Your Ad Here

Rudely Raping in cambodia

Cambodia is one of other poorest countries. there are lot of poor people especially original Khmer living at the country side or remote area. lost of good security and lack of food and developing. Raping between fathers and their daughters is at remote area or in the town too. However, there are also some organization to observe this problem right now Like A federal jury has convicted a retired US Marine captain of travelling to Cambodia to have sex with underage girls after hearing testimony from his victims.

Michael Joseph Pepe, 54, of Oxnard, California faces up to 210 years in prison for the guilty verdicts on seven felony counts, the US Attorney's office in Los Angeles said in a statement on Thursday.

During the trial, six girls testified that Pepe drugged, bound, beat and raped them and a prostitute told the court on videotape about bringing him young victims, federal prosecutors said.

A total of seven girls, ages 9 to 12 at the time, were sexually abused by the former Marine captain, the statement said.

Prosecutors also provided evidence seized by Cambodian authorities including rope and cloth strips used to restrain the victims, sedatives and homemade child pornography.

"This case represented one of the most egregious examples of international sex tourism we have ever investigated and the jury's verdict is a reminder that pedophiles who attempt to evade detection and prosecution by committing sex crimes overseas face serious consequences," said Robert Schoch, special agent of the US Immigration and Customs Enforcement office of investigations in Los Angeles.

Pepe was prosecuted under a federal law adopted five years ago, the Protect Act, that bolstered penalties against predatory crimes involving children outside the United States.

The investigation was a joint effort by the Cambodian National Police, US Immigration and Customs Enforcement, the Federal Bureau of Investigation and the State Department's Diplomatic Security Service....ok if any one have more about this please share your comment bellow


Read more!

Life and sex stay together? Click to read it

Wow, talking about sex, every one need it, even though Ta Jas ( old men) think of it and always think of SRey Kmeng (young girls). we, all men should care about our wife I mean if you like sex if you get married with any one who are older than you, you will be dis pointed with having sex. as you know clearly about girls and women, she will be desire less of having sex when she gets weak during her Ror.Doe get low, so she will be lazy of having sex any more. Ok for now if you have more idea about this please leave the comments here


Read more!

Estimation of HIV/AIAS Countries in Asian..Click to read more

Cambodia
The first case of HIV/AIDS in Cambodia was officially identified in 1991 through screening of blood donors, although HIV had been detected in Cambodian refugees in Thailand two years earlier. Sex workers and men seeking treatment for sexually transmitted infections were among the first groups to report high levels of HIV infection. Today, with an adult prevalence rate of 2.7 percent, Cambodia, one of the region’s poorest countries, has the highest infection rate in Asia, with an estimated 170,000 persons living with HIV/AIDS in 2001. Under the President's Emergency Plan for AIDS Relief, Cambodia received more than $16.8 million in Fiscal Year (FY) 2004, approximately $17.4 million in FY 2005, approximately $19.3 million in FY 2006, and is providing $19 million in FY 2007 to support an integrated HIV/AIDS prevention, treatment and care program. 2008 Country Profile: Cambodia
National HIV prevalence rate among adults (ages 15 to 49): 0.8 percent1
Adults and children (ages 0-49) living with HIV at the end of 2007: 75,0001
AIDS deaths (adults and children) in 2007: 6,9001
AIDS orphans at the end of 2007: not available1
Under PEPFAR, Cambodia received more than $16.8 million in Fiscal Year (FY) 2004, approximately $17.4 million in FY 2005, approximately $19.3 million in FY 2006, and $19 million in FY 2007 to support an integrated HIV/AIDS prevention, treatment and care program. PEPFAR is providing nearly $17.9 million in FY 2008.
Recognizing the global HIV/AIDS pandemic as one of the greatest health challenges of our time, President George W. Bush announced the President’s Emergency Plan for AIDS Relief (PEPFAR) in 2003 — the largest international health initiative in history by one nation to address a single disease. The United States is changing the paradigm for development, rejecting the flawed “donor-recipient” mentality and replacing it with an ethic of true partnership. These partnerships are having a global impact and transforming the face of our world today.
Partnership to Fight HIV/AIDS
The Royal Government of Cambodia has committed significant resources to fighting HIV/AIDS. Through PEPFAR, the U.S. Government (USG) and its partners are working in partnership with the Royal Government of Cambodia to implement Cambodia’s National Strategic Plan for HIV. Close cooperation between partner governments; non-governmental, community-based and faith-based organizations; and people living with HIV/AIDS are essential in building effective and sustainable HIV prevention, treatment and care services. Given the limited health care resources and capacity in many communities, PEPFAR is committed to building integrated HIV/AIDS prevention, treatment and care services that maximize the effectiveness of available services.

PEPFAR Results in Cambodia
# of individuals receiving antiretroviral treatment in fiscal year 2007 5,700
# of pregnant women receiving prevention of mother-to-child HIV transmission (PMTCT) services in fiscal year 2007 31,200
# of pregnant women receiving antiretroviral prophylaxis for PMTCT in fiscal year 2007 170
# of counseling and testing encounters (in settings other than PMTCT) in fiscal year 2007 108,100

Note: All USG bilateral HIV/AIDS programs are developed and implemented within the context of multi-sectoral national HIV/AIDS strategies, under the host country’s national authority. Programming is designed to reflect the comparative advantage of the USG within the national strategy, and it also leverages other resources, including both other international partner and private-sector resources. The numbers reported reflect USG programs that provide direct support at the point of service delivery. Individuals receiving services as a result of the USG’s contribution to systems strengthening beyond those counted as receiving direct USG support are not included in this total. Numbers may be adjusted as attribution criteria and reporting systems are refined. Numbers above 100 are rounded to nearest 100.
HIV/AIDS in Cambodia

HIV prevalence in Cambodia is among the highest in Asia. Although Cambodia is one of the poorest countries in the world, extraordinary HIV prevention and control efforts exerted by the Royal Government of Cambodia and its partners have helped to reduce the spread of HIV.2 Cambodia’s HIV/AIDS epidemic is spread primarily through heterosexual transmission and revolves largely around the sex trade. HIV transmission occurs mainly in sexual partnerships where one partner has engaged in high-risk behaviors.3 This increased proportion of infections among women may reflect declining prevalence rates among males, as well as deaths among males infected in the early years of Cambodia’s epidemic. Significantly, a low prevalence rate in the general population masks far higher prevalence rates in certain sub-populations, such as injecting drug users, people in prostitution, men who have sex with men, karaoke hostesses and beer girls, and mobile and migrant populations.
1 UNAIDS, Report on the Global AIDS Epidemic, 2008.
2 Vonthanak Saphonn, MD, PhD, et al. “Trends of HIV-1 Seroincidence Among HIV-1 Sentinel Surveillance Groups in Cambodia, 1999-2002.” Journal of Acquired Immune Deficiency Syndromes. 39(5), August 15, 2005: pp. 587-592.
3 Elizabeth Pisani, et al. “Back to Basics in HIV Prevention: Focus on Exposure,” British Medical Journal. 326(21), June 2003: pp. 1384 -1387.
Cambodia Logo PEPFAR Achievements in Cambodia to Date
Challenges to PEPFAR Implementation
Cambodia is a post-conflict country, making scaling up activities a significant challenge. Major constraints to the implementation of HIV/AIDS activities include:
* High levels of high-risk sexual and substance use behaviors;
* Poverty, which drives prostitution, survival sex, and corruption;
* Barriers limiting access to prevention, treatment and care services, including distance to service locations, limited financial resources, a lack of transportation and infrastructure, and geographic barriers;
* Low salaries in the public health care sector; and
* Limited skills and capacity of health care providers.

