Needs, Concerns of Youth link HIV/AIDS Crisis & World Population Day

What is the world's population right now?

July 10, 2002 - World Population Day, July 11, 2002, occurs as 15,000 scientists, health care experts public health workers and others engaged in HIV/AIDS prevention, control and care, are gathered in Barcelona, Spain to take stock of the global HIV/AIDS epidemic. The needs and concerns of the world’s youth link these two events and the issues of population and AIDS.

During the 20th century, human population quadrupled from approximately 1.5 billion to more than 6 billion. Impressive gains have been made since international population programs were first launched some 40 years ago. The average number of children born to women in developing nations has dropped from 6 to 3; the use of contraceptives has increased from 10 percent to 60 percent; global life expectancy has doubled and the population growth rate has been reduced from more than two percent annually to 1.2 percent. Still, rapid demographic change will remain a global challenge throughout the 21st century.

Today, global population has climbed to 6.2 billion and is growing at an annual rate of 1.2 percent, or 77 million people per year. World population is expected to climb to more than 9 billion by 2050 under the UN’s medium variant (most expected) projection of future growth – with the overwhelming majority of future growth in the world’s poorest, developing nations. The emergence of the global HIV/AIDS epidemic is complicating the demographic future – changing age structures and reducing life expectancy in the hardest hit countries.

Linking these two issues are the needs and challenges of the world’s youth. Almost half of the global population is under the age of 25. Of these, more than 12 million are living with HIV/AIDS and half of all new infections are occurring n the 15-24 age group. Every day, 6000 young people are newly infected with the virus that causes AIDS. Whether today’s youth is educated about and provided access to information and services that help them delay the onset of sexual activity and protect themselves from HIV/AIDS and unplanned pregnancy will determine not only their own futures, but also the future of the world. Empowering young people to make wise decisions for themselves will slow the momentum of population growth and the spread of HIV/AIDS.

Young People At Risk

The socioeconomic factors that place young people, particularly adolescent girls at risk for early sexual activity and unplanned pregnancies are virtually identical to the risks that make them vulnerable to HIV transmission.

In many cultures, young girls and women are socialized to be submissive on matters related to sex and therefore lack the power or standing required to discuss contraception, understand and pursue sexual health and/or negotiate safe sex. In contrast, it is socially acceptable (if not expected) in many cultures for men to be sexually promiscuous, and certain myths (such as the belief that having sex with a young virgin will “cure” an older man of AIDS) are especially problematic. Lack of access to education, and the gender gap in basic education also factors into vulnerability, as educational status is one of the most powerful determinants of an individual’s reproductive health status. Women and girls are also less likely to receive sex and reproductive health education, especially in cultures that consider such information as synonymous with promoting promiscuity.

As reflected in this year’s World Population Day efforts poverty is another major factor in the vulnerability of young people. The poor have less access to health care services and basic health information. The lack of economic opportunity also forces some women to engage in high-risk behaviors, such as prostitution, in order to earn income. This kind of “sex for survival” is all too often the only recourse for adolescent girls and women who have been widowed by AIDS and ostracized by their family and friends.

The timing of the onset of sexual activity is a key determinant of whether young people are aware of strategies to protect themselves from unplanned pregnancy and HIV infection. Recent studies by UNICEF, UNAIDS and the World Health Organization demonstrate the close correlation between the age of sexual initiation and the likelihood of using a condom – with younger people 3-4 times less likely to protect themselves than when they are older and more mature. Moreover, the young people display a stunning lack of understanding about how the virus that causes AIDS is transmitted and even less about how to protect themselves.

Mother To Child Transmission

Transmission of HIV/AIDS from mother to child is the primary, near exclusive cause of infection for infants and very young children. The disease can be spread during the course of pregnancy, delivery or post-partum in the course of breastfeeding. More than 5 million infants have been infected since the onset of the HIV/AIDS crisis, with more than 700,000 new infections each year. In seriously affected countries, the risk that an HIV-positive mother will infect her child is as high as 35%.

Antiretroviral drug therapies and provision of alternatives to breastfeeding have been shown to dramatically reduce the risk of mother-to-child transmission rates. In order to make these services available in places of greatest risk, there is a need to dramatically expand voluntary testing and counseling services for women, enhanced access to antiretroviral drugs, as well as prenatal and post-partum care services for HIV-positive women.

In June, US President George Bush announced a new $500 million initiative to prevent mother-to-child transmission of HIV/AIDS in 12 African and several Caribbean countries.

Protecting Today’s Youth – Tomorrow’s Hope

Just as the challenges associated with rapid population growth and the escalating HIV/AIDS epidemic are linked, so are the key response strategies. Prevention represents the clearest, most unambiguous strategy for avoiding unplanned pregnancies, guarding against disease and helping young people delay the onset of sexual activity.

The key elements of international prevention strategies aimed at youth are well know:

• Access to basic health information and services, including sexuality and reproductive health education;
• Universal basic education;
• Protection of youth from exploitation and violent conflict;
• Provision of economic opportunities; and
• Reaching young people at an early age to educate them about healthy behavior, including postponing the onset of sexual activity

There is a growing body of evidence that these strategies work – from the increased use of condoms by young men in Brazil to reduced rates of HIV prevalence in Zambia, Uganda and elsewhere. The challenge now is to address the unmet needs of millions of young people around the world who do not have access to information, education, basic rights and opportunities.

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