Originally published by UNESCO on 16 October 2019

On 9 October, Po Pravde Govorya, an educational show by UNESCO, UNAIDS and OK.RU, went live on air to discuss how to talk with teenagers about health and sexual relations. The Russian social network Odnoklassniki hosted Po Pravde Govorya, [Telling the Truth], a live talk show co-organized by the UNESCO Institute for Information Technologies in Education (UNESCO IITE) and the UNAIDS Regional Office for Eastern Europe and Central Asia (UNAIDS EECA). Experts and celebrity parents discussed ways of talking with kids and teens about complex issues such as puberty, sexual relationships, personal boundaries, HIV and AIDS, and much more. The two-hour show hosted by TV presenter and journalist Lika Dlugach, received some 1.3 million views and 1,320 likes from OK.RU users.

The talk show guests included film and theater actress Elena Borshcheva, journalist Tatiana Nikonova, family therapist Marina Travkova, obstetrician-gynecologist Tatiana Rumyantseva, Alfiya Maksutova, editor-in-chief of DVOR, a social media page for youth, Vinay Saldanha, UNAIDS Regional Director for Eastern Europe & Central Asia, and Tigran Yepoyan, UNESCO Regional Health Education Advisor.

They used examples from their personal life and professional practice to illustrate how to discuss sensitive issues with kids and teens in an atmosphere of trust and without embarrassment, how to help young people make sense of what happens to their minds and bodies as they reach the challenging period of puberty, and how to educate them, honestly and non-judgmentally, about the basics of health and relationships.

Should we talk with kids and teens about sex and if so, how to do it right?

Marina Travkova, family therapist

We should tell them the truth in a way that is adapted to their age. But I would like really like all parents to understand that they do not need their child to be a certain age or to pick a special time and place for this conversation. Like it or not, you have been communicating with your kids about sex all the time since the moment they were born, because understanding sexuality is not only about technical knowledge of where babies come from. There is a lot more to it, including how your children feel about themselves, their personal boundaries, whether or not they tolerate uncomfortable clothes, how they feel about being hungry, whether they can refuse to kiss a granny who loves them. All of these are integral parts of our sexuality. The hands of the father and mother who hold and caress the baby build the first layer of what will later become his or her sexuality. How they feel about themselves, their body, the world around, their personal boundaries. We’ve been having this conversation with our kids all the time by sending them messages about the way to live their lives, to make choices, to fall in love, and to treat their bodies. When your child approaches you with a concrete question, this is a moment not to be missed – a moment of trust. Parents who feel at a loss or afraid to say the wrong thing should remember that it’s always possible to say, “I don’t really know, to be honest,” and perhaps find and offer your child a good book on the topic. You also need to understand that today, teens live in an incredibly open world, and the average age they are introduced to pornography is 9 to 11. Indeed, many teens today say or write, “How can I explain to my mom that she needs to read something about sex?” This is the way teens take care of their parents.

What questions do teens want answered?

Tatiana Nikonova, journalist

Most of the time, teens seek answers to questions which have little to do with what adults want them to ask about. What are most parents concerned about? Pregnancy, bad company, sexually transmitted diseases. But teenagers are interested in relationships. What to do and say, how to tell a person you love them, how to survive rejection, how to say no, and how to deal with the fact that everyone knows something about you that you’d rather keep private. Very often, teens struggle with the issues of bullying and aggression. What happens on a date and what can happen besides being offered sex – this is also something they’d like to know.

How to be more confident talking with your children?

Marina Travkova, family therapist

I can share two lifehacks with parents of teenagers. The first is to speak honestly about yourself, e.g. about the first time you fell in love, the first time you said no to a boy who was in love with you and how it made you feel – all of this has great value for your child. The second lifehack is to be honest with them about your fears.

Tatiana Nikonova, journalist

Discuss TV serials with them – something is always happening there! Like, unplanned pregnancies, complex diseases, breakups, misunderstandings – these are the most common stories in TV shows and a virtually endless source of topics for discussion.

Is it true that sex education can encourage young people to have sex earlier in life?

