In the spirit of Research Exercise we completed on December 8th 2011 and what it stood for, we feel it is important to highlight the need to highlight approaches that have been working with respect to engaging young people in HIV prevention efforts. We will also share some ideas and reflect on trends in this regard. This is not a report of the research exercise we conducted. The report and follow-up articles will be shared later this month.
Young people are taking the lead in the fight against HIV/AIDS. Compounded by the challenge of being one of the most at risk group for new infections, with limited access to information and services (that are relevant and friendly), their leadership is critical in halting the spread and beginning to reverse the spread of HIV/AIDS. This position is widely accepted. At the June 2011 High Level meeting on HIV/AIDS, global leaders gave further support to increasing and strengthening youth engagement in HIV prevention in the Political Declaration on HIV/AIDS. Building from this global commitment, actors should move to improve and scale up the way they are engaging young people in these efforts.
But where do we start? With 30 years since the first HIV cases were recorded and more than two decades of prevention efforts, is there anything new that can be done to enhance the engagement of a particular group, in this case young people? As dynamic as the youth population is from demographic and social standpoints, the assumption here is that there is always more to be done.
In the late 1980’s and early 1990’s, the dynamics of sexual relations were a lot more complex. Courtships were long and health decisions were rather individually influenced. Now the shift is extreme. There is increasing access to adult content on the internet (almost no oversight); social networks are used by young people as an identity and social standing parameter; and the influence of these networks on health choices young people make. This is but one challenge facing prevention efforts and there are others. What is critical to note is that young people are most at risk for new infections and therefore the solutions towards effective infection prevention must be led by or receive adequate input from young people.
Some approaches to note
There are many approaches used in HIV prevention interventions targeting young people. Some are working and need no question, some are working but need effective monitoring and evaluation and some are not working at all. There is no single solution, thus a periodic review, evidence and data must inform and continuously shape the approaches that have been proven to work.
For the purpose of this piece, the focus here will be on Behavior Change based prevention approaches (approaches that target behavior change as a means to prevent new infection).
These approaches include;
- HIV/AIDS based skills building/ training
- Health Education – Curriculum based – in the school setting
- Education and Services Outreach (out of school setting)
- Friendly health services and providers
- Using the Media (print, radio and television)
- HIV/AIDS Advocacy and Information Dissemination
- Peer Education.
These are only a few. But again, it is important to note that for an approach to be effective it must be supported by scientific evidence to impact behavior change in prevention efforts. Interventions must be adequately monitored and evaluated and using these approaches should be informed by each country’s context.
Scaling-up Youth Engagement
Whilst I found extensive documentation behind the different HIV prevention approaches (proven, successful, being tested and those that have not worked), none reflected on how youth engagement can be scaled in HIV prevention. We have an important window of opportunity now; there is increased international commitment to increase investment for prevention, we have a new global commitment on HIV/AIDS through the Political Declaration adopted early this year, the world is now also thinking beyond the 2015 MDGs deadline, countries have extensive multi-sectoral AIDS strategies and much more. Youth engagement in HIV prevention must also be a priority – not just mentioning this phrase, but supporting it with clear actions that must also be documented and lessons disseminated.
At Connect African Development Blog, we believe scaling up young engagement in HIV prevention approaches, such as those outlined above relies not in how many young people (quantity) are involved in the relevant interventions, but rather the quality of engagement. Some sources indicate things such as providing information and services, and recognizing diversity in the youth cohort as ways of how to work with young people in prevention, how to increase their engagement. We believe organizations working with young people in HIV prevention, the United Nations and government should consider another premise, which is at the core of the definition of youth engagement – decision making.
Scaling up youth engagement should be done through;
- Providing space for youth to engage, not tokenism but in a way that suggests trust in young people’s capacity. Make a strategic commitment and invite young people to openly engage - this encourages their creativity, assures commitment and provides a unique channel to reach other young people effectively,
- Let young people operationalize and populate these approaches to HIV prevention. Whilst the key principles are upheld, let young people define how peer education is carried out and results measured. Let them provide design how youth friendly health services are delivered and use their insight on the changing youth interest to design a media prevention strategy and content.
- What we have seen is young people being recruited, trained and asked to fit into an already defined framework. In our view, young people find it difficult to identify with the interventions. Their engagement becomes confused and guided by material and self-development interests.
- Incentivize youth engagement and creativity. Social networks for instance have millions of young users. What we have seen is that it is hard to keep young people’s attention on a particular subject. We know this is critical, because an issue is popular, young people tend to identify to its key characteristics – they want to be identified with it. Thus similarly, encourage young people to complement these approaches with ideas on building broader interest, maintaining debate on issues covered by the intervention and branding the interventions with positive qualities to reach out to other young people.