Reducing Stigma and Discrimination against People Living with HIV/AIDS
With support from PEPFAR, Pact Cambodia, an indigenous non-governmental organization, and the Cambodia People Living with HIV/AIDS Network are implementing the Community Response to Reducing HIV/AIDS Stigma and Discrimination Project. The project uses community fora to educate community members about HIV/AIDS. Lorn Khoeun, an HIV-positive 35-year-old from Tanuk village, witnessed the positive impact of the PEPFAR-supported community forum in her village. After losing her husband to an HIV/AIDS-related illness three years ago, Lorn Khoeun and her daughter faced stigma and discrimination from members of the community as a result of Lorn Khoeun’s HIV-positive status. Neighbors were afraid to buy watermelons or food from Lorn Khoeun, and her food selling business suffered as a result. Lorn Khoeun and fellow community members attended the community forum in her village where they discussed HIV/AIDS awareness; stigma and discrimination; HIV/AIDS law; and raising and mobilizing support for people living with HIV/AIDS from communities, local authorities, health care providers and opinion leaders. Since the forum, community members have altered their behavior and are more supportive of people living with HIV/AIDS. They are also friendlier towards Lorn Khoeun, buying her food and products, visiting her house, playing with her children, and eating together with her. Now, she can continue her business and support her daughter.
Lorn Khoeun’s food selling business is supported by community members.
Lorn Khoeun’s food selling business is supported by
community members.


Phally lives positively and teaches others to do the same.
Phally lives positively and teaches others to do
the same. Phally: The Story of a Courageous Woman
When the home-based care team first visited Phally in December 1999, she was depressed and sick with an HIV-related illness. At that time, there were minimal HIV/AIDS services available in her area, and a referral system linking patients to other available services was non-existent. Support from PEPFAR helped to establish a continuum of care for people living with HIV/AIDS in Phally’s home district. Phally never gave up her desire to make a positive difference in the lives of people living with HIV/AIDS. The involvement of Phally and other people living with HIV/AIDS in the continuum of care is central to the process of integrating and improving the quality of HIV/AIDS care, treatment and support services. Phally is now a skilled and active peer-educator and counselor, who serves as a positive role model for her peers. Her friendly, lively personality inspires all who meet her. “I’m a member of the care and treatment team at Moung Russey Referral Hospital,” Phally said. “I facilitate the ‘Friends Help Friends’ monthly support group meetings at the hospital. I also conduct counseling sessions with people living with HIV/AIDS, to prepare them for beginning antiretrovirals. An important part of my job is to visit people living with HIV/AIDS and their families while they are hospitalized, to provide moral support and information about HIV/AIDS and self care.”
Buddhist Monks Provide HIV/AIDS Care

With support from PEPFAR, Buddhism for Development is helping to bridge the gap between the religious and secular communities in Cambodia. Buddhism for Development provides home-based care to people living with HIV/AIDS and services to children who have lost parents to HIV/AIDS. The group operates a six-week “Peace Development School,” at which monks learn to provide HIV/AIDS-related health care and study vocational training and agricultural extension methods. Of the monks who have gone through the Peace Development School, many returned to their home villages and established HIV/AIDS associations that provide HIV-prevention services and home-based care. These monks also established centers at pagodas, providing direct care and support for orphans and vulnerable children, and working to find ways to keep these children in school.

Overview of AIDS and HIV in Asia
In the early to mid-1980s, while other parts of the world were beginning to deal with serious HIV & AIDS epidemics, Asia remained relatively unaffected by this newly discovered health problem. By the early 1990s, however, AIDS epidemics had emerged in several Asian countries, and by the end of that decade, HIV was spreading rapidly in many areas of the continent.
Today, HIV/AIDS is a growing problem in every region of Asia. East Asia has been identified by UNAIDS as one of the areas of the world where ‘the most striking increases’ in the numbers of people living with HIV have occurred in recent years (along with Eastern Europe and Central Asia).1 Although national HIV prevalence rates in Asia appear to be relatively low (particularly in comparison with sub-Saharan Africa), the populations of some Asian countries are so vast that these low percentages actually represent very large numbers of people living with HIV. The latest statistics compiled by UNAIDS suggest that at the end of 2007, 5 million people were living with HIV in Asia.2

Various factors make Asia vulnerable to the spread of HIV, including poverty, inequality, unequal status of women, stigma, cultural myths about sex and high levels of migration.3 4 Some experts predict that Asia may eventually overtake Africa as the part of the world with the highest number of HIV-infected people. Others, however, argue that Asia’s epidemics are on a different trajectory to those found in Africa, as HIV infection in Asia is still largely occurring among members of ‘high-risk groups’, unlike Africa where HIV and AIDS are widespread amongst all sections of some countries’ populations.5
Although its useful to understand the overall impact that AIDS is having on the Asian region as a whole, there is no single ‘Asian epidemic’; each country in the region faces a different situation.
“It’s very difficult to speak about ‘the Asian epidemic’. Whatever we come up with, we always find a big exception in Asia.”
Peter Piot, head of UNAIDS 6

Asian countries are experiencing different trends. HIV infection rates are growing in parts of India, but have stabilised or declined in other parts of the country. In Cambodia, Myanmar and Thailand, there has been evidence of declines in HIV infection levels. In Indonesia, Pakistan and Vietnam, meanwhile, the number of people living with HIV has rapidly increased. In Vietnam, this number more than doubled between 2000 and 2005, and HIV has now been detected in every province and city in the country. It is feared that the the speed and severity of the growing HIV epidemic in Pakistan, is outpacing the response. The number of people newly infected with HIV is also rising in China and Bangladesh, although at a much slower pace.7
How HIV is transmitted in Asia

* When HIV is transmitted through unprotected sex in Asia, it’s often during paid sex. More people in Asia engage in sex work (either as a client or a worker), than any other type of behaviour that can carry a high risk of HIV infection.8 High levels of HIV infection have been documented among sex workers and their clients in parts of India, and this situation is mirrored in other Asian countries; in South and South East Asian countries outside India, it’s thought that sex workers and their clients accounted for almost half of people living with HIV in 2005.9
* Injecting drug use is a major driving factor in the spread of HIV throughout Asia, notably in China, Indonesia, Malaysia and Vietnam. In China, nearly half of all people infected with HIV are believed to have become infected through injecting drug use, and in North-East India injecting drug use is the most common HIV transmission route.10 There is often an overlap between communities of IDUs and communities of sex workers in Asia, as those who sell sex may do it to fund a drug habit, or they may have become involved in sex work first before turning to drug use.11

* Sex between men accounted for some of the earliest recorded cases of HIV in Asia, and transmission through this route is still a prominent feature of many countries’ epidemics. Most men who have sex with men (MSM) in Asia do not identify themselves as gay because of cultural norms that discourage homosexuality; in some cases they may even be heads of families, with children.12 This means that MSM can serve as a ‘bridge’ for HIV to spread into the broader population. HIV outbreaks are becoming evident among MSM in Cambodia, China, Nepal, Pakistan, Thailand and Vietnam.13
* Mother-to-child transmission is also a significant HIV transmission route in Asia. At the end of 2007, it was estimated that 140,000 children in South and South-East Asia, and 7,800 children in East Asia, were living with HIV, most of whom became infected through mother-to-child transmission.14
HIV prevention in Asia
HIV prevention sign, Ho Chi Minh City, Vietnam
HIV prevention sign in Ho Chi Minh City, Vietnam
Asia has been the base for some extremely successful large-scale HIV prevention programmes. Well-funded, politically supported campaigns in Thailand and Cambodia have led to significant declines in HIV-infection levels, and HIV prevention aimed at sex workers and their clients has played a large role in these achievements. The Indian state of Tamil Nadu is another area where HIV prevention has had a substantial impact. Here high-profile public campaigns discouraged risky sexual behaviour, made condoms more widely available, and provided STI testing and treatment for people who needed them. These efforts resulted in a large decline in risky sex.15

Successes such as these prove that interventions can change the course of Asia's AIDS epidemics. As HIV infection rates continue to grow however, it's clear that more needs to be done. The groups most at risk of becoming infected – sex workers, IDUs, and MSM – are all too often being neglected. For instance, although injecting drug use is one of the most common HIV transmission routes in Asia, it is estimated that less than one in ten IDUs in the region have access to prevention services.16 Similarly men who have sex with men are overlooked and poorly monitored by most governments, even though it is firmly established that this group play a significant role in some countries’ epidemics.17
The coverage of prevention of mother-to-child transmission (PMTCT) services is also very low in Asia. In South-East Asia, less than 5% of pregnant women are offered HIV counselling and testing.18 Across East, South and South-East Asia, the proportion of HIV-infected pregnant women receiving ARVs is just 5%.19
See our HIV prevention around the world page for more about efforts to stem the spread of HIV in Asia and other parts of the world.
AIDS treatment in Asia
The availability of AIDS treatment has more than tripled in Asia since 2004. At the end of 2007 an estimated 420,000 people in the region were receiving antiretroviral drugs (ARVs). Although this rise is encouraging, access to treatment varies widely across the region. Overall it is estimated that three quarters of people in need of ARVs in Asia still have no access to them.20
HIV Positive man and antiretroviral medicines
HIV positive man sitting at home
before taking his antiretroviral medicines
A major constraint is the high cost of ARVs, as both first- and second-line drugs are still unaffordable to most governments. Cheaper generic drugs are now produced by a number of pharmaceutical manufacturers in Asia, and together with the increasing availability of lower-cost branded ARVs, it’s hoped that this will make it easier for governments to obtain and distribute the drugs. Yet even where drugs are available, the poor state of healthcare in many Asian countries, particularly a shortage of trained doctors, is hindering governments' abilities to organise life-long treatment programmes for millions of people living with HIV.21
For the latest statistics for treatment provision in individual countries in Asia, see our AIDS treatment targets page.
Country profiles - South East Asia
Cambodia