Vinay Saldanha, UNAIDS Regional Director for EECA

Numerous studies in different countries have found that not only sexuality education programs do not lead to an earlier or more active onset of sexual life, but have the opposite effect: adolescents tend to have a later sexual debut, fewer partners, a lower incidence of risky behaviors, and they are more responsible about the use of condoms and contraception. Together, this reduces the risks of contracting HIV and other sexually transmitted infections. Of course, such programs must be age-appropriate, evidence-based and, most importantly, they must be timely, i.e. before children become adults, otherwise it will be too late. This is what is said in the International Technical Guidance on Sexuality Education developed by several UN organization led by UNESCO.

Why do we need to talk with children about HIV if most people who get infected are adults?

Vinay Saldanha, UNAIDS Regional Director for EECA

In EECA countries alone, dozens of thousands of children and adolescents live with HIV. Therefore, we cannot say that this disease does not concern children. But it is essential to have a high-quality sexuality education program to make sure that a discussion of these complex issues brings positive outcomes.

What can we do if a kid does not believe that HIV exists, because they have read on the internet that “HIV is a hoax”?

Tatiana Rumyantseva, obstetrician-gynecologist

Give this kid a link to the website of the World Health Organization, to other sites which discuss infections. There are many organizations of people living with HIV who work to help others. You can take the kid to such an organization and let him or her meet people there. This approach might work well with someone who responds to emotions more than to words.

How to talk about HIV and not scare people?

Tatiana Rumyantseva, obstetrician-gynecologist

This information serves as a warning. Speaking about infections, I would say that some of them cannot be cured but require lifelong treatment. It makes good sense to plant a grain of concern for their future in young people’s minds. We usually spell out the dangers which we want to protect children from, and the same should apply to sex.

What source of information would a teenager trust the most?

Elena Borshcheva, actress

Bloggers. All teens are watching bloggers. Good educational programs for teens on TV are lacking, so young people learn a lot from bloggers. It makes sense to share essential information through their idols.

Recently, I came across a book and read it before giving it to my daughter. The author is American, and some realities are different from ours, but the concept of personal boundaries in relationships not only between a boy and a girl but also between friends is very well explained. And I thought, “Where was this book when I was a child?” It explains, plain and simple, how to act in certain situations, how to check what’s right, and what to say.

We all want relationships in the first place, warm relationships in which we need and love each other, and sex is part of such relationships. But many people – especially young people — do not quite understand why sex is special and whether a girl can refuse a guy, although it is her right. They need to learn how to tell real love from being taken advantage of in a relationship.

Can websites help parents in educating their children, and how can we teach children to safely navigate the diverse resources?

Tigran Yepoyan, UNESCO Regional Health Education Advisor

Absolutely yes. There is an increasing number of such resources available for parents and for teenagers. As far as teenagers are concerned, media literacy is the key, and UNESCO has been working to help countries educate teachers about media literacy, so that they may teach their students. Here are some basic lifehacks: it is essential to help children develop an ability to critically assess and analyze information, never take it for granted but double-check and look at the source of information: who created the website, who are the authors of posted materials, whether they provide links to primary sources and refer to relevant experts and research findings; ask yourself whether the main purpose of the website is to provide objective information or to impose a particular behavior pattern or lifestyle, manipulate the reader, or sell a product or service.

About DVOR, an online community for teens

New HIV infections in Brazil increased by more than 20% between 2010 and 2018, so it’s crucial that young Brazilians start talking about HIV and learn how to protect themselves. That’s the aim of a project led by the United Nations Children’s Fund (UNICEF).

Swiping through one of his social media accounts, Jonas da Silva checks out the latest parties and public events in Salvador. He is also chatting online with other young people. They talk about sex, how and if they use condoms with their partners, what they know about HIV prevention and if they have been tested for HIV. 

“What’s cool about the project is that we have young people talking to young people. We use our language and slang to address HIV,” he says. “This connection is vital. We can see they trust us, and this is when we know we have touched them with the information they need.”

He and another 30 young people have been trained to work as volunteers in the Viva Melhor Sabendo Jovem (VMSJ) Salvador project. Their goal is to raise awareness among other young people about the importance of HIV testing and prevention. For that, they need to be where their peers are—online and on the street.

