It’s World AIDS Day! A reason to celebrate?
World Aids Day makes for a perfect opportunity to shed light on both global and local developments in the fight against HIV. Although HIV/AIDS affect societies as a whole, it is young people who bear the greatest burden. Global estimates show that 25% of infected persons are between 10-24 years old while those age 15-24 comprise of 35% of new infections, resulting in 900,000 new infections annually. That’s why funding and measurements fighting HIV need to tackle youth-specific needs, determined by youths themselves. As an international youth organisation, we are proud to help make youth voices heard and share examples of youth-led actions against HIV. Let’s take a deeper look into the specific struggles youth face and what suggestions youth offer.
We are thrilled to pass the mic to three of our youth Country Coordinators and members who are sharing stories, struggles and best practices from Nigeria, Uganda and Pakistan.
A story from Nigeria
“Funmi, an 18-year-old student in Lagos, Nigeria, was accompanying her friend to the hospital when a health worker approached her, offering free HIV testing. Funmi agreed, and while she was being counselled on HIV and how to prevent contracting it, she realizes how little she knows about it. All she knew was that it is a deadly disease. She had learned nothing about how one gets infected or how transmission can be prevented. Funmi had been having sex with different partners, and she hadn’t liked using condoms at all, but rather relied on the morning-after pill. After the test, Funmi gets the result: she’s HIV-positive. Without her random visit to the hospital, she would have never found out.”
As Funmi’s example underlines, women are specifically at risk in Nigeria because of their lack of access to education. The 2017 UNAIDS report on Nigeria calls for concern; just 24.4% of people age 15-24 have any knowledge of HIV prevention. Less than 50% of people use protection during high-risk sex (meaning with a non-marital, non-cohabiting partner). Despite public campaigns and improved distribution of educational materials on HIV, gaps in knowledge of the transmission and prevention of HIV remain, especially amongst young people, for example through safe sexual practices.
Both Funmi’s story and the accompanying statistics show a lack of knowledge and access to tools among youth on HIV. What Nigeria needs is an increased focus on young people’s education. That includes youth-specific information and youth empowerment which would be an investment in youths’ ability to make informed decisions. It is critical to address poor education and poverty as the main factors in HIV infection. As much as adequate education can be seen as the best contraceptive and prevention to HIV, poverty increases the risk of HIV as it creates additional barriers to health information and services (for example through rural vs. urban divides, geography, costs for transport etc). Media campaigns mobilizing vulnerable communities, such as youth, have shown the best results to reach young people. Now it’s on the government to provide sustainable funding for these.
A story from Uganda
“9-year-old Namirimu had been enrolled in primary school by her father. One year later, her father died due to HIV/AIDS-related complications. At the tender age of 10, Namirimu was left an orphan, since her mother had died years before as a result of HIV/AIDS. After the burial of her father, her elders decided to make her paternal uncle her guardian, one of her closest relatives and kin. At this point, no one had ever told her about HIV, let alone got her tested. She didn’t know anything about her HIV positive status, its transmission, and prevention, or about sexual and reproductive health at all.
While Namirimu was staying with her paternal uncle, he began making advances on her. He abused her, and whenever she fought back, he beat her heavily. Namirimu went to school with a torn uniform and bruises from her uncle’s punches, kicks, and hits. Her aunt did not defend her at all; instead she encouraged her husband to torture the little girl since she isn’t “of her own family”. During her second school term, Namirimu gets pregnant. Her uncle facilitated a secret abortion in a hospital. While she was at the clinic, her eyes landed on a poster about family planning, and contraceptive pills. She asked the health worker about contraceptive pills and learns about HIV, sexual, and reproductive health for the first time. A little later, back in school, a team of health organisations from UYAFPAH (Uganda Youth Alliance for Family Planning and Adolescent Health) and Action for Children visited her classroom. They shared information about family planning and rights, and Namirimu had her U-turn moment! Namirimu is now a peer educator at that same school, has left her uncle’s home and lives with a distant aunt who freely talks to her about family planning and contraception, marriage, and relationships, and the dangers of HIV/AIDS.”
Like Namirimu, young people are often left in the dark about sexual and reproductive health. When they have no families, or when their parents shy away from educating them, young people instead look to TV, popular culture, peers, or whoever is around. Adolescents and youths without proper education and access to knowledge and services are extremely vulnerable. Knowledge of HIV transmission and prevention is one of the most significant factors towards reducing the risk of infection. Increasing the focus on education and information is crucial for behavioural change, like safer sex, and for decreasing infection rates among young people.
