HIV interventions aimed at adolescents and young adults evaluated in studies

September 2006

TORONTO – Researchers recently reviewed the effectiveness of different types of HIV interventions in schools, health services, media and communities aimed at young people most at risk of acquiring HIV. The researchers graded these interventions for their usefulness.

The review, “Steady, Ready, GO!”, was launched at the XVI International AIDS Conference held here last month and identified what should be done to reduce HIV infection in adolescents and young adults and to achieve the global targets set by world leaders.

The 2001 U.N. General Assembly Special Session on AIDS adopted a universal access goal for people aged 15 to 24 years: By 2010, 95% of young people should have access to the information, skills and services that they need to decrease their vulnerability to HIV.

However, despite these commitments, people within this age range remain at the center of the AIDS pandemic in terms of transmission, vulnerability and impact, with an estimated 4,000 to 5,000 people in this age group acquiring HIV every day.

“Steady, Ready, GO! provides a clear agenda for action for governments around the world if they want to prevent HIV among young people,” said Joy Phumaphi, assistant director-general of family and community health at WHO. “In light of the available evidence, governments will need to have a very good reason for not acting. We know what works and we should be doing it. We should not confuse lack of implementation with lack of evidence.”

Reviewing data

Researchers reviewed more than 80 studies from different developing countries and settings and classified interventions to make the evidence easy for policy makers and program managers to understand and use.

From the mass of evidence available, the effectiveness of different types of interventions were graded as the following: Go, stop asking for more evidence and get on and initiate; Ready, implement widely but evaluate carefully; Steady, not ready yet for implementation because more research and development are required.

“With 40% of all new adult HIV infections occurring among young people aged 15 to 24, more investment in comprehensive HIV prevention efforts for young people is absolutely critical. We need youth-specific HIV prevention programs to be based on what has been proven to work and tailored to countries’ individual epidemics and realities,” said Purnima Mane, PhD, UNAIDS director of Policy, Evidence and Partnerships.

Among the interventions that should be widely implemented because they have been classified as “go” or “ready” are:

• Schools: Curriculum-based interventions, led by adults and based on defined quality criteria, can have an effect on knowledge, skills and behaviors;
• Health services: Interventions can increase young people’s use of services, provided that service providers are trained and changes are made in health facilities to ensure that they are “adolescent-friendly.”
• Mass media: Interventions can work on knowledge and behaviors if they involve a range of media; for example, TV and radio supported by print that are explicit about sensitive topics but in line with cultural sensitivities;
• Communities: Increased knowledge and skills can be achieved through interventions that are explicitly directed to young people and are delivered through existing organizations and structures;
• At-risk young people: Interventions that provide information and services through static and outreach facilities can help achieve the global goals for young people most at risk of HIV, such as young sex workers, young injecting drug users or young men who have sex with men.

The review was carried out under the auspices of the UNAIDS Inter-agency Task Team on Young People, in which WHO has been working with the London School of Hygiene and Tropical Medicine, UNAIDS Secretariat and key UNAIDS co-sponsors, notably UNFPA and UNICEF.