Cambodia’s HIV epidemic can be traced back to 1991. After an initial rapid increase, HIV infection levels declined after the late 1990s, and have reached a steady level in recent years. It’s believed that interventions with sex workers, carried out by the government and non-governmental organisations (NGOs), played a role in this decline; the adoption of a ‘100% condom’ policy that enforced condom use in brothels led to a substantial rise in condom use among sex workers and their clients, and a drop in HIV infection levels among brothel-based sex workers. Despite these achievements, Cambodia still has the second highest HIV prevalence rate in Asia, with 0.8% of the adult population infected. Ongoing concerns include low levels of condom use among MSM, an increase in sex work occurring outside of brothels (making it harder to reach sex workers with interventions), and mother-to-child transmission of HIV – around one third of new infections occur through this route. HIV is mostly transmitted through heterosexual sex in Cambodia, and almost half of those infected are women.22 23
Indonesia

High levels of HIV infection are found amongst IDUs in Indonesia, and also among sex workers and their clients. Around 270,000 people in Indonesia are living with HIV, this number has risen sharply in recent years due to several factors: the country’s extensive sex industry; limited testing and treatment clinics and laboratories for sexually transmitted infections (STIs); a highly mobile population; a rapidly growing population of people who inject drugs; and the challenges created by major economic and natural crises that Indonesia has experienced (the Asian financial crisis heavily affected the country in 1997, and the 2004 Tsunami devastated parts of Northern Sumatra, the largest island in Indonesia).24
Lao People's Democratic Republic (Laos)
Despite being surrounded by countries that have relatively high HIV infection levels (Thailand, China, Vietnam, Cambodia and Myanmar), Laos has a comparatively small HIV problem. There are various reasons for this: the government was quick to acknowledge AIDS when it first emerged in the country, and took action to warn people about it; Laos has not seen the same level of large-scale migration that has occurred in other parts of Asia; there are relatively high rates of condom use among sex workers and their clients; and it’s thought that very few people in the country inject drugs.25 26
Malaysia

Malaysia’s HIV epidemic is largely driven by injecting drug use. Other than IDUs, HIV is spreading quickly amongst women, fishermen, lorry drivers and factory workers. A senior health official in Malaysia has warned that the number of people living with HIV in the country – currently around 80,000 – could rise to 300,000 by 2015 if nothing is done. The government launched a five-year strategic plan to tackle HIV in 2006, which includes drug substitution therapy and needle exchange programmes for drug users.27
Myanmar (Burma)

After first appearing in the mid-to-late 1980s, HIV became increasingly common in Myanmar. Today, with an estimated 0.7% of the adult population infected, the country faces a serious epidemic. Myanmar’s authoritarian military regime is widely condemned for its human rights abuses, and in 2005 these concerns led the Global Fund to Fight HIV, TB and Malaria to withdraw it’s proposed $98.4 million grants for the country.
The Philippines

The Philippines has a very low HIV prevalence, with well under 0.1% of the population infected. Even in groups such as sex workers and MSM that are typically associated with higher levels of HIV, prevalence rates above 1% have not yet been detected – in the case of sex workers, this is possibly due to efforts to screen and treat those selling sex since the early 1990s. There are reasons to believe that this situation may not last, however. Condom use is not the norm in paid sex, drug users commonly share injecting equipment in some areas, and among Filipino youth, there is evidence of complacency about AIDS.
Singapore

Although the number of people living with HIV in Singapore is relatively small, the country’s status as an international travel and business hub, along with the high number of infections found in surrounding countries, make it possible that the country will experience a more serious epidemic in the future. In 2006 a record 357 people in Singapore were newly diagnosed with HIV. To combat these rising figures, the government has chosen to focus on preventing mother-to-child transmission, but controversially, has rejected widespread condom promotion.28 Another controversial policy in Singapore is the strict law banning sex between men, which campaigners argue undermines efforts to promote safe sex among MSM.29
Thailand

Thailand is an example of a country where a strong national commitment to fighting AIDS has paid off, with widespread access to treatment and an admirable history of HIV prevention efforts. However, some of these past prevention successes are starting to be undermined by a current lack of HIV prevention, rising STI rates, and a growing number of MSM becoming infected with HIV.
Vietnam

Around 40,000 people are becoming infected with HIV each year in Vietnam, mostly through injecting drug use or paid sex. The number of people living with HIV in Vietnam doubled between 2000 and 2005, and this rise included a large increase in the number of people who became infected through injecting drug use. Levels of HIV among injecting drug users reached as high as 63% in Hanoi, and 67% in Hai Phong, in 2005.
See our South East Asian statistics page for more data on this region.
East Asia
China

China is seen as a major source of concern by many AIDS experts, because of the large size of its population and the existence of social, economic and cultural factors that make it easy for HIV to spread. At the moment 700,000 people in China are living with HIV (0.1% of the adult population), but it’s feared that this number will increase dramatically in future years, as HIV spreads from the groups most at risk – injecting drug users and those who buy or sell sex – to the general population.30 31
Japan

In 2007, around 9,600 adults and children were living with HIV in Japan.32 Data released by the Japanese government in February 2007 showed that annual numbers of new HIV infections and AIDS cases has risen to an all time high in 2006, to 914 and 390 people respectively.33 The most prominent rise occurred among MSM, who it’s previously been documented account for at least 60% of annually reported HIV infections in Japan.34
South Asia
Afghanistan

There have only been a small number of cases of HIV in Afghanistan, in contrast to the relatively large numbers recorded in the neighbouring nations of Pakistan and Iran. Nonetheless HIV and AIDS are growing problems. Conditions are in place for an epidemic to develop, including high numbers of displaced people, high levels of illiteracy, low social status for women, and a shortage of health facilities. Afghanistan is one of the world’s leading producers of opium, and the availability of drugs could lead to increased levels of injecting drug use.35 A 2006 study found that around one third of IDUs in the capital city of Kabul had shared contaminated injecting equipment, and that 4% were infected with HIV.36
Bangladesh


The first HIV/AIDS case in Bangladesh was reported in 1989. Since 1994, HIV infection levels have increased, although the problem is still relatively small scale, with around 12,000 adults – 0.2% of the total population – infected. It's nonetheless predicted that Bangladesh may gradually be heading towards an epidemic, unless a greater response is developed. At the moment HIV is mainly confined to groups such as IDUs, migrant workers and MSM, and it's reported that this focus on risk groups has led to a lack of urgency among policy makers in dealing with the problem.37
India

India is experiencing a diverse HIV epidemic that affects states in different ways, and to different extents. The groups most affected include injecting drug users, sex workers, truck drivers, migrant workers, and men who have sex with men. Some have predicted that India will soon be experiencing a ‘generalised’ epidemic, where the HIV prevalence rate – currently 0.3% in India ­­– rises above 1%. Others have played down current estimates of the numbers infected, and have argued that, because HIV transmission in India still largely occurs among risk groups, its unlikely that HIV will spread widely among the general population.38 Regardless of the future path of India’s epidemic, it’s undeniable that AIDS is having a devastating impact, and that there are still many major issues – including stigma and poor availability of AIDS treatment – that urgently need to be addressed.
Pakistan

Pakistan’s first reported case of HIV occurred in 1987. Until the late 1990s, most subsequent cases occurred in men who had become infected while living or working abroad. After 1999, HIV and AIDS cases began to be recorded among Pakistani sex workers, IDUs, and prisoners.39 Despite a low overall HIV prevalence (0.1%), social and economic conditions in Pakistan – including poverty, low levels of education, and high levels of risk behaviour among IDUs and sex workers – are likely to facilitate the spread of HIV in coming years.40
Preference From… http://www.pepfar.gov/pepfar/press/81877.htm. http://www.avert.org/



Read more!

