr/l12edsum.shtml

The Joint United Nations Programme on HIV/AIDS (UNAIDS) estimates
that 11.8 million young people are now living with HIV/AIDS, compared
with 10.3 at the end of last year. But the worst is yet to come, ac-
cording to Hopkins researchers. Public health officials estimate that
current illness and deaths from HIV/AIDS represent just 10% of the
eventual impact. In 1998, UNAIDS reported, 2.5 million youth became
infected with HIV - 7,000 each day, or about five per minute.

The epidemic has hit hardest in sub-Saharan Africa, where over eight
million youth are living with AIDS -- two-thirds of them young women,
according to the Hopkins report. In Africa and elsewhere, as older
men seek increasingly younger partners to avoid becoming infected,
female adolescents are particularly vulnerable. Women become infected
on average ten years earlier than men. In certain regions young women
are two to six times more likely than young men to be infected.

In some African countries-Botswana, Mozambique, Namibia, Swaziland,
and Zimbabwe - "it may already be too late to avoid catastrophic num-
bers of AIDS deaths," writes Hopkins researcher Karungari Kiragu. As
infected youth eventually die, life expectancy will drop to around 30
years by 2010. Even now "in some communities many adolescents head
their own households, raise children, and care for their parents who
are dying of AIDS. Without immediate action, what is true of these
communities today could become true of towns, cities, and even entire
nations in the future."

"Youth are the future, if they survive," said Dr. E. Anne Peterson,
Assistant Administrator for Global Health at the United States Agency
for International Development (USAID), which funded the report. "And
I believe they are ready to lead the way in changed and fewer risk
behaviors to give themselves, their country and their culture hope of
surviving this pandemic."

In countries worst affected by the epidemic little can be done to re-
duce the number of deaths to young people in the near term, according
to the Hopkins report. Statistics from UNAIDS show, for example, that
in Botswana some 88% of 15-year-old boys will eventually die of the
disease if the risk remains at present levels. Even if the risk of
infection could be cut by half by 2015--before the young boys turn
30--the percentage of deaths due to AIDS would drop only to 78% be-
cause so many people already are infected and likely to spread HIV to
others. In other countries, such as Thailand, where the disease is
not so prevalent, further prevention efforts would have more effect.
Reducing the risk by half by 2015 would lower the percentage of 15-
year-old boys who will eventually die of AIDS by half from 22% to
11%.

Twenty years' experience has demonstrated that national strategic ap-
proaches, not just more projects, are essential to contain the epi-
demic effectively, according to Population Reports. Comprehensive
strategies in Australia, Brazil, Senegal, Thailand, and Uganda which
combine the efforts of government, private sector, and nongovernmen-
tal organizations, have had the most success at reducing the preva-
lence of HIV.

Infected adolescents -- because they are likely to have been recently
infected -- are at their most infectious stage. Sexually active young
people are more likely to have a series of sex partners, too, so they
can spread HIV more rapidly. If these adolescents changed their be-
havior, the spread of the epidemic could be slowed. In countries
where the epidemic is already generalized, a combined focus on youth
and on high-risk groups--such as drug injectors, street kids, and sex
workers -- would be the most effective. Models suggest that such a
campaign could have the same impact at only 20% of the cost of a
broad national campaign. Despite over 15 years of international at-
tention to the need, young people today still have only limited op-
portunities to learn about HIV/AIDS. In Bangladesh, for example, sur-
veys reveal that 96% of females ages 15 -19 and 88% of males did not
know any way to protect themselves against HIV/AIDS. In Bolivia the
percentages were 33% among females and 26% among males.

The report calls for comprehensive strategies to include:

- Increased political and financial support for AIDS prevention among
youth in developing countries. While 95% of people with HIV infection
live in developing countries, 95% of all AIDS prevention funding is
spent in industrialized countries. Moreover, a larger share of that
spending should focus on youth.

- Increased education and communication. Some adults still think that
sex education encourages sexual experimentation. In fact, some
school-based programs have delayed the onset of sexual activity and
increased condom use without increasing sexual activity.

- More youth-friendly services. Social policies and health care pro-
viders' behavior often reflect intolerance and discrimination against
youth, limiting access to health information and care and making
young people reluctant to seek information, guidance, and care.

- More attention to the root causes of youth's vulnerability. Pro-
grams must address cultural practices and the economic dependence
that put young people--especially young women-at high risk of HIV in-
fection.

Population Reports is an international review journal of important
issues in population, family planning, and related matters. It is
published four times a year in four languages by the Population In-
formation Program at the Johns Hopkins Center for Communication Pro-
grams for more than 170,000 family planning and other health profes-
sionals worldwide, with support from the US Agency for International
Development (USAID). USAID administers the US foreign assistance pro-
gram, providing economic and humanitarian assistance in more than 80
countries worldwide.

For more information contact:
Stephen M. Goldstein
Tel: +1-410-659-6331
or
Kim Martin
Tel: +1-410-659-6140

at Johns Hopkins Center for Communication Programs
111 Market Place, Suite 310
Baltimore, Maryland 21202, USA
Tel: +1-410-659-6300
Fax: +1-410-659-6266
mailto:[email protected]
http://www.jhuccp.org.
Press Room: http://www.jhuccp.org/press

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