Sex and youth: contextual factors affecting risk for HIV/AIDS: a comparative analysis of multi-site studies in developing countries (Part 1: Young people and risk-taking in sexual relations)

What are the best ways to protect young people from the dangers of HIV and sexually transmitted diseases (STDs)? This set of studies from UNAIDS draws on interviews and discussions with nearly 3000 young people in 7 countries in Africa, Asia and the Americas. They present a comparative analysis that reveal very similar themes and issues. The position of young people is shown to be complex, and no single HIV/STD prevention strategy is universally appropriate.

The document contains an introduction which examines different definitions of 'young people' and gives an overview of existing research frameworks. Further chapters describe the background to the studies and the conceptual framework applied by the researchers; outline the study design and methodology; present the comparative analysis of the data; and make recommendations on key themes and issues relevant to programme development and implementation.

Important findings of the research include the following:

• There are many different sexual cultures within any particular setting: no individual country has just one
• In all countries, young people use specific terms and shades of meaning to understand their sexual feelings and experience and to locate themselves within their culture and age group
• Attempts to delay young people’s transition to adult status through extended education or raising the age for marriage do not succeed in delaying sexual activity
• All countries are experiencing a decline in traditional sexual values: in some countries young people are adapting aspects of traditional cultures in order to create a new one
• In all seven countries young women report difficulties in handling young men’s expectations and understandings of sex. Although there are some differences between (and within) countries, there is a widespread and marked perception that young men are sexual beings and young women ought not to be
• All studies reported a marked effect of economic modernisation and pressures caused by rural transformation and urbanisation, both at the personal level and in creating new sexual opportunities for young people.

There is little to be gained from developing HIV/STD policies from simplistic visions of young people as a homogeneous 'at risk' population. There is no one population called 'young people' and no one strategy to be devised to provide for them. The authors of the report make the following recommendations for future policy and programme development:

• Researchers and policymakers must move towards a more sophisticated frame of reference involving a contextualised understanding of young people’s sexual conduct
• Efforts to prevent HIV/AIDS and promote sexual health among young people must be upgraded, using sex education programmes delivered in both formal and informal education settings
• Programmes are needed that focus on the risk many young women face with reference to HIV/STD. Young women must not be defined as merely 'vulnerable': it would be foolish to ignore their active pursuit of sexual interests
• There is a need to draw up an agenda for young men in addition to that for young women. Their sexual health is not just about HIV and STD prevention, but about recognising their sexual needs, and their desire for information and support
• Unless attention is paid to young men’s sexuality, efforts to help young women will be ineffective
• Representations of young men as sexual 'predators' and of young women as 'victims' are equally unhelpful. Young people are likely to reject health promotion messages based on such generalisations.