Every School Needs to have AIDS Education..... Click to read more

Basic AIDS education remains fundamental to the global effort to prevent HIV transmission. AIDS education can – and does – target all ages, and sexually active adults are one principal target. AIDS education is also vitally important for young people and the school offers a crucial point-of-contact for their receiving this education. Providing AIDS education in schools, however, is sometimes a contentious issue. This page will explain why AIDS education in school is so vital, why it is so controversial, and offer some suggestions as to how an effective program can be sensibly and efficiently achieved.
Why do we need AIDS education in schools?
Many young people lack basic information about HIV and AIDS, and are unaware of the ways in which HIV infection can occur, and of the ways in which HIV infection can be prevented. Schools are an excellent point of contact for young people – almost all young people attend school for some part of their childhood, and while they are there, they expect to learn new information, and are more receptive to it than they might be in another environment.
Most young people become sexually active in their teens, and by the time this occurs they need to know how to prevent themselves becoming infected with HIV.
Other ways in which young people might access AIDS education may not be universal – not all young people will access the same media, for example, or access the same medical services. However, the school is a place where almost all young people can receive the same message. Other media by which young people are presumed to learn about sexual health may not exist in all cases or may be misleading.
Traditionally, the responsibility of teaching a young person about ‘the birds and the bees’ has been seen as being a parental one. In these days of HIV, however, this type of basic information about reproduction is insufficient and will not give young people the information they need to be able to protect themselves. Parents may not provide even this limited information because they are too embarrassed, or because their beliefs oppose it. Young people, too, may be embarrassed discussing sexual matters in a situation where their parents are present. At school they are in a situation where they are independent, and not subject to parental disapproval.
“ If I wouldn't of learned about all the STD's that I could get from being sexually active I might not be a virgin right now. ”
- Erika -
In some countries, young people may not be able to access family planning or sexual health clinics because of their age – or they may be able to access such services but think that their age precludes them from access. Young people often know that they require information, especially if they are becoming sexually active, but may feel too embarrassed to actively seek out sexual health information, or may fear that their parents may find out. In many parts of the world, the fear of ‘what if they tell my parents’ still prevents young people from approaching medical staff, especially family doctors who may know their parents.
The principal reason that AIDS education in schools is so important is that all over the world, a huge amount of young people still become infected with HIV. Most young people become sexually active in their teens, and by the time this occurs they need to know how to prevent themselves becoming infected with HIV. If they are to be enabled to protect themselves, they must be given the information that empowers them to do so.
Attitudes to AIDS education in schools
The main obstacle to effective AIDS education for young people in schools is the adults who determine the curriculum. These adults – parents, curriculum planners, teachers or legislators – often consider the subject to be too ‘adult’ for young people – they have an idea of ‘protecting the innocence’ of young people. This often occurs for moral or religious reasons, and can cause very heated debate.
There is also obstruction to adequate AIDS education from adults who are concerned that teaching young people about sex, about sexually transmitted infections, HIV and pregnancy – that providing them with this information will somehow encourage young people to begin having sex when they otherwise might not have done.
“ I come from a family who believes that having sex out of marriage is not the moral thing to do. I also don't think sex ed. is something that young kids should be learning. Learning sex at a young age is like provoking more young people to have sex just for the fact they want to experience it for themselves instead of just getting information about it. ”

- Monica -
This attitude still prevents adequate HIV and sex education from being taught in schools, in spite of the fact that it is a view that the majority do not share. A study in America, for example, shows that the majority of Americans (55%) believes that giving teens information about how to obtain and use condoms will not encourage them to have sexual intercourse earlier than they would have otherwise (39% say it would encourage them)1 .
The same study tells us that only 7% of Americans believe that young people should not receive sex education in schools. Many adults recognise that informing young people about the dangers of HIV is the best way to prevent them from becoming infected in later life. Many schools in many countries do provide adequate AIDS education – but many, sill, do not. Young people are rarely asked for their opinions by those adults who decide what they will study – but when they are asked, they almost always demand more comprehensive sex and HIV education.

“ I am a student, living in Johannesburg, South Africa. I believe that sex ed that is handled appropriately, and that is age-appropriate, will really empower kids to make healthier, informed and positive choices. ”
- Maire -
In some places, legislation may dictate the type and quality of AIDS education that schools are allowed to offer – some countries have no policies on AIDS education, allowing schools to include it or not, as they decide. Other countries may have policies that specifically preclude AIDS education, or certain types of AIDS education. Legislation allowing or inhibiting certain types of AIDS education often comes from the moral views of the voting majority – or reflects the religious attitudes of the government in power. The most commonly used types of AIDS education are discussed in our page on AIDS education and young people.
It is within the context of these attitudes and beliefs that teachers and educators must work to provide the most effective information and education they are able to.
When should young people start to be taught about AIDS?
There is no set age at which AIDS education should start, and different countries have different regulations and recommendations. In some areas this is a very sensitive subject, and some groups regard teaching young people how to protect themselves as a form of abuse. It seems obvious, however, that people should know how to protect themselves before they begin having sex, rather than after.
“ At school, my sex ed was pretty poor. It started in year 8 when we are about 12-13, which is kind of 2 late really. Quite a few of my friends had already had heterosexual sex and had not protected themselves at all. ”
- Laura -
Especially when educating young people, AIDS education often shares territory with sex education. Education which teaches about sex and sexuality can also teach about preventing pregnancy and STI infection.
“ I know by the time I was taught about sex it was too late, I had already made my mistake. ”
- Safiyyah -

AIDS education should start at about seven or eight years of age. When working with very young people, this type of education does not necessarily need to involve learning about sexual activities or drugs, but should at least teach children that 'AIDS' is not a pejorative term of abuse. Playground name-calling, to some extent, reflects attitudes in general society, but it can also grow up to become discrimination.
Planning a good curriculum
In an academic situation, especially with younger learners, some subjects fail to impart information to the students simply because the students are not interested, and do not pay attention. This is unlikely to be the case with AIDS education; the simple fact that AIDS education involves the discussion of sex – a topic of fascination for young people who are discovering their own sexualities – is likely to ensure at least initial attention. This attention will wane, however, if the information is not imparted in a lesson interesting enough to maintain students’ concentration. It is not only important to have AIDS education, but to provide AIDS education in the right way.
In addition to providing information, a good, class-based lesson where a pupil is amongst his/her peers can help to shape attitudes, reduce prejudice, and alter behaviour.
The following are a few of the important points to consider when planning an AIDS education lesson or curriculum.
Age of students

Is the material that you intend to cover appropriate to the age of the young people in the class? Education about HIV needs to commence early in childhood and develop through adolescence and into adulthood – starting before students are of an age at which they might encounter high-risk situations, but at an early age young people do not require detailed information. This information should be delivered gradually, as they grow older.
Classroom prejudices
School playgrounds often contain many prejudices, and you will probably have to deal with more than one in an AIDS-awareness lesson. HIV+ people, especially, face prejudice around the world that can lead to the continued spread of the virus. In some schools, the words ‘gay or ‘AIDS’ may be used as a term of abuse – this must be addressed, too. Certainly, the material covered in class must reflect the diversity of the community. Prejudices often result from ignorance. ‘Can I get it from toilet-seats?’ is a common question illustrating just such ignorance. This type of misunderstanding not only engenders prejudice, it also causes unnecessary anxiety.
Current knowledge

