Achieving and assessing behaviour change

There are significant barriers to behaviour change in young people. A range of social factors contributes to young people engaging in unprotected sex, despite knowing that abstinence and condom use prevent HIV infection. Evidence also suggests that young people often recognise promotion of abstinence only programmes, or programmes advocating delayed sexual activity, as a 'moral agenda' dressed up as health promotion. Key social factors hindering behaviour change include:

• lack of access to condoms
• young people's lack of confidence in their own capacity to abstain from sexual activity, or their feeling that they cannot insist on condom use with partners
• male control and the fear of violence in sexual relationships make it difficult for young women to negotiate when, with whom and how sex takes place.

Evidence suggests that women tend to respond more positively than men to abstinence messages