The project follows the calendar of traditional street parties and festivals, especially those that attract a large concentration of young people. It also responds to specific demands from key populations by mapping public gatherings where young lesbian, gay, bisexual, transgender and intersex people hang out. With a colourful small truck—the Test Truck—Mr da Silva and his co-volunteers can provide privacy for people who want HIV counselling and testing.

Since the project launched in August 2018, more than 1000 young people aged between 16 and 29 years have been tested for HIV in around 30 outings for the truck. As part of a strategy to promote testing among adolescents and young people, the volunteers also facilitate workshops on HIV and other sexually transmitted infections and host talks about sexuality and sexual health in schools. These events reached more than 400 students in the first six months of the project.

“The VMSJ Salvador peer education methodology makes it possible to engage more young people in these activities. It also helps them to become aware of the importance of HIV prevention and care,” said Cristina Albuquerque, Chief of Health and HIV/AIDS for UNICEF in Brazil. “Young people who get tested during our activities congratulate the initiative and complain that they have very few of these opportunities around town.”

In 2018, according to Ministry of Health estimates, young people aged between 15 and 24 years represented almost 15% of all new HIV diagnoses in Salvador.

“For us, too, the volunteers, this experience is important because we also start to take better care of ourselves, to apply these prevention methods to our lives and to pass the message on to those around us, to our friends and family,” said Mr da Silva.

The project is implemented in partnership with GAPA Bahia―one of the oldest nongovernmental organizations dealing with HIV issues in the country―and counts on the support of the UNAIDS office in Brazil. The young volunteers all went through a rigorous selection process before undergoing a training programme that included topics such as human rights, counselling and information on HIV and other sexually transmitted infections. They were also trained on community-based programmes, the functioning of the public health system and HIV services available in Salvador. The initiative includes a continuous training strategy on related topics.

“One of the most important things I have learned is that we have to respect each other’s choices and that we are here only to assist with information and inputs that we consider most appropriate to that person’s history and behaviour”, said Islan Barbosa, another of the volunteers.

“The project represents an important response to HIV testing demands in the city, especially among key populations, who very often avoid using public health facilities for that purpose. We are taking HIV testing to where these people are,” said Ms Albuquerque.

Around 19 000 inspirational young people gathered at WE Day UN on 25 September to celebrate the incredible work they are doing to make positive change in their communities and around the world. All the young people who attended the event had earned a free ticket by taking action on one local and one global cause of their choice. Taking place in New York, United States of America, during the seventy-fourth session of the United Nations General Assembly, this year’s WE Day UN was held in partnership with UNAIDS, the UN Global Compact and UN Women.

UNAIDS has enjoyed a long-standing partnership with WE Day, helping to educate young people about HIV and to support them in their socially conscious efforts to make a sustainable impact in their societies and around the world. Through the important work of WE Day, UNAIDS is able to reach more than 20 000 schools across the United States, the United Kingdom and Canada.

Speaking to the young audience in the Barclays Center Stadium in New York, Gunilla Carlsson, UNAIDS Executive Director, a.i., said, “AIDS is not over, but it can be! You can be the generation that ends AIDS and leads the world in achieving the Sustainable Development Goals, creating a better world for generations to come.”

Ms Carlsson used the opportunity to remind young people of the importance of achieving the Sustainable Development Goals and how critical it is to talk about HIV to break down the stigma around the epidemic. Her remarks were preceded by a newly released animation from UNAIDS that demonstrates the interlinkages and interdependence of HIV and the Sustainable Development Goals and how efforts to end AIDS can lead to a wider, people-centred social transformation.

Young people in Ghana have committed to help promote a sustainable environment by reducing the amount of waste they generate, both at home and in school.

“Reduce, reuse, recycle,” was the theme when the advocates met the UNAIDS Ghana Country Director, Angela Trenton-Mbonde, in Accra, Ghana. The advocates took turns to make personal pledges to adopt better waste management practices in order to promote environmental sustainability.

“I commit to acquiring a personal reusable water bottle and to avoiding single-use plastic bottles. This, I believe, will safeguard the planet for everyone,” Pricilla Addo said. 