AIDS education can be targeted towards areas of informational need if you are aware of what young people already know about AIDS. The best way to find out this information is by asking them.
Active learning
It is not enough to simply give students information about HIV and AIDS for them to learn. The learning-by-rote approach common in traditional academic settings provides students with information but does not allow them to absorb the social and practical aspects of how this information might be put to use. AIDS education should never involve pupils sitting silently, writing and memorising facts.
Active learning offers an opportunity to make AIDS education lessons fun
‘Active learning’ approaches are now seen as the most effective way that young people can learn health-related and social-skills. Group-work and role-play are particularly important methods in which students might discover the practical aspects of the information they are given. These methods also allow pupils an opportunity to practise and build skills –saying “No” to sex, for example – and pupils retain information better if they are offered an opportunity to apply it.
Active learning, furthermore, offers an opportunity to make AIDS education lessons fun. AIDS education classes can be constructed to involve quizzes, games, or drama, for example – and can still be very effective learning sessions.
Involving parents and guardians
Many schools already have a good deal of input from parents and families of their pupils, and this input may go as far as being allowed to determine the content of the curriculum. If possible, it is usually advantageous to involve the parents and guardians in the planning process, before an AIDS education curriculum is decided – parents who have already agreed the content that their children will study are unlikely to complain about it being unsuitable. Furthermore, parents who are involved in the education of their children will be able to give additional support, if it is needed, outside the classroom.
Other sources
Outside agencies or organisations may also be able to make a positive contribution to an AIDS education curriculum in a way that the school’s internal resources will not. Some local health agencies will offer talks within a school, as will some local HIV organisations. Check out what is available. This has the additional advantage of building a bridge between the pupils and an external source of help or advice.
Legislation

Some areas and countries will have legislation covering what sex or AIDS education can or should be given. If this is the case, you will have to make sure that your curriculum conforms to local guidelines. Other legislative areas in which AIDS may effect your school are :
Bullying
– does your school’s anti-bullying policy adequately protect HIV+ and gay pupils?
Admissions
– does your school’s admissions policy contain measures to prevent discrimination against HIV+ pupils?
Health and Safety
– does your school’s health & safety policy include universal precautions policy?
Considering cultures
Planning an AIDS education syllabus should involve some consideration of the culture in which the learners live. Many cultures have a specific and well-defined set of views on human sexuality, and even at an early age, young learners will have been influenced by them.
The primary factor in determining what information is given to the class should be their age (see above), and cultural attitudes cannot be allowed to censor the information given. Most cultures frown, for example, on talking openly about HIV transmission routes, but this is a necessary part of the education process. AIDS education should provide this information and still remain sensitive, wherever possible, to cultural and religious sensibilities.
The culture of the learners is an ever-present factor in the classroom, and this culture provides the context in which AIDS education must take place.
What materials are already available?
In the years since the AIDS epidemic began, there have been many disparate efforts to prevent or reduce HIV infection by educating people about the dangers of AIDS, and enabling them to protect themselves from infection. A good deal of classroom material has been created, focusing on young people from cultures around the world. Too often, when an AIDS education curriculum is to be planned, the planners spend considerable time constructing a resource that is ultimately unnecessary as there are already materials available that would suffice. If necessary, spend time adapting existing resources for your class, but it should now never be necessary to produce completely new material.
Making it cross-curricular

HIV and AIDS education is often provided that deals only with medical and biological facts, and not with the real-life situations that young people find themselves in AIDS should also not be looked at from an entirely social perspective, either – effective AIDS education needs to take into account the fact that both scientific and social knowledge are vital to providing a pupil with adequate AIDS awareness. There is much more to HIV prevention than simply imparting the basic facts. Knowing how the virus reproduces, for example, won’t help someone to negotiate condom use. AIDS education must be a balance of scientific knowledge and social skills. Only if life skills are taught, and matters such as relationships, sexuality and the risks of drug use discussed, will young people be able to handle situations where they might be at risk of HIV infection. Furthermore, questions or comments about HIV may arise at unexpected moments, and teachers from a wide range of disciplines need to know how to answer them.
Are any students HIV+?
When dealing with any class of young people, you can’t make assumptions about their HIV status. In high-prevalence areas it is especially likely that one or some class-members will be HIV+, but this could be the case anywhere. Universal precautions should be taught as part of a HIV awareness lesson. AIDS education specifically tailored for HIV+ people is an important aspect of HIV prevention, but applies only in a class where every student is HIV+.
Sexuality of students
On average, at least one student in every class will be gay. You can’t make assumptions about the sexuality of the students in your class, or about the sexualities in the families that they come from – and for this reason, your HIV lessons need to include information about and for people of all sexualities.
Making it work in the classroom
The process of educating young people about AIDS can be a challenging one. Even if all the factors mentioned above are considered, a lesson can be unsuccessful if the teacher is inadequately prepared, uncomfortable or uncommitted. Anyone who has experienced the education system is aware that the atmosphere within a lesson is key to students retention of the course information.
Teaching the teachers
Teachers need to be clear on their own feelings and beliefs.
AIDS education necessarily involves some detailed discussion of sexual matters. If teachers are uncomfortable with this, they will convey this discomfort to the class – and the message that ‘sex is not nice to talk about ’ is the precise opposite of what AIDS education aims to convey. Before taking an AIDS education class, teachers need to be clear on their own feelings and beliefs as they relate to sex, death, illness and drug use.

Teachers also need to feel that they are entirely clear on the information that they will be passing on – they need to feel confident that they are able to answer any questions that might be asked. This necessitates an adequate level of teacher-training – something that is sadly lacking in many parts of the world. In India, for example, where estimates suggest that more than 2 million people are living with HIV, 70% of teachers have been given no training or information at all 2.
Listening to the learners
Young people who have an input into their AIDS education have said that they want their AIDS education to take place in all academic years of their school, to use active learning methods, to include a balance of facts and social awareness, to be built on what pupils already know – and, crucially, to be a separate topic. Whilst Biology, Geography and English can – and should – mention AIDS in the context of their subject matter, young people specifically ask for syllabus time devoted to providing them with good, well-planned and balanced AIDS education.
It is also important to recognise that the young people who make up the class may be uncomfortable with the subject – for cultural or personal reasons. Learners cannot be compelled to feel comfortable, but can be induced. Some basic tips that can help to decrease discomfort are : * Don’t expect a learner to speak in front of their classmates – unless they have volunteered to do so.
* Allow learners to consult and plan in groups before presenting any information to the class.
* Remember that some learners may have relevant personal issues that they will be reluctant to share – they may be gay, for example, of HIV+.
* Listen to the learners – allow the class to ask questions and to express what they want from an AIDS syllabus.
Last word
In spite of all the efforts that the past two decades have seen in AIDS prevention, the epidemic still presents a serious challenge to societies around the world. Every year, increasing numbers of people globally are infected with HIV, and people continue to die. AIDS education for young people is a crucial weapon in the HIV-prevention arsenal, young people are one of the main groups who must be targeted, and the school is the most important means of reaching them.
Still, however, schools in many countries around the world do not have adequate AIDS education curriculum. Although it is not a legislative requirement in all countries that AIDS education is provided, it remains a requirement of the global effort against AIDS. Every young person who passes through the school system anywhere in the world should come out knowing how to protect themselves from AIDS. This is not only the responsibility of every adult who is involved – it is the right of young people everywhere.From..http://www.avert.org



Read more!

