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Study identifies prevention interventions set to GO!

Young people and HIV: the evidence is clear --- act now!

by the World Health Organization

For the first time, the effectiveness of different types of HIV interventions in schools, health services, media, communities, and for young people most at risk of HIV have been reviewed and graded for their usefulness.  The review Steady, Ready, GO!, launched at the XVI International AIDS Conference, identifies what should be done now to reduce HIV infection in young people, and achieve the global targets set by world leaders.

The 2001 UN General Assembly Special Session on AIDS adopted universal access goals for young people: by 2010, 95 percent of young people to have access to the information, skills and services that they need to decrease their vulnerability to HIV.

However, despite these commitments, young people (15-24 years) remain at the center of the AIDS pandemic in terms of transmission, vulnerability and impact, with an estimated 4-5,000 people in this age group acquiring HIV every day.

Over 80 studies were reviewed, from different developing countries and settings. The interventions have been classified in a way that makes 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 have been graded as:

·        GO! (stop asking for more evidence and get on and do it!)

·        Ready (implement widely but evaluate carefully)

·        Steady (not ready yet for implementation because more research and development is required).

The review makes recommendations for policy makers, program managers and researchers.

"Steady, Ready, GO! provides a clear Agenda for Action for governments around the world if they want to prevent HIV among young people," says Joy Phumaphi, Assistant Director-General, 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."

This publication will be as important for NGOs as it is for governments. NGOs frequently have very limited resources and are often working in a politically charged environment. Steady, Ready, GO! will help advocates move beyond opinions and moral judgements to scientific fact, and provide much needed information to young people themselves.

"With 40 percent of all new adult HIV infections occurring among young people aged 15-24, 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, 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:

·        In schools: curriculum-based interventions, led by adults, that are based on defined quality criteria, can have an impact on knowledge, skills and behaviors

·        In 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". 

·        In the mass media: interventions can have an impact on knowledge and behaviors if they involve a range of media, for example TV and radio supported by print, and are explicit about sensitive topics but in line with cultural sensitivities

·        In 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

·        For young people most at-risk: 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.