JOHANNESBURG – When AIDS counselor Patience Ncusani urges teens in her Soweto neighborhood to wait to have sex, or cautions young women that an older boyfriend can be deadly, she has special rapport.
"Whatever language they're using, I can use, because I'm a young person, too," the earnest 21-year-old said Wednesday, the day a U.N.-led alliance urged young people to change behaviors that increase their risk of contracting AIDS, and called on their elders to provide leadership, education and support.
In a joint report released Wednesday titled "Opportunity in Crisis: Preventing HIV from early adolescence to young adulthood," five U.N. agencies, the World Bank and the International Labor Organization said that around the world some 2,500 young people are infected daily with HIV, and that in the year 2009 people between the ages of 15 and 24 accounted for 41 percent of new HIV infections among all those over the age of 15.
The report urged communities, leaders and young people to act to stop sex with multiple partners or with older partners, whose prevalence of HIV is statistically higher. That behavior, the groups say, is "fueling HIV transmission among young people, particularly young women."
Elhadj As Sy, who directs U.N. children's fund programs in eastern and southern Africa, where most young people with AIDS live, said the task was not easy because it involved issues adults were reluctant to discuss among themselves, let alone with their children.
"We're dealing here with sex, with blood and with procreation," As Sy said as he presented the report in Johannesburg. "You take these three to any African country, and you have a very explosive cocktail."
In 2001, at a U.N. special General Assembly session on AIDS, the world's countries pledged to reduce the prevalence of HIV among young people by 25 percent by 2010. The world has managed only a 12 percent reduction, As Sy said, to an estimated 5 million people between the ages of 15 and 24.
"The picture is a grim one. But the report is telling us we can do something," he said. "Let's move from despair to hope. We can do something about this epidemic."
Ncusani, a counselor with South Africa's Love Life program established in 1999 to address the AIDS epidemic among young people, said she has had students walk out when she arrived at classroom. Once she is able to gain their trust and respect, she said, she stresses self-reliance.
Ncusani said the young people she talks to are confused by mixed messages. On the one hand, she said, condoms and birth control pills are available to teens. On the other, parents and teachers are telling them to abstain from sex.
"Opportunity in Crisis" says sex and intravenous drug use are the main causes of AIDS among young people. It pointed to strategies that can help, such as a campaign in Tanzania to ridicule the idea of men pursuing younger women, and a program in Albania to train older drug users to rebuff young people who want to experiment.
"Existing prevention strategies have had limited success, so we have to look for creative new approaches to reverse the HIV/AIDS epidemic," Mahmoud Mohieldin, the World Bank's managing director, said in a statement. "These must address people's very basic needs for education, economic security, inclusion, dignity, and human rights. These issues are particularly crucial when we consider the health and well-being of adolescent girls, mothers and children, and socially marginalized groups."
The report said poverty and unemployment have to be addressed because they can push young people into prostitution. It also cited concerns about discrimination against women, which can keep women from refusing unwanted sex, negotiating safe sex, or objecting to a partner's infidelity. And it says many teens lack access to basic information about HIV and how to prevent AIDS, and to testing services.
When she was 13, Ncusani's mother left home to live with her stepfather, leaving Ncusani and her then 17-year-old brother on their own. Ncusani said she became an AIDS counselor to ensure other young people had the guidance she lacked. She said she's learned what she does is at least as important as the information she offers to her young neighbors.
"They've never seen me doing the opposite of what I'm saying," she said.