We, young people need to learn about AIDS education ..Click to read more

Why is AIDS education important for young people?
The HIV epidemic has been spreading steadily for the past two decades, and now affects every country in the world. Each year, more people die and the number of people living with HIV continues to rise – in spite of the fact that we have developed many proven HIV prevention methods. We now know much more about how HIV is transmitted than we did in the early days of the epidemic, and we know much more about how we can prevent it being transmitted. One of the key means of HIV prevention is education – teaching people about HIV : what it is, what it does, and how people can protect themselves. Over half of the world’s population is now under 25 years old. This age group is more threatened by AIDS than any other; equally it is the group that has more power to fight the epidemic than any other. Education can help to fight HIV, and it must focus on young people.
There are two main reasons that AIDS education for young people is important:
* To prevent them from becoming infected.
Young people are often particularly vulnerable to sexually-transmitted HIV, and to HIV infection as a result of drug-use. Young people (15-24 years old) account for half of all new HIV infections worldwide - more than 6,000 become infected with HIV every day 1. More than a third of all people living with HIV or AIDS are under the age of 25, and almost two-thirds of them are women. In many parts of the world, young people in this age-group are at particularly high risk of HIV infection from unprotected sex, sex between men and IV drug-use because of the very high prevalence rates often found amongst people who engage in these behaviours. Young people are also often especially vulnerable to exploitation that may increase their susceptibility to infection. Even if they are not currently engaging in risk behaviours, as they become older, young people may soon be exposed to situations that put them at risk. Indeed, globally, most young people become sexually active in their teens. The fact that they are – or soon will be – at risk of HIV infection makes young people a crucial target for AIDS education.
* To reduce stigma and discrimination.
People who are infected with HIV around the world often suffer terribly from stigma, in that people who are HIV+ are somehow thought to be ‘dirty’, or to have ‘brought it on themselves’ by ‘immoral practices’. They often experience discrimination in terms of housing, medical care, and employment. These experiences, aside from being extremely distressing for HIV+ people, can also have the effect of making people reluctant to be tested for HIV, in case they are found to be HIV+. Stigma and discrimination often starts early – as name-calling amongst children. AIDS education can help to prevent this, halting stigma and discrimination before they have an opportunity to grow.
Why is AIDS education for young people an issue?
The problem seems to stem from the fact that HIV is often sexually transmitted, or is transmitted via drug use. Any subject that concerns sex between young people or drug use tends to be seen from a moralistic perspective. Many adults – particularly those of the religious right – believe that teens need to be prevented from indulging in these high-risk activities. They believe that young people shouldn’t – and don’t need to be – provided with any education about these subjects, other than to be told that they are ‘wrong’, and not to do such things. Unfortunately, however, adults have been trying to stop young people from having sex and taking drugs for many, many years with little success, so this method alone seems unlikely to offer any real relief in terms of the global AIDS epidemic.
There are other difficulties in taking an exclusively moral approach to HIV education. Firstly, this is what tends to perpetuate stigmatisation of HIV+ people. By teaching young people that indulging in ‘immoral’ sex and drugs will lead to HIV infection, educators imply that anyone who is HIV+ is therefore involved in these ‘immoral’ activities. This stigmatisation tends to make people reluctant to be tested for HIV, and therefore more inclined to remain ignorant of their status – and perhaps go on to infect others. AIDS education shouldn’t ever include a moral judgement – it is one thing to teach young people that promiscuous sex and intravenous drug use are unsafe, another thing to teach them that these things are morally wrong.
AIDS education shouldn’t ever include a moral judgement – it is one thing to teach young people that promiscuous sex and intravenous drug use are unsafe, another thing to teach them that these things are morally wrong.
Many AIDS educators around the world are disturbed at this growing trend of providing AIDS education from a moralistic perspective, and argue that AIDS education ought to be non-judgemental, making young people aware of how HIV can be transmitted and how they can avoid becoming infected - without passing moral judgement on those who engage in infection-related behaviours, whether they do so safely or not.
The opposing, more conservative viewpoint, however, argues that young people shouldn’t be taught about sexual health and drug-related dangers at all. They feel that teaching them about these things, even teaching about their dangers, may encourage young people to indulge in these risk behaviours. Research suggests that this is not the case at all, and certainly young people themselves tend to be very enthusiastic about the fact that they need sex and sexual health education. Unfortunately, curriculum planners tend not to listen to the young people who will be their students. This viewpoint can result in no AIDS education at all being offered.
“I did not go to school and learn about the civil war and decide to start a civil war, nor would I have had sex because of a class in school.”
- Mark -
However, many young people become sexually active long before adults would prefer them to do so, or expect them to do, and teens are not all ‘innocent ‘. Quite simply, if teens are having sex, they need sexual health information. Fortunately, many curriculum planners and legislators have recognised this, and provide young people in many countries with abstinence-plus or comprehensive sex & HIV education. A more detailed look at the results of such curriculum in the classroom can be found in our Teaching AIDS in schools page.
Different approaches to AIDS education for young people
Most countries in the world offer teens some sort of sexual health and HIV education in their schools at some stage. AIDS education can also be targeted at young people in non-school environments – through their peers, through the media, and through doctors or their parents. In some countries, individual schools are allowed to determine what AIDS education they will offer. In other countries, this is determined by legislation passed by central government. And in other countries – especially poor ones that are severely affected by HIV – AIDS education is imported by foreign governments, charities and NGOs, that come in to the country and deliver AIDS education as part of a larger package of HIV prevention work.
AIDS education for young people today falls generally into one of two categories: either 'abstinence-only', or 'comprehensive'. These are actually types of sex education, rather than AIDS education specifically - AIDS education in many schools comes as a part of a sex education program, if it occurs at all. The type of AIDS education program that is offered usually depends on the attitudes of those who determine the syllabus content. Right-wing organisations, some religious organisations, and the family-values lobby tend to prefer abstinence-only education, while those who feel that preventing young people from becoming infected with HIV is more important than keeping them ignorant about sexual behaviour prefer comprehensive AIDS education.
A report found that over 80% of abstinence-only curricula contained false or misleading information
Abstinence-only education teaches students that they must say no to sexual activity until they are married. This approach does not teach students anything about how to protect themselves from STDs or HIV, how pregnancy occurs or how to prevent it, and teaches about homosexuality and masturbation only as far as to say that they are wrong. Those who favour this method of education claim that teaching young people about sex will make them want to try it, thus increasing their risk of contracting HIV, amongst other things.
Abstinence-only education is popular in America, especially so now that it has a Republican President. A House of Representatives report at the end of 2004 found that over 80% of abstinence-only curricula contained false or misleading information. 2 This is not only a concern for those living in America, but increasingly for the rest of the world, as America exports its HIV-prevention and education attitudes to countries with much higher levels of HIV infection. This is particularly worrying in that abstinence-only programmes have been shown not only to fail to reduce the numbers of sexually transmitted infections and unplanned pregnancies seen in pupils, but recent studies indicate that they might actually be related to an increase in these problems.
Comprehensive AIDS education teaches about sexual abstinence until marriage, and teaches that it is one way of protecting yourself from HIV transmission, STIs and unwanted pregnancy. It also teaches that there are other ways of preventing these things, such as condom use. People who favour this approach take the perspective that, while abstaining from sex until marriage is a good idea and should possibly be encouraged, there will always be some young people that do not choose to abstain – and these people must be provided with information that enables them to protect themselves. This type of education also teaches not only about the dangers of drug use, but also about methods of HIV-prevention that drug users can employ – the use of clean needles, for example.
Abstinence-only and comprehensive AIDS education have been combined to produce abstinence-plus education. This type of education focuses on sexual abstinence until marriage as the preferred method of protection, but also provides information about contraception, sexuality and disease prevention. Many abstinence-only campaigners complain that abstinence-plus and comprehensive education are the same thing, although abstinence-plus educators claim that this type of course contains more focus on sexual abstinence until marriage.
There has been debate for many years over which form of sex education is most effective in terms of preventing underage sex, unwanted pregnancy and STD and HIV transmission, although most studies seem to show that comprehensive sex and AIDS education is at least as effective as abstinence-only – and probably more so. However, currently the trend in America – and which is being exported to much of the developing world – is towards abstinence-only education. If it is as unsuccessful as studies indicate it to be, then we can expect this morality-induced type of education to become responsible for an increase in HIV figures amongst the young, especially in high-prevalence parts of the world to which America has taken its methods.
Fifteen percent of Americans believe that schools should teach only about abstinence from sexual intercourse and should not provide information on how to obtain and use condoms and other contraception. Forty-six percent believe that the most appropriate approach is abstinence-plus 3. Almost half of those surveyed felt that the word ‘abstinence’ included not only sexual intercourse, but ‘passionate kissing’ and ‘masturbation’, too.
What types of AIDS education can be offered outside schools?
Not all young people are fortunate enough to attend school. This might be for one of a variety of reasons. In some countries, it is necessary to pay for schooling, and poor families may be unable to afford to send a child to school, or may be unable to send all their children to school. Sometimes children will be required to work, making them unavailable for school. In other areas, young people may live in areas where a local school is not accessible. In some situations, young people may have been excluded from school for reasons that might be due to the young person’s behaviour, academic or intellectual abilities, or due to discrimination. Some young people play truant, and will have only very limited attendance. The proportion of young people who attend school differs markedly in various parts of the world.
Clearly, although AIDS education offered through the school might reach many young people, it will not reach all, and other forms of education are required.
One of these is the media. Most young people will, at some time, be exposed to the media. This can include newspapers, television, books, radio, and also traditional media such as street performances or murals. One advantage of media-based AIDS education is that it can target specific groups amongst the population. If the message is to be targeted at young people, then it will be placed in media that are favoured by this audience.
Many countries have tried some form of AIDS education advertisements, films, or announcements. A good example of this is the LoveLife campaign in South Africa, an education program ‘by young people, for young people’. LoveLife used eye-catching posters and billboards to tell young people that sex was fun, but that it could be dangerous, too. The campaign also inserted its message into TV soaps that were popular with young people, and used rap and kwaito music to get its message across.
There are, however, problems with media-based campaigns. It is hard to know to what extent the AIDS information has reached young people, and it is difficult to gain continued funding for initiatives whose success is so hard to measure.
Another way in which young people receive information about sex and HIV is through their peers. This is something that happens anyway to a great extent – many young people receive their first information about sexuality from their friends, although this information is often distorted and inaccurate. This type of peer education can be harnessed, though, and used to convey accurate, targeted information. Peer education is, quite simply, the process by which a group is given information by one of their peers who has received training and accurate information. This is a method often used with groups which have been marginalised. Such groups might have cause to distrust information given to them by an authority figure; if the same information comes from a member of their own group, however, they may well listen. This method of information-provision is often used with such groups as sex workers, the homeless, or drug-users. There is no reason that this method shouldn’t be used with young people, however, and in many parts of the world, it is used. Indeed, it is particularly appropriate for young people who do not attend schools and will not have an opportunity to benefit from an AIDS education curriculum.
AIDS education for the future
Although the debate continues about how much – if any – AIDS education young people should receive, studies continue to show that being informed about the facts and the dangers of HIV and AIDS enables young people to protect themselves and is a crucial tool in the battle against HIV. There is no cure or vaccine for HIV, so prevention is the only way in which we can place any limits on the epidemic. One of the most economical and effective means of HIV prevention is education – involving young people themselves in the HIV prevention effort.
On a global level, America’s disposition towards the promotion of abstinence-only education is cause for concern. America’s spending on HIV prevention around the world exceeds that of any other country, and is to be welcomed – as long as it doesn’t use this money to promote its pro-abstinence-only views of AIDS education. These views – which have been shown to be less successful than comprehensive AIDS education techniques which include an abstinence element – may prove to be damaging to America’s domestic AIDS prevention work 4. When exported to high-prevalence countries in Africa, they could prove disastrous.

