GENEVA, 12 August 2013—On this International Youth Day, the Joint United Nations Programme on HIV/AIDS (UNAIDS) calls on young people to use their creativity and leadership in the AIDS response.

“As agents of change, young people must claim their right to health and be part of the decision making processes that will impact their lives,” said UNAIDS Executive Director Michel Sidibé.

There have been tremendous achievements in the response to the HIV epidemic for adolescents and youth but much more needs to be done. Young people are not only beneficiaries of HIV services but also play an important role as partners and leaders in the AIDS response. This is why UNAIDS has expanded its youth programme and recently established the Youth Advisory Forum to channel young people’s voices and opinions into key UNAIDS initiatives. 

Globally, an estimated 4.6 million young people are living with HIV. Each day, about 2300 young people are newly infected with HIV. Many young people living with HIV do not have access to treatment or do not know their HIV status. In many countries, young people are prevented from accessing sexual and reproductive health services, including HIV testing and condoms, due to age-related restrictions.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners to maximize results for the AIDS response. Learn more at unaids.org and connect with us on Facebook and Twitter.

(From left to right) UN Messenger of Peace Charlize Theron, South African President Jacob Zuma, and UNAIDS Executive Director Michel Sidibé. Credit: UNAIDS

The challenges facing young people in South Africa were the focus of a dynamic meeting between South African President Jacob Zuma, UN Messenger of Peace Charlize Theron and the Executive Director of UNAIDS Michel Sidibé. Prominent issues in the discussions included the vulnerability of young women and girls to HIV in South Africa, the need for Africa to become more self-sufficient in producing antiretroviral medicines  and the remarkable progress South Africa has made in responding to HIV recent years. 

President Zuma said, “We came from a difficult time. We had all the plans but the manner in which we interfaced with the world was very difficult. I want to thanks UNAIDS, specifically Michel Sidibe, who has been a pillar of strength in supporting our country on HIV. During this very short time we have changed the life expectancy of our people due to his support and guidance."

The importance of reaching young people with HIV services was also stressed together with the need to integrate health care into education and youth programmes. The example of South Africa’s Integrated School Health Programme, which aims to reach school children with primary health care services and life orientation skills, was highlighted as a positive way forward in improving the health of young South Africans.

“It’s time to end AIDS,” said Mr Sidibé. “It’s time for zero preventable deaths due to AIDS, zero tolerance for violence and new infections among young women.”

A recent study revealed that young women between the ages of 15 and 24 are three times more likely to become infected with HIV than young men in the same age group. HIV prevalence is also much higher among women (23%) in South Africa than in men (13%).

Ms Theron spoke passionately about some of the issues facing young people in South Africa that she has seen and heard through the work of her non-profit organization the Charlize Theron Africa Outreach Project.

“I can promise that we will continue to support you to keep yourselves and your peers safe from HIV,” said Ms Theron.

Ms Theron and Mr Sidibé also met with Friends for Life, a non-profit organization located in Alexandra township in Johannesburg. Friends for Life is a community-based HIV prevention, care and support organization which works closely with young people.

“The visit was such a great opportunity for us to share our ideas and concerns as young people,” said Thulani Tshefuta, a representative of the South African National AIDS Council’s youth sector. “We hope that through speaking about the situation of youth in South Africa and continuing to serve as advocates, we see a change in our communities and in the lives of young people living with HIV.”

Kazan, Russian Federation was the host of the 27th Summer Universiade — World University Games. The event attracted 11 000 young athletes from more than 160 nations competing in 27 sports from artistic gymnastics to wrestling.

With this backdrop an HIV prevention project called Games for Health. Games for Life was launched. Around the world about 2300 people aged 15-24 become infected with HIV every day and many of the young people living with HIV are unaware of their HIV status. In the region where the Games took place (Eastern Europe and Central Asia) the number of people living with HIV has almost tripled since 2000.

As part of the launch of Games for Health. Games for Life,  35 000 HIV prevention hand-outs were distributed to participants and volunteers. And some 8000 volunteers participated in information sessions about HIV where they discussed issues such reducing stigma and discrimination and promoting the rights of people living with HIV.

