Contents
Chapters
- The Invisible Epidemic
- How Young People Become Infected
- Why So Vulnerable?
- Adolescent Behavior Increases Vulnerability
- Lack of Information
- Norms and Expectations
- Poverty and Deprivation
- Social Intolerance and Discrimination
- Addressing the Epidemic
- Reaching Out
- Consequences of Inaction
- HIV/AIDS: What Young People Want to Know
- Profiles
- Youth at the Center
Highlights
- Why young women face more risk
- Culture can hurt
- Profile: Going public
- Education should start early
- Condoms for dual protection
- Orphans: A new challenge
- What can parents do?
- Reaching street children
- Putting youth at the center
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Published by the Population Information Program, Center for Communication Programs, The Johns Hopkins University Bloomberg School of Public Health, 111 Market Place, Suite 310, Baltimore, Maryland 21202, USA.
Volume XXIX, Number 3
Fall 2001
Series L, Number 12
Issues in World Health
Lack of Information
Many adolescents are at risk because no one—including parents, educators, counselors, health care workers, or the media—has taught them about HIV/AIDS or about how to protect themselves and others. Despite over 15 years of international recognition of the need for education and communication to prevent HIV/AIDS, young people today still have only limited opportunities to learn about the virus and the disease.
Some adults still think that sex education encourages sexual experimentation. Consequently, programs and campaigns often are limited in what they can discuss. For example, educators at the University of Cairo in Egypt had to alter their program "so as not to be accused of immoral propaganda" (72).
Despite such worries, reviews of program evaluations find that HIV/AIDS education programs do not hasten the start of sexual activity, do not increase the frequency of sex, and do not increase the number of sex partners among adolescents. In fact, some programs that included discussion of contraception delayed the onset of sexual activity and increased the likelihood of condom use (107, 108, 191).
While the importance of education about HIV/AIDS is widely recognized, 44 of 107 countries studied recently did not include AIDS education in their school curricula (295). In interviews with 277 secondary school principals in South Africa, 60% acknowledged that their students were at moderate or high risk of HIV/AIDS, but only 18% of the schools offered a full sex education curriculum (292).
 Uganda Ministry of Health |
This poster from Uganda urges young women to help friends avoid relationships with older men—"sugar daddies"—who might infect them. |
At the same time, traditional ways of educating the young about sex have diminished or disappeared altogether. For example, in many sub-Saharan countries Christian missionaries discouraged initiation rites that defined the passage from youth to adulthood (205). As a result, opportunities for telling young people about sex, traditionally a part of those rites, were lost (186). The social bonds and traditions that used to shape young people's behavior and help them make the transition to adulthood have weakened in the face of urbanization, new attitudes toward sexuality, and the breakdown of the extended family.
As a result, more young people are sexually active but without adequate information to protect themselves. In Cameroon, Côte d'Ivoire, Kenya, Tanzania, and Zambia—countries where HIV/AIDS is now epidemic among adolescent women—the Demographic and Health Surveys (DHS) in the mid-1990s found that 20% to 50% of young women did not know any way to protect themselves (see Figure 2). In Mozambique, where an estimated 15% of young women have HIV (162), 74% of young women and 62% of young men could not name a single way of protecting themselves.
Young women are far less knowledgeable about HIV than are young men (see Figure 2). For instance, in five countries surveyed the percentage of young women who know a way to protect themselves against HIV is only half that of young men (361). Moreover, young women often hesitate to challenge misinformation from their partners lest they appear too knowledgeable about sex (393).
When young people do know something about HIV/AIDS, their knowledge is often shallow. For example, when students in Papua New Guinea were asked how to protect against HIV, 27% said that it was enough to get to know a partner first or to make sure that their partner had not had sex in the previous six months (92). Similarly, many young people do not know that a healthy-looking person can have HIV. In some countries where AIDS is widespread, such as Lesotho and South Africa, 50% to 75% of women ages 15 to 19 do not know that a person with HIV may look healthy (45, 361).
Many adolescents incorrectly think that HIV/AIDS can be transmitted in ways unrelated to known risks. In Papua New Guinea, for example, one-third of tenth grade students thought incorrectly that a person could get HIV from a mosquito bite, and 15% thought sharing a drinking glass could cause HIV infection (92). In Trinidad 16% of secondary students thought incorrectly that a person could get HIV from toilet seats (244).
Misinformation about HIV transmission contributes to negative attitudes about people living with HIV/AIDS. In Russia 40% of male high school students and 30% of female students said they "would not like to be in the same class as a person with AIDS" (215). In Scotland nearly 34% of adolescent men and 22% of women would feel uncomfortable if their teacher had HIV/AIDS (353).