Whenever educators and planners ask, and listen to young people, they are told time and time again that young people overwhelmingly ask for adequate AIDS education. In most parts of the world, this means more AIDS education than they are presently getting. Young people know that they have the right to the information that enables them to safeguard their lives and those of their sexual partners – they must be listened to, and provided with that information clearly, openly and honestly.
From..http://www.avert.org/


Read more!

Alcohol builds of having desire of sex and Fun

Alcohol, drugs and sex. Sound like fun? Well, they can be, and often are. But they can also carry risks, especially when they’re mixed together.
Drink and drugs both go hand in hand with socializing. People usually do these things at parties, hanging out with friends, at bars or at clubs. Why? Because drink and drugs can make you feel more relaxed, confident, and less inhibited. When you're feeling this way in a social situation, it’s more likely that you’ll meet someone you like and want to hook up with – maybe even have sex with. The trouble is, that person may be someone that you wouldn’t have gone near if you’d been sober. Even worse, you might be so drunk or high that you forget (or simply don’t bother) to use a condom, which could lead to unwanted pregnancy, or a sexually transmitted infection (STI) being passed on.
“We had sex at New Year, which was very blurred as we were both extremely drunk... I do remember that we didn't use anything and I was not on the birth control pill.” - 17 year-old girl “I got really drunk a couple of weeks ago and ended up having unprotected sex… it is the first time I had sex and I am really worried.” - 17 year-old boy 1
Do alcohol and drugs make sex better?
feetS of young people
Young people drinking alcohol at a party
A lot of people seem to think this, but in many cases it’s not actually true. Drink and drugs might make you feel less nervous about sex – but then if you need these things to feel comfortable, you’re probably not with the right person, or you may not be ready to start having sex yet.
"My boyfriend wants me to do sex things with him but the only way I can manage is when I get drunk because otherwise I am too scared or embarrassed.” - 16 year-old girl 2
What’s more, sexual performance can actually diminish after a night out. Alcohol is an anesthetic. It numbs the genitals' nerve cells, making it more difficult to reach orgasm. Alcohol can also make it harder for boys to achieve an erection. Drugs can have a similar effect. Some people take drugs like ecstasy (E, MDMA), cocaine (coke, charlie, blow) and amphetamines (speed) to make them more sexually excited, to make them 'last longer' in bed, or because they think they will have a more pleasurable orgasm. However these drugs can actually cause erection and orgasm problems. You may hear stories about people having sex for hours while taking drugs, but that’s probably because they can't reach orgasm – it doesn't necessarily mean that they're having better sex!
What does alcohol actually do to you?
Alcohol is a depressant. This means that it temporarily slows down your central nervous system (the brain and the spinal cord), which controls your bodily functions, blocking out some of the messages trying to get through to your brain. Your reactions slow down and you may feel more relaxed and less anxious. Keep on drinking and you eventually become intoxicated – i.e. drunk, wasted, hammered, sloshed. At this point people often get blurred vision, slur their speech and become uncoordinated. Sometimes people get friendly, happy and carefree when they’re drunk, at other times they may become aggressive or angry. It depends on their personality, and what situation they’re in. Their ability to react to the world slows down, and this is why people are told not to drink and drive.
Some people find it fun to get a bit drunk and lose their inhibitions once in a while. At the same time, it’s generally harder to make sensible judgments when you’ve been drinking – which is why alcohol is famous for making people say or do things that they later regret!
Because alcohol loosens you up so much, it’s not uncommon for people to run into trouble when they’re drunk, getting into fights or accidents. In the U.S. for example, around 5,000 people under 21 die every year from alcohol-related injuries.3
How about drugs?
Street children sniffing glue in Cambodia
Street children sniffing glue in Cambodia
Drugs vary greatly in strength and the effect that they can have on you. Some drugs are depressants (like alcohol), and make you drowsy and more relaxed. Marijuana (weed, pot, cannabis) falls into this class. Marijuana is one of the most common drugs used by teens and is often perceived to be relatively safe, but this isn’t necessarily the case. The strains of marijuana available today are generally much stronger than those around during the hippie era of the 60’s and 70’s, which is when the drug gained its reputation as a harmless herb. While smoking a spliff can make you feel more chilled out, it can also induce feelings of anxiety and paranoia, or simply make you feel sick. There’s also increasing evidence linking regular marijuana use to long-term mental health problems such as memory loss and depression in some people.
Other drugs are stimulants. They make you feel more awake and alert, and give you loads of energy. Ecstasy, speed and cocaine are examples of stimulants. These drugs increase your heart rate, body temperature and blood pressure. They can make you feel confident and euphoric. In high doses though, they can make you feel confused or dazed, overheat, have a heart attack or even suffer brain damage.
LSD (acid, trips) and magic mushrooms are examples of another class of drug called hallucinogens. They change your perceptions of reality, and can make you see, hear or feel things that aren’t really happening. These hallucinations might be funny or enjoyable, but they can also be very scary and upsetting. You hear all sorts of stories about people having ‘bad trips’, where they’ve freaked out after taking hallucinogens, and in some cases these bad trips can have long-lasting effects.
Heroin is one of the strongest and most dangerous drugs available. It’s highly addictive and easy to overdose on, which often leads to death. Since heroin is often injected into the body, users risk becoming infected with blood-borne diseases such as HIV if they share needles with other people.
Everyone I know is drinking, taking drugs or having sex…

