Published in the Bulletin of Experimental Treatments for AIDS Summer-Autumn 2001 issue, by the San Francisco AIDS Foundation.

Adolescent Sexuality, Gender, and the HIV Epidemic

Summer-Autumn 2001 Table of Contents

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Adolescent Sexuality, Gender, and the HIV Epidemic

Youth at Risk

by Kim Rivers and Peter Aggleton

Approximately one-third of the world’s population is between 10 and 24 years of age, and four out of five or 80% of young people around the world live in developing countries, a figure expected to increase to 87% by the year 2020. In many countries the majority of young people are sexually experienced by 20 years of age and premarital sex is common among 15–19-year-olds. For example, surveys have found that 73% of young men and 28% of young women in this age group in Rio de Janeiro, Brazil, reported having had premarital sex, compared with 59% and 12% respectively in Quito, Ecuador, and 31% and 47% respectively in Ghana.

Sexually transmitted diseases (STDs) including HIV are most common among young people aged 15–24 years and it has been estimated that half of all HIV infections worldwide have occurred among people under 25 years of age. In some developing countries, up to 60% of all new HIV infections occur among 15–24-year-olds. Yet vulnerability to STDs including HIV is systematically patterned so as to render some young people more likely to become infected than others. Gender, socioeconomic status, sexuality, and age are important factors structuring such vulnerability. Unequal power relations between women and men may render young women especially vulnerable to coerced or unwanted sex, and can also influence the capacity of young women to influence when, where, and how sexual relations occur.

The consequences of HIV/AIDS can be far-reaching for young people. Not only does HIV disease have terrible consequences for the individual, causing serious illness and eventual death, it has the potential to trigger negative social reactions on a larger, group scale. Across the world, people with HIV/AIDS routinely experience discrimination, stigmatization, and ostracization. Children and young people who are orphaned by the epidemic and who themselves may be infected are sometimes left without the support of adults. For women and adolescent girls, the consequences of AIDS can be particularly dire. For example, strong evidence suggests that in some countries women may be “blamed” for HIV disease, even in circumstances where they have been infected by remaining faithful to their husband or other male partner [Ed. note: This is also known as practiced sexual monogamy]. Evidence also suggests that women are less likely to receive the kind of care and support made available to male household members. Moreover, where the male head of household has died there may be loss of social support for young women, ostracization from the community, and lack of legal protection to inherit land and property. Some young women may find themselves unwelcome in the extended family and may be coerced into sex work in order to survive.

Given the significant number of young people living in developing countries seriously affected by the epidemic, it is crucial that work be undertaken to ensure that they are able to protect themselves. This involves providing them with access to information and resources, as well as promoting a climate which is understanding of young people and their sexual and reproductive health needs. In recognition of the enhanced risks faced by young people, the Joint United Nations Programme on HIV/AIDS (UNAIDS) and its cosponsoring organizations including the United Nations Development Programme (UNDP) have identified young people as a critical group for HIV-related prevention activities. World AIDS Day 1998 gave special emphasis to this fact in its identification of young people as a key group with which to work.

Kim Rivers and Peter Aggleton are from the Thomas Coram Research Unit at the Institute of Education, University of London (UK).

Page last updated 25 October 2001