Another advocate, Samuel Nyarko, said, “I pledge to personally ensure that waste generated in my household is well separated so that plastics can easily be collected and recycled. I will educate my schoolmates and community to do the same.”

Ms Trenton-Mbonde encouraged the young people to ensure that their commitments to the planet are fulfilled. “For a sustainable environment, each of us must take personal responsibility and make one commitment, no matter how small and insignificant it may seem in the beginning, because in the end we are all connected: people and planet,” she said.

The youth advocates comprised young people from Hope for Future Generations, a Ghanaian not-for-profit nongovernmental organization focused on empowering women, children and youth.

A dozen young people from nine different countries in Latin America came together in July at the 10th International AIDS Society Conference on HIV Science in Mexico City, Mexico, to develop new youth-friendly communications strategy related to HIV prevention for young gay men and other young men having sex with men.

Although the 12 had never met face-to-face before, they had held several virtual meetings to pave the way for the conference, organized by the Latin American HIV-Positive Youth Network (J+LAC), with support from the Pan American Health Organization/World Health Organization (PAHO/WHO), UNAIDS and UNICEF.   

Every year in Latin America, an estimated 100 000 people become newly infected with HIV—a number that has not changed over the past decade. In 2018, young people between the ages of 15 and 24 years accounted for one fifth of all new HIV infections in the region. Young gay men and other men who have sex with men, sex workers, transgender people and injecting drug users are particularly affected.

“We need to remind the world that we cannot talk about prevention without young people and make the world realize that we are involved and concerned,” said Kenia Donaire, a Honduran who was born with HIV.

UNAIDS, PAHO/WHO and UNICEF are strong advocates for the involvement of young people not only as beneficiaries of services but also as partners and leaders in the design, development, implementation and monitoring and evaluation of policies and programmes.

“Too often, young people are not at the decision-making tables creating the programmes they need to protect themselves from HIV. You have the potential to set an example on how young people can lead, advocate, create demand and deliver tailored services to end an epidemic that is the second leading cause of death among adolescents. We need new ways to communicate, generate demand and link young people at higher risk of HIV to services,” said Shannon Hader, UNAIDS Deputy Executive Director, Programme.

Young people living with HIV in Latin America have been working together to design an HIV prevention communications strategy for young gay men and other young men having sex with men in the region. In advance of travelling to the conference, they worked together to map existing communications campaigns and initiatives on combination prevention of HIV and other sexually transmitted infections and discussed how to translate complex scientific content into effective key messages for their peers.

“Young men who have sex with men and other vulnerable youth need access to HIV prevention information in a way that makes sense to them,” said Maeve de Mello, regional advisor on HIV prevention at PAHO.  “We are very pleased to support this talented group of young people. Their personal experience and voices will better prepare us to address this public health concern in a way that adults alone cannot.”

At the conference they shared their ideas with leading health and communications experts and discussed digital strategies to reach young people with compelling messages on HIV prevention and ending stigma and discrimination.

“Learning about the latest advances and successful experiences in the response to HIV, while being able to learn what goes on from the other side of the screen from digital experts such as YouTube was a really enriching experience,” said Horacio Barreda, one of J+LAC coordinators. “We need a strategy that focuses on the needs and affinities of young gay people, who live their lives in the virtual and off-line worlds.”

“This is a successful start of an important journey through which we believe we will reach Latin American youth in all its diversity.”

The group now plans to bring their strategy and advice to key stakeholders in the response to HIV, including to ministries of health, United Nations agencies, and other partners.

While Botswana has made great progress in reducing the number of new HIV infections—down around 36% in total since 2010—young people remain highly vulnerable to the virus. Adolescent girls and young women are particularly at risk of HIV infection as well as other sexually transmitted infections and unintended pregnancy.

In 2018, almost one in four new HIV infections in Botswana occurred among young women and adolescent girls aged 15-24 years old. Less than half of young women and adolescent girls say they have comprehensive knowledge about HIV.

To see what more can be done to address the issues making young people more vulnerable to HIV, the First Lady of Botswana, Neo Masisi, held a retreat in July to look at the challenges confronting them.       