The results of this HIV prevention initiative were presented to the next Universiade organizing committee and will be shared with the organizers of major upcoming sporting events including the Sochi 2014 Winter Olympics and the 2018 FIFA World Cup.

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The United Nations Secretary-General Ban Ki-moon met with UNAIDS Executive Director Michel Sidibé to discuss UNAIDS’ plans to further expand its focus on youth and HIV. The meeting was held on the side-lines of the 67^th United Nations General Assembly taking place in New York from 10-11 June 2013.

The UN Secretary-General, through his five-year action agenda presented in January 2012, tasked the UN system to address the needs of the largest generation of young people the world has ever known. In support, UNAIDS developed its youth programme, which aims to increase youth leadership, ownership, and mobilization in the AIDS response at the country, regional, and global level by 2015 and beyond.

The programme was developed using social media and crowdsourcing technology, and enabled some 5 000 young people to participate in the processes. Based on this model, UNAIDS is now supporting a community dialogue for social change to inspire a new wave of social action in the AIDS response as well as mobilize the youth constituency in the lead up to the post-2015 negotiations. The dialogue will start in November leading up to World AIDS Day.

At the meeting, UNAIDS also shared the outcomes of the recent strategy meeting where youth organizations formed a pact for collaboration for social transformation in the AIDS response. Young participants identified five key priorities for the movement including ensuring HIV remains a priority in the post-2015 development framework.

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Young participants at the UNAIDS workshop. Credit: UNAIDS

Young people in South Africa are facing the challenge of creating a movement to overcome the impact that the AIDS epidemic is having on their lives.

Issues such as intergenerational and transactional sex, substance abuse and high rates of teenage pregnancy are just some of the many factors that put young people at even higher risk of HIV infection than people in other age groups.

Recently, UNAIDS brought to Johannesburg, South Africa, young people from around the country to discuss ways to effectively empower youth to take the lead in the response to AIDS. The base for the discussion was the application of the CrowdOutAIDS Strategy—the UNAIDS Secretariat’s youth-led policy recommendations—in the context of South Africa.

“The UNAIDS CrowdOutAIDS Strategy puts the focus on youth. In the strategy, young people are part of the process in terms of involvement and engagement,” said Bruce Dube, Managing Director of Youth Village, an online portal for youth. “Every young person has a contribution to make, not just at a high level. Young people have the power to effect change in their own communities,” he added.

The elimination of existing high levels of stigma and discrimination, increase availability of youth-friendly HIV services and facilities, and the creation of opportunities to develop youth–driven solutions were identified as the key elements for the young South African activists to act upon.  

“It was clear from the discussions at the workshop that young people are eager to create spaces where they can gather and create dialogue not only about the challenges, but importantly, what solutions lie in their hands,” said UNAIDS Country Coordinator, Dr Catherine Sozi.

Participants in the workshop explored ways to strengthen community mobilization and political advocacy led by young people to scale up the demand and supply of HIV services for all young people regardless of HIV status, sexual orientation or gender identity. The young activists also strengthened their skills for effective leadership at national and provincial levels. They also had an opportunity to brainstorm ways to gain access to HIV-related information, especially through digital technologies, and forge strategic networks among themselves and their respective youth organizations. The workshop will lead to the development of an action plan, using the CorwdOutAIDS Strategy to guide future activities.

“HIV activism is not part of the youth lifestyle—we need to change that and incorporate it into all facets of our lives,” stressed Mr Dube. 

Participants at the Youth and UNAIDS event held in Hammamet, Tunisia from the 20-22 of May. Credit: UNAIDS

AIDS activism has radically changed since the beginning of the epidemic. New modes of communication are amplifying people’s voices, creating cross-national webs of solidarity opening up new opportunities for progressive social change.

Young activists in countries around the world are increasingly demanding HIV services to be tailored to their needs and claiming their seat at the decision-making table.

While the HIV prevalence has fallen by nearly 27% among young people aged 15-24 globally between 2001 and 2011, young people still account for 40% of all new HIV infections among adults. In 2011, there were some 4.6 million young people living with HIV.

