Preventing HIV/AIDS and Promoting Sexual Health Among Especially Vulnerable Young People

This report was developed as part of the 'Safe Passages to Adulthood,' a five-year Department for International Development (DfID) funded programme of research into young people’s sexual and reproductive health in poorer country settings. It is based on an expert meeting on ‘Working with Especially Vulnerable Young People,’ held in the United Kingdom in December 2001.
Participants came from a variety of projects in developing, transitional and developed countries, with a focus on programmes conducted in resource-constrained settings. Representatives from a number of non-governmental organisations (NGOs), as well as from United Nations sponsored projects and activities, discussed their experiences and approaches to work with
especially vulnerable young people. The groups of young people represented fell into three main categories: young people who sell sex; young people who inject drugs; and young migrants and refugees.



According to the report, young people have been identified as being at special risk of sexually
transmitted infections (STIs) including HIV/AIDS. The majority of the world’s young people
lack information about the range of options available to reduce the likelihood of STIs, HIV/AIDS and conception. Even where such knowledge may be available, young people are frequently denied access to the resources and services that might enable them to put into practice what they have
learned. More seriously, gender inequalities operate so as to systematically deny young
women the resources and opportunities available to their male peers.
Open discussion of sex, safer sex and drug use remains a taboo in the majority of societies.
Young women may lack access to knowledge and the means of protection in the belief that
their innocence should be protected. Young men on the other hand may remain ignorant and ill
prepared because adults assume they have already learned about sex. The report proposes that youth is a critical time for laying the foundations for healthy sexuality.



The expert meeting aimed to provide an opportunity to review what has been achieved in this field, and to disseminate lessons learned. Based on the experiences and discussions of the meeting, the report synthesises a number of lessons learned identified by the participants:

• Only rarely do young people in difficult circumstances face a single set of problems. More often, they encounter complex
  combinations of vulnerabilities (such as those linked to sex work and drug use, or being a refugee and involvement in transactional sex), which together pose a threat to health and well-being. This poses major challenges for knowing when
  and how best to intervene.
• holistic and multi-levelled programmes and interventions work best. These recognise the complexity and inter-relatedness
  of health problems as they affect young people’s lives;
• working to strengthen positive responses is a good strategy, reinforcing the already safe behaviours that exist, rather than in promoting behaviour change;
• programmes and interventions must be evidence based;
• young people’s involvement in efforts to promote sexual and reproductive health, as well as in other forms of health promotion, is not only required by the United Nations Convention on the Rights of the Child, but it is also common sense to avoid devising programmes and interventions that speak to imaginary, as opposed to real, needs;
• distraction, pleasure, fun and having a sense of pride are factors affecting programme success;
• young people are a remarkably heterogeneous population. Their diversity, and the corresponding
  variation in needs, calls for a differentiated response;
• the needs of young women are frequently different from those of young men. A gender perspective is therefore
  essential;
• adopting a rights based perspective, in which the validity of young people’s claims to the knowledge
  and resources that will allow them to protect their sexual and reproductive health (and that of others),
  is part of the international recipe for success;
• programmes and actions need to be sustained over time if they are to be successful; and
• there needs to be greater connectedness between actions at different levels and in different
  contexts, as well as a multi-disciplinary approach.

According to the report, the sharing of expertise from around the world served to
emphasise the reasons why such young people should be placed high on the agenda for sexual
and reproductive health promotion work. It also highlighted the importance of context in looking
at sexual and reproductive health issues in different countries, and the implementation of
culturally appropriate programmes and interventions.