Young women participating in the retreat shared some of their experiences with the First Lady and officials from the Ministry of Health.       

“I come from a strained family structure where poverty is rife. I never felt loved at home and looked for love outside. I got a boyfriend and eventually I too became a teenage mother,” said Belinda.

The discussions at the retreat will feed into a framework for the development of a national flagship programme for young people.

“Today’s young people are dealing with multiple challenges and they have to take on so much—at school, within changing family dynamics, societal expectations. They question their norms, values and their own worth,” said Ms Masisi. “We need to treat them as leaders so that they can feel valued.”                

The Minister of Health, Alfred Madigele, said further consultations would be held with young people to produce the framework.

Earlier this year, the UNAIDS Executive Director a.i., Gunilla Carlsson, appointed Ms Masisi as UNAIDS Special Ambassador for the empowerment and engagement of young people in Botswana.      

A study undertaken by Watipa and commissioned by UNAIDS and the PACT as part of its #uproot agenda found that young people play an essential role in demand creation, linkages to care and uptake of services for HIV and sexual and reproductive health and rights.

The report showcasing the results, titled Young people’s participation in community-based responses to HIV: from passive beneficiaries to active agents of change, showed that young people, particularly role models and leaders who are living with HIV, play a critical part in enabling access to HIV treatment and retention in care. The results showed that the support provided by young people to their peers has a positive effect on antiretroviral therapy adherence, navigating disclosure and living positively with HIV. Details of the types of support show that young people are actively involved in peer psychosocial support, peer-to-peer consultations, policy engagement processes, peer mobilization around specific campaigns and projects, and peer-supported hospital and care access.

Young people, including young key populations and young people living with HIV, also play a key role in primary HIV prevention, early testing and diagnosis. Peer education, outreach and community engagement are all areas where young people are informing and influencing their peers. In some examples, young people working as peer supporters and volunteers provided HIV testing and counselling services, distributed condoms or worked alongside community-based health assistants.

62% of surveyed individuals who were members of a youth organization in the HIV response indicated that they themselves provide HIV services directly to young people. These were services designed to benefit and reach young people as the focus groups. The provided services include information about sexual and reproductive health and rights (51%), peer support (50%), psychosocial support (42%), condom promotion and distribution (41%), antiretroviral therapy adherence support (32%) and HIV counselling and testing (30%). Many of the organizations surveyed offered integrated services, including referrals, prevention, and testing and treatment of other sexually transmitted infections (STIs) (38%), tuberculosis (28%) and/or hepatitis B and C (22%).

As one key informant mentioned, “It’s easy to disseminate the knowledge among ourselves, because if [I] am part of it, then it’s easier to talk to somebody of my age about it.”

The primary data was collected through three methods: 1) an online quantitative survey with 32 questions that was offered in five languages (Arabic, English, French, Russian and Spanish), peer interviews, which were semi-structured qualitative interviews conducted by young people in either English or their local language in six different countries, and key informant interviews, which were semi-structured qualitative interviews conducted in English via Skype by two young consultants leading the research team. The total number of participants was 143, between the ages of 20 and 29.

The role of young people in community-based responses to HIV is vital to achieve and sustain positive health outcomes in the context of HIV. One key informant said that “Young people living with HIV are changing the game in the community. They are peer educators, mentors . . . they support other young people at health facilities to direct them about services to make the process swifter for them while receiving services. Many young people are involved in advocacy where they speak for the voices of [the] young.”

However, the lack of appropriate or proportional remuneration for the role of young people in demand creation and enabling linkages to care seems to be a critical barrier to the sustained, effective and meaningful involvement of young people. Other barriers inhibiting their participation included a lack of funding for institutional support, a lack of capacity or support for the knowledge necessary to participate fully in technical discussions, and a lack of tailored tools and resources to support participation in different processes and mechanisms.

The study also provides thirteen recommendations from the young people who participated in the research, and are aimed at government authorities, United Nations entities, donors, civil society organizations and other stakeholders in the HIV response. These recommendations include the need to involve young people in design, planning and delivery of HIV policies, programmes and services as well as recognize the essential role that young people have in implementing service delivery to their peers.