HIV/AIDS & Adolescents – Policy & Other Perspectives

A major chunk of the world’s population, roughly 1.2 billion, is aged between 10 to 19 years i.e. every sixth person on the planet is an adolescent. Adolescents represent a growing share of people living with HIV worldwide. While HIV prevalence has reduced significantly among the western countries, the developing world continues to suffer from HIV burden. UNICEF reported that an estimated 120,000 children and adolescents were living with HIV in India, in 2017. 

Adolescence is a critical phase in the lifecycle; it marks the period of physical and psychological development of a person. Given the transitional nature of this age group, the tendency to experiment sexually leads to several risks including early sexual debut, sexual coercion and violence, and substance abuse. This puts adolescents at a greater risk of contracting STIs than adults. Early onset of HIV among adolescents not only affects their immediate health, but also has long-term adverse impacts on their education and social capital. In the face of these risks, the need for awareness becomes critical. Unfortunately, young people in India lack the access to information regarding sexual health and wellbeing, resulting in misconceptions about HIV transmission, among other issues. 

National Family Health Survey-4 (NFHS-4) has revealed that, in India, 22% of young women and 32% of young men aged 15-24 years have comprehensive knowledge of HIV. This includes knowing that consistent use of condoms during sexual intercourse and having just one uninfected faithful partner can reduce the chance of getting HIV, and knowing that a healthy-looking person can have HIV. The report further states that the percentage of young women with comprehensive knowledge about HIV has increased only marginally from 20 percent in NFHS-3 to 22 percent in NFHS-4 and the proportion of young men with comprehensive knowledge has declined in the same period, from 36 percent to 32 percent. This points to a major setback in the government’s efforts to create awareness among youth around HIV. 

Further, data from NHFS-4 shows that awareness of HIV/AIDS varied by age, sex, residence and marital status. Comprehensive knowledge about HIV increased with age: only 16% of women and 25% of men aged 15-17 have comprehensive knowledge, compared with 26% of women and 37% of men aged 23-24. Young women and men in urban areas are more likely than their counterparts in rural areas to have comprehensive knowledge about HIV. Awareness among youth varies greatly by state of residence as well. 

Population Council’s project UDAYA in the states of Uttar Pradesh and Bihar (a home to more than 72 million adolescents) corroborates the findings from NFHS-4. The project revealed that awareness of contraceptive methods remained superficial among adolescents. For instance, in Uttar Pradesh, while 63 percent of unmarried adolescent girls were aware of contraceptive methods (oral pills, condoms, emergency contraceptive pills), only 17 percent had the correct knowledge about at least one of these contraceptive methods. Their awareness of the issue is riddled with misconceptions and taboos related to sexual health. This presents a real need for pre-nuptial/pre-marital counselling for young people to promote safe sex and the use of contraceptives. This will provide them with appropriate knowledge when they need it the most, and help reduce the burden of new HIV cases. 

These findings highlight the need to provide comprehensive knowledge about sexual health and wellbeing, to all adolescents. The Adolescence Education Programme (AEP) undertaken by the Ministry of Human Resource Development in partnership with National Aids Control Organisation, UNICEF, UNESCO and UNFPA, is a step in the right direction. The government and the private sector need to work together to develop more such innovative programmes to provide young people the access to information and counselling services. Furthermore, project UDAYA revealed that HIV/AIDS awareness rates among adolescents improved with formal education, household wealth status and mother’s education. This calls for a diverse set of interventions to prevent new HIV infections, including better access to healthcare services and commodities, education and life skills. As today’s adolescents are predicted to be the driving force behind India’s development, we, as a nation, need to take much better care of our young adults. 


Dr. Avina Sarna

Avina Sarna is a senior associate with the Population Council's HIV and AIDS program. A physician by training, she has extensive experience bridging clinical medicine with high-impact public health interventions. Sarna joined the Council in 2001 to lead the Access to HIV Treatment global operations research agenda under the Council’s Horizons program, which documented barriers to antiretroviral treatment services, assessed community-based prevention approaches for people living with HIV, and identified integration points between reproductive health and HIV services. She has also led research on HIV prevention and treatment among injecting drug users and microbicide adherence among female sex workers.

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