Against this backdrop, UNAIDS brought together 12 global and regional youth organizations working on HIV, sexual and reproductive health and rights, and lesbian, gay and transgender rights  with the 16 community, country and regional youth activists that constitute the recently established UNAIDS Youth Advisory Forum. The aim was to strategize on a clear direction to move the AIDS response forward for young people.   

“Many small organizations lack the time, resources, and strategic space to reflect on their work and forge new alliances,” said Pablo Aguilera, director of the HIV Young Leaders Fund and member of the UNAIDS Youth Advisory Forum. “We called for this meeting to ensure the movement is responsive to the needs of young people most affected by HIV.”

To deliver results for young people on the ground, a decentralized, connected global youth movement—that thinks globally but acts locally is needed to initiate a new wave of activism in the AIDS response.

The meeting, called the Youth and UNAIDS: A pact for social transformation took place in Hammamet, Tunisia from the 20-22 of May. The main outcome of the consultation was a pact outlining five key themes that cut across individual organizational agendas where youth organizations can make tangible impact towards the goals set in the 2011 United Nations General Assembly Political Declaration on HIV and AIDS.

The five themes include: Integrating HIV services into sexual and reproductive health services, with a focus on government accountability and sexuality education; enabling legal environments and removing punitive laws that impede access to services for young key populations at higher risk; scaling up treatment and disaggregating data for evidence informed advocacy; using resources effectively; and ensuring that HIV remains a priority in the Post-2015 development framework through strategic lobbying of national delegations.

“This new commitment to collaborate around specific priorities is a radical departure from business as usual in the youth AIDS response. Through strengthening collective action that goes beyond organizational agendas, we hope the movement can achieve concrete change for young people affected by HIV,” said Caitlin Chandler, community representative who co-facilitated the meeting together with Beth Goodey from the youth-led development agency Restless Development.

Supporting increased collaboration and strategic direction of the youth movement in the AIDS response is a key priority for the new UNAIDS youth programme, which aims to increase youth leadership, ownership, and mobilization in the AIDS response at the country, regional, and global level by 2015 and beyond.

“We want to work closer with organizations of young people living with HIV and young key populations at higher risk to create broad alliances,” said Mariangela Simao, UNAIDS Director of Gender, Human Rights and Community Mobilization Department. “It’s an effective strategy to ensure national ownership for progressive social change—because the demand for change will come from within,” she added.

The IATT report on the global education sector’s HIV response shows mixed results with progress in some fields and stagnation in others.

There is room for optimism in the overall progress of the global education sector’s response to HIV, says a new in-depth study of 39 countries around the world. However, a worrying degree of stagnation in some areas still exists and much more needs to be done if the sector is to fulfil its critical role in helping to intensify HIV prevention. 

The report, 2011-2012 Education Sector HIV and AIDS Global Progress Survey: Progression, Regression or Stagnation? was commissioned by the UNAIDS Inter-Agency Task Team (IATT) on Education and  compares results from a similar comparative study in 2004. It finds that now almost all countries have an education sector HIV policy, that an increasing number of teachers are trained to share knowledge about the epidemic and that it occupies more space in the curriculum, taught through life-skills education.

But policy development in theory does not necessarily translate into implementation in practice. The extent to which HIV is addressed is still marginal. Despite noted improvements, many more teachers need to be trained and knowledge about the virus remains low.

Recent research in a range of countries shows that less than half of young people have comprehensive and correct knowledge about HIV. This matters a great deal, the report contends, as education is the foundation for the success of all HIV programming. High quality information and the space to explore key issues such as sex and relationships are seen as fundamentally necessary for comprehensive AIDS education.   

Young people can use their knowledge to make informed choices about how to protect themselves and others from HIV. In addition, the very fact of being educated in itself reduces vulnerability to the virus, especially for girls, as it promotes self-esteem, assertiveness and economic independence. 

According to UNESCO Global Coordinator for AIDS Soo-Hyang Choi, “Education is a protective factor for HIV infection and it contributes to a global citizenry that can address stigma and discrimination. Education, therefore, plays a central role in the AIDS response.”