World AIDS Day matters: Tackling intersectional barriers
The stories from Uganda and Nigeria teach us about the underlying causes of youth vulnerability towards HIV infection: poverty and lack of education. Without tackling these two, there is no chance of winning the fight against HIV/AIDS. Programs that engage youth within the formal education system can reach some these youth, but they are not a satisfying response for those whose isolation from education leads to a lack of access to family planning services and information. We need to focus on intersectional barriers which make poor uneducated youth without stable families the most vulnerable group. Let’s see what positive examples exist out there!
Reaching youth through edutainment
The Shuga series is an incredibly popular television show for young people. The series was aired in more than 40 countries across Africa. Its first two seasons were commissioned by a shared initiative called
MTV Staying Alive Ignite! which is an initiative created by the Kenyan government, and a US fund. The series was created as a part of a multimedia campaign on HIV prevention, spreading messages about responsible sexual behaviour and tolerance. Its later episodes were made and set in Nigeria and even touched on maternal and child health, family planning, gender-based violence, and female empowerment. This series is an example of edutainment that educates youths on HIV and helps changing the negative associations against people living with HIV. Accompanied by a social media campaign, Shuga has reached its target group successfully with a program tailored specifically to prevent and destigmatize HIV.
Reaching youth through sports
The concept of “Sports for Development and Peace” (SDP) has brought positive change to communities around the world. SDP uses team-based sports to teach social and moral values to young people. Since 2001 when the United Nations officially endorsed it, SDP programs have been initiated globally by different organizations, two famous ones being Right to Play and UNOSDP (United Nations Office on Sports for Development & Peace).
In Pakistan, a project called Sports for Social Change was implemented by the Kafka Welfare Organization. Through SDP activities, it taught youth about positive values, including acceptance, tolerance, mutual respect, discipline and understanding of cultural diversity. A participant said “During activities (…) I experienced equality (…). We are all equal (…) Now I accept people from all backgrounds and cultures”. The power of sport helps youth to overcome barriers and differences; it unites them based on friendship and team spirit.
Our Country Coordinator from Pakistan, Umair, uses sports as a tool to reach youth in his community and to teach them about sexual health, contraception, and social welfare. In his community as well as in many others, one of the most prominent barriers to use of contraception is the cultural stigma. Contraception is considered taboo in Pakistan, and is not talked about at all. SDP activities create safe spaces in which he breaks down these cultural barriers and make it easier for young people to talk about contraception, HIV/AIDS, Sexual and Reproductive Health and Rights and family planning. Umair uses a variety of sports analogies: “Like a goalkeeper is needed to prevent goals from happening, a condom is needed to prevent HIV.” This image was used during friendly soccer matches. Individuals report feeling free to express their opinions and share their feelings after the ice has been broken through fun and games. Umair specifically includes people affected by HIV/AIDS as well as youth from different genders. He also used these safe spaces to talks about unwanted pregnancies, maternal health, and social welfare when organizing SDP activities.
The three stories demonstrate that the factors that put youth at risk are interrelated. High risks of HIV infections, sexual violence, poverty, lack of access to education and family planning services are not separate factors but create an environment that enables transmission and infection. When we draw the connection between the factors that make youth vulnerable, we can tackle them together and find sustainable solutions. Unfortunately, this is often not where funding goes. The global donor community divides its money by cause, which does not make sense since we don’t live one-cause lives. To understand these factors, we need to ask those affected by them: youth. By hearing youth voices and accepting their lead, we can learn how the barriers are interrelated, and what youth need to overcome them.
It is simple to say but hard to do: we need sustainable funding for youth-led projects and organizations that focus on the intersectionality of the barriers youth face. Happy World Aids Day, keep up the good fight.
All authors are part of the International Youth Alliance for Family Planning. The IYAFP is a registered 501(c)3 based in Washington, DC. It is a pro-choice, pro-rights organization for youth aged 15–30, no matter where they are from.
Marietta Wildt is the Executive Director for Public Relations for the IYAFP. She brings in experience from research, grassroots movement and academia and is based in Germany.
Owoyemi Ayomide is a medical doctor and public health practitioner. He presently works with a NGO offering HIV care services in Nigeria.
Amanda Joan Julian Mary Banura is the Ugandan Country Coordinator for the IYAFP and Co-Founder of the Uganda Youth Alliance for Family Planning and Adolescent Health (UYAFPAH).
Umair Asif is IYAFP’s Country Coordinator from Pakistan and an activist leading a youth-based NGO working to empower youth on health issues.