WASHINGTON (TrustLaw) - Young people account for 40 percent of new HIV infections globally, a fact that puts the goal of an AIDS-free generation out of reach for years, according to experts.
Infections among young women are twice the rate of those of men of similar age.
The reasons are myriad and range from country to country, studies show. They range from lack of education and gender inequality to high-risk behaviour among vulnerable groups including injecting drug users, sex workers and men who have sex with men.
But for those in the West, Emily Carson, 22, has a simpler explanation. “In my opinion, and from what I’ve seen in my community, in a lifetime when I’ve never known a world without AIDS, it’s complacency,” said Carson, youth programme coordinator at the 19th International AIDS Conference which ends a six-day run here Friday.
“I think because we’re not seeing, on a daily basis, our friends and family members passing away from AIDS, it doesn’t register,” said Carson, who is shepherding the 2,000 registered youth delegates from 100 countries around the conference.
The United Nations Programme on HIV/AIDS (UNAIDS) defines young people as those between the ages of 15 and 24 years.
Greater access to life-saving antiretroviral drug therapy means AIDS-related deaths - at 1.7 million in 2011 - are at their lowest level in a decade, according to the latest UNAIDS report released earlier this month.
New infection rates among adults have stalled at 2.2 million annually since 2009. Young people represent 40 percent of all new infections, meaning 890,000 are infected every year, or nearly 2,500 every day, according to UNAIDS.
Of the 34 million people living with HIV globally, some 5 million are young people and 60 percent of those are young women, UNAIDS said.
Women’s bodies are more susceptible to HIV, and lack of education and gender inequalities in many countries make it more difficult for young women to negotiate safer sex. Girls and women who are married young are often partnered with older men, who are more likely to have HIV. And those who offer transactional sex - unrelated to prostitution - to procure food, housing and other resources, are also likely to have older male partners.
A study of young American women carried out by Rachel Jones, an associate professor of nursing at Northeastern University in Boston, found that women will often deliberately forgo safe sex on emotional grounds. “We found women engaged in unprotected sex with partners they believed engaged in HIV risk behaviour … to win a man, hold onto a man and to show trust,” she said at a conference session on HIV and youth.
The annual rate of adult infection in the United States has been around 48,000 people for the last 20 years, and people between the ages of 13 and 29 years represented 40 percent of them, according to the Centers for Disease Control and Prevention (CDC), which released a report on U.S. high school students and HIV at the conference.
Progress has been made, particularly among young black American high-school students over the last 20 years, but progress among youth overall has stalled in the last decade.
“Risky behaviour remains far too high among all students, and it’s clear that to realise our goal of an AIDS-free generation, parents, schools and communities will need to intensify efforts to ensure that every young person in America knows about HIV and how to prevent infection,” said Kevin Fenton, director of the CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention.
“My generation is obviously not ‘AIDS-free’, but we’re a key bridge generation in achieving that goal,” Cristina Jade Pena, 27 and HIV-positive, said in statement by the Young Leaders’ Caucus of the North American chapter of the Global Network of People Living with HIV/AIDS (GNP+) at the conference. “If we take the right steps now, we might still be able to end AIDS for our future children.”
Many vulnerable youth are in developing countries, particularly in hard-hit sub-Saharan Africa, where two-thirds of the world’s HIV-infected people live. But while the rate of infection is slowing there, it is rising in places like Eastern Europe and Central Asia and the Middle East North Africa (MENA) regions.
New HIV infections in the MENA region rose by 39,000 people in 2011 – a rise of more than 36 percent since 2001. The rise is driven primarily by unprotected sex and injecting drug use, according to experts at a session on the region at the conference. It was also one of the few regions to report an increase in AIDS-related deaths, rising from 14,000 in 2001 to 25,000 in 2011, UNAIDS said.
Youth in the MENA region are at a particular disadvantage due to the high stigma associated in many countries with sex in general, same-sex relationships in particular, and the cultural restrictions placed on young women in negotiating not only safe sex but their choice of sex partners, said Hassan Cherry, a young activist from Lebanon and director of the Think Positive Association.
Access to condoms and other preventive measures are also limited in some countries and, at 13 percent, the region has one of the lowest rates of antiretroviral drug coverage in the world.
Some progress has been made in places like Tunisia, Morocco and Yemen, but many countries in the region lag far behind. “The world is moving ahead with treatment and human rights,” said Dina Jaffary, a leader with the YPeer International Network, which works with youth on sexual and reproductive health around the world. “In the Arab states, it’s just been moving forward treatment-wise. Rights-wise, it’s the same as it was 30 years ago. So, you can imagine how scary that is.”