Room for improvement

The IATT report gives a salient example of what is happening on the ground and where improvements can be made in a long term study in Southern and Eastern Africa. The research found that on average two thirds of grade six students (between 13 and 14 years of age) across 11 countries did not have even minimal understanding of HIV required to preserve and promote their health. Knowledge levels ranged from 19% in Lesotho to 70% in Tanzania.

However, 99% of their teachers did in fact have this knowledge but did not impart it to their students. The study concluded that teachers were uncomfortable sharing such information or felt that it went beyond their remit.  They were also given limited training in the topic—by government experts, UN agencies or civil society organizations—both before they started teaching and once they were actually on the job.

Scott Pulizzi, Coordinator of UNAIDS IATT on Education, maintains that this must change, “Every learner needs a qualified teacher who is mandated and supported by the school administration and the community to teach skills-based sexuality education, including HIV. Without systemic change in the education sector, teachers will not be able help their learners acquire the knowledge and develop the skills to reduce their vulnerability to the virus.”  

Progression, Regression or Stagnation? recommends a detailed action plan to ensure that learners get a potentially life-saving HIV education. Steps include:

• Establishing high-level political will for a comprehensive AIDS response in education;
• Developing a country-appropriate management system to coordinate and implement  existing policy and plans;
• Supporting sector-wide teacher training on HIV; 
• Ensuring that curricula and accurate teaching materials are age-appropriate, gender-sensitive, life skills-based and available in all schools for all learners; and
• Engaging parents and the community in implementation.

The report emphasizes that an AIDS-free generation is within reach.  And it concludes by stressing that, “The objectives of Getting to Zero: zero new HIV infections, zero discrimination and zero AIDS-related deaths are possible and it starts with education.”

The IATT is convened by UNESCO and includes other UNAIDS Cosponsors, bilateral agencies and civil society organisations

The Confederation of North, Central America and Caribbean Association Football (CONCACAF) and UNAIDS signed a Memorandum of Understanding on 19 April in Panama City, Panama and agreed to engage football in the AIDS response, particularly among young people.

The agreement was signed on the sidelines of the 2013 CONCACAF Under-17 Championship in the presence of CONCACAF President Jeffrey Webb and Senior Adviser Dr Djibril Diallo, who represented UNAIDS Executive Director Michel Sidibé. It was signed in the presence of FIFA President Sepp Blatter, FIFA Secretary General Jerome Valcke and Confederation of African Football (CAF) Secretary General Hishram ElAmrani.

The two organizations agreed to carry out joint advocacy and communication activities in competitions organized by CONCACAF in support of the UNAIDS “Protect the Goal” campaign. This initiative was launched in January at the 2013 Orange Africa Cup of Nations in South Africa and is part of UNAIDS’ sport for global advocacy programme. The campaign promotes HIV prevention and treatment, in advance of the 2014 FIFA World Cup in Brazil.

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Under the revised penal code young people between the age of 14 and 18 years old will be able to exercise their sexual and reproductive rights.
Credit: UNAIDS

The Constitutional Tribunal of Peru is amending an article in its penal code which for many years had criminalized consensual sexual activity among young people. Sentencing was particularly severe with adolescents facing up to 30 years in prison. Article 173 of the penal code was also preventing young people from accessing essential health and reproductive services for fear of prosecution.

Under the revised penal code young people between the age of 14 and 18 years old will be able to exercise their sexual and reproductive rights providing the two parties are consenting. Non-consensual sexual relations will still constitute a crime in Peru with lengthy sentencing for people found guilty.

"The Constitutional Tribunal ruling generates a protective effect in relation to adolescents, because it provides them with greater access to sexual and reproductive health services as well as guidance and information to avoid sexually transmitted infections, including HIV," said Mima Barnechea from the United Nations Population Fund (UNFPA).

In 2012, UNFPA and UNAIDS presented a formal request before the Constitutional Tribunal advocating for the declaration of unconstitutionality of Article 173.  This process was part of a wider effort particularly from the Office of Peru’s Ombudsman, Eduardo Vega Luna as well as legal demands presented before the Tribunal by more than 10 000 Peruvian citizens.

"UNAIDS welcomes the Constitutional Tribunal’s decision and congratulates the magistrates for their determination to protect adolescents’ human rights,” said UNAIDS Coordinator for Peru and Bolivia, Regina Castillo. “The Tribunal’s decision reinforces young people’s right to make decisions regarding their health and sexuality and the need to construct policies and programmes that recognize young people as active actors of change.”

According to a National Demography and Health Survey of 2011 a large percentage of Peruvians initiate sexual relations before the age of 18.  More than 12% of female adolescents (ages between 15 and 19) have been pregnant at least once.

"This decision is a milestone that sets the basis for plans and programs at national level to prevent teen pregnancy and reduce sexually transmitted infections including HIV and maternal mortality," said Carlos Tacuri Calderon, youth activist in Peru and member of INPPARES.

UNAIDS estimates that around 74 000 people are living with HIV in Peru of which approximately half became infected before the age of 20. This situation stresses the need to raise awareness on HIV and its modes of transmission among teenagers. In December 2012, the Ministry of Health in collaboration with UNAIDS and other partners launched the campaign “take an HIV test––it’s better to know” which aimed to reach young men with key HIV prevention messages and provided free HIV tests.

UNAIDS Goodwill ambassador, football player Michael Ballack during his visit to the Health4Men initiative.
Credit: UNAIDS/M.Safodien

In his role as UNAIDS International Goodwill Ambassador, the German football star Michael Ballack conducted a 3-day mission to Johannesburg, South Africa, where he learned about the impact of HIV on communities and used his star-power to raise public awareness of the epidemic.

On 18 January, the first day of his visit, he met with men who have sex with men (MSM), a key population at higher risk of HIV during a visit to the Health4Men initiative at the Yeoville Clinic in Johannesburg. The innovative programme provides free sexual health services to MSM, who often experience stigma and discrimination and struggle with a lack of services catering to their needs. Mr Ballack toured the programme, spoke with health providers and met with MSM.

“I think it is so important that we give attention to HIV because it is everybody’s business,” said Mr Ballack.

“Having somebody like Michael Ballack, who is a big, big celebrity come here to meet people living with HIV, I am very grateful for that and I am very happy,” said one of the Health4men’s clients.

“It is almost impossible to discuss MSM sexual issues openly in South Africa. This is why it is important for these kinds of services to be integrated, into mainstream health care services provided throughout the country,” said Glenn de Swardt, Programme Manager at the Health4Men site.

The Grassroot Soccer project in Soweto was on the itinerary on day two. Along with UNAIDS Executive Director, Michel Sidibé Mr Ballack spent time with participants of the programme. Grassroot Soccer uses football to deliver key life-skills to young people.

“Michael Ballack has done so much to raise awareness of AIDS and UNAIDS is so lucky to have him give his time, energy and name to the HIV movement,” said Mr Sidibé.

UNAIDS Goodwill ambassador, football player Michael Ballack delivering key life-skills to young people during his visit to the Grassroot Soccer project.
Credit: UNAIDS/M.Safodien

Mr Ballack also attended the opening of the 2013 Orange Africa Cup of Nations, which is the continent’s most prestigious football tournament. During the tournament, Mr Ballack met with the President of South Africa, Jacob Zuma as well as with other African Head of States, attending the event. UNAIDS launched its HIV awareness campaign, “Protect the Goal” during the opening.

South Africa has the largest HIV epidemic in the world with an estimated 5.6 million people living with HIV. During the past few years the country has made remarkable progress in reversing the course of the AIDS epidemic. Now, the country has the largest HIV treatment programme in the world with 1.9 million people living with HIV on antiretroviral therapy.

“I have really learnt a lot during this trip and I look forward to continuing to work with UNAIDS on stopping the spread of HIV,” said Mr. Ballack.

The football champion has been a UNAIDS International Goodwill Ambassador since 2006 and he has dedicated time and effort to disseminating HIV prevention messages through the media.