It might feel as though this is true, but it probably isn’t. Most teens don’t drink, and even a lot of adults choose not to. It’s even less common for people to do most other recreational drugs. As for sex, although a lot of teens brag about losing their virginity young, they’re not always telling the truth: the average global age for first having sex is around 19, and in some countries it’s as high as 23.4 The point is that if you don’t want to drink, take drugs or have sex, then you’re certainly not alone.
“If you only want to try drink, drugs or sex because of peer pressure, then this is totally the wrong reason”
A lot of teens feel pressured into trying alcohol, drugs and sex by their friends, schoolmates and other people of the same age group – their peers. When this happens, it’s called peer pressure. Peer pressure is the pressure that you feel to be like everyone else and fit in. It can be about all kinds of things, from fashion to dating and beyond. It’s not always a bad thing, and it plays a big role in helping to shape our identities, how we talk, act and dress. But peer pressure can also cause people to do things that go against their will or beliefs – and with drink, drugs and sex, this is often what happens.
You might find yourself at a party where everyone’s drinking or taking drugs, and feel like people will think you’re a loser if you don’t join in. Or you might feel like you’re not cool because you’re still a virgin, and so have sex with someone simply because you don't want to feel like you’re the only person who hasn’t.
“I remember a party with my sister. I was very scared, thinking: I have to drink. These people are so much older. I have to impress them.” - Megan 5
“When I was in year 9, my friends pressured me into smoking marijuana or "pot". I really didn't want to but I thought life is short, and I gave into peer pressure. The first time, I suddenly spaced out and got high. I didn't know what to do, I wanted to beat people up. I hated it, but I kept on trying it whenever we were at parties.” - Simone 6
“At 16 I was not ready to lose my virginity, I didn't have a steady boyfriend, I had little confidence in myself and I had no idea what I was getting myself into. All my friends were having sex. They acted as if losing your virginity was no big deal. It is! Trust me! I now know that I lost my virginity to the WRONG guy! He was a sleaze and I was just another girl to him.” - Fi 7
At the end of the day, you can be in control. You may have your own reasons for wanting to try drink, drugs or sex, but if you’re only doing these things because of peer pressure, then this is totally the wrong reason. It’s not always easy to say ‘no’, but if the people you’re with are really your friends, they’ll respect your decisions. Stand your ground and do what feels right for you, not anyone else.

“You don't need to drink just because somebody's telling you to drink. You have your own ways. That's what you got to tell them: My way is to stay the way I am, and I don't want to drink. If they can't respect that, then you need to leave them.” - Ilton 8
“One morning, I had a wake up call and decided to not hang around these friends. I knew after this whole experience with pot, I would not give in to peer pressure again. My experience helped me realize what not to do.” - Simone 9
I’m only having a few drinks. That’s fine, right?
It might be, but you should still be careful. Alcohol tolerance varies greatly between different people, and for some, a few drinks is all it takes to get drunk.
Even if you’re only planning on having a small amount of alcohol, or sticking to soft drinks, you still need to keep your wits about you. It’s possible that someone could spike your drink with 'date rape' drugs like Rohypnol or GHB, which take as little as 15 minutes to kick in and can wipe out your memory of what happens in the next eight hours, leaving you open to sexual assault and rape. The most common drug used to spike people’s drinks is actually alcohol. Extra alcohol can be added to people’s drinks without them knowing, or attackers may simply buy someone more and more drinks until they get drunk beyond the point where they know what they’re doing. They might put vodka into someone’s drink for instance, or buy them double measures of spirits when they’ve only asked for singles.
The intention of drink spiking isn’t always sexual assault. Sometimes it might be done as a joke, out of anger or spite, or to rob you. It happens to both boys and girls and is alarmingly common in some countries.young people drinking around a table
Young people drinking alcohol at a party

This doesn’t mean that you can’t go out and enjoy yourself; if you take a few simple precautions, you should be OK. Make sure you never leave your drink unattended. If you do have to leave it for a while, give it to a friend that you know and trust. Don’t swap or share drinks and think twice about accepting a drink from someone you don’t know well. If you suddenly start to feel unusually drunk or unwell without knowing why, it’s possible that your drink has been spiked; ask a trustworthy friend to help you and take you home. In the same way, if one of your friends starts acting strangely then keep an eye on them.
Another thing to remember is people who are looking to take advantage of you don’t always have to spike your drink – they may simply wait till you get drunk or high of your own accord. If you are going to drink, the key is not getting so out of your head that you don’t know what you’re doing! If you do think you’re going to get wasted, always make sure that you’re surrounded by trustworthy friends who will look out for you.
I’m going to do drugs, but only once…

It’s human nature to want to experiment once in a while, and in many cases this can be harmless. But it’s worth bearing in mind that there are lots of people out there who say “only once” and end up doing drugs regularly or even getting addicted. No one starts taking drugs with the intention of becoming an addict or using them regularly. It’s always a case of “I’ll just try them” or “I’m just an occasional user”. But often people enjoy the experience so much that they stop thinking about the risks and start using regularly. Before they know it, the drugs have caused changes to the structure and function of their brains, and they feel the urge to keep taking those drugs.
"It hit me like a tidal wave. It was incredible... it was no wonder I wanted to feel that way again soon. Before long I started popping ecstasy every other saturday night... soon I was using every Thursday, Friday and Saturday... All this partying took its toll on me. My body ached from the hours of dancing. My eyes were bloodshot with big, dark circles around them. I was always sick and depressed. I began to hate everything... Now it seemed that even ecstasy couldn't numb the pain. So I began to move on to other drugs.” - 10
Another thing to remember is that you only have to take some drugs once for them to have a serious effect, or even kill you. There are many cases where people have died after doing drugs like ecstasy, solvents (inhalants) or heroin for the first time.
We’ll fool around, but won’t go all the way with sex…
It can be fine if you and your boyfriend/girlfriend want to experiment with touching one another, or try pleasuring each other without having full on sex. Just remember that oral sex can lead to STIs being passed on if you don’t use a condom, as can anal sex.
Sometimes people make the mistake of thinking that if a couple start having unprotected sex, but stop before the boy ejaculates (comes), then this will prevent pregnancy. This isn’t necessarily true. Before and while he has sex, a boy’s penis releases a lubricating liquid called pre-come, and this substance can contain sperm. Even if a small amount of this substance gets inside the vagina, it can be enough to make a girl pregnant.
If you use a condom when necessary then, in most cases, you should be fine.
The final word
We’re not going to tell you that you shouldn’t drink, take drugs, or have sex, and equally we’re not going to encourage you to do these things – it’s ultimately up to you to assess the risks and make decisions in the context of your own life. What we will say that is that if you are going to drink, take drugs or have sex, be aware of the problems they can cause and take measures to minimize the risks to yourself and those around you.

* If you’re going to drink, do it responsibly and make sure you’re around people you can trust.
* If you’re going to do drugs, the same applies, and you should also make sure that you know the score about what you’re taking – read more about drugs on information sites like Frank.
* With sex, make sure that you use a condom to prevent STIs and pregnancy, or if you’re with a regular partner who you’re certain doesn’t have an STI, other birth control methods that can prevent pregnancy.
* Keep in mind the law. Almost all recreational drugs are illegal, and they usually carry heavy penalties. The legal drinking age varies between countries but is generally at least 18, and 21 in some countries, such as the U.S. Laws about sex also differ between countries, so make sure that you know the age of consent.
* Combining drink and drugs with driving is illegal in almost every country and is always a bad idea.
* Don’t let peer pressure dictate your decisions. Work out what’s best for you as an individual, and stand up for yourself. If you don’t want to drink, take drugs or have sex, then that’s perfectly fine, and you shouldn’t let anyone tell you differently.



Read more!

Using condom can escape from many disease

How important to use Condom?
Condoms are the only form of protection that can both help to stop the transmission of sexually transmitted diseases (STDs) such as HIV and prevent pregnancy.
Getting ready, choosing the right condom
condoms
A number of different types of condom are now available. What is generally called a condom is the 'male' condom, a sheath or covering which fits over a man's penis, and which is closed at one end.
There is also now a female condom, or vaginal sheath, which is used by a woman and which fits inside her vagina. The rest of this page is about the male condom.
What are condoms made of?
Condoms are usually made of latex or polyurethane. If possible you should use a latex condom, as they are slightly more reliable, and in most countries they are most readily available.
Latex condoms can only be used with water based lubricants, not oil based lubricants such as Vaseline or cold cream as they break down the latex. A small number of people have an allergic reaction to latex and can use polyurethane condoms instead.
Polyurethane condoms are made of a type of plastic. They are thinner than latex condoms, and so they increase sensitivity and are more agreeable in feel and appearance to some users. They are more expensive than latex condoms and slightly less flexible so more lubrication may be needed. However both oil and water based lubricants can be used with them.
It's not clear whether latex or polyurethane condoms are stronger – there are studies suggesting that either is less likely to break. With both types however, the likelihood of breakages is very small if used correctly.
The lubrication on condoms also varies. Some condoms are not lubricated at all, some are lubricated with a silicone substance, and some condoms have a water-based lubricant. The lubrication on condoms aims to make the condom easier to put on and more comfortable to use. It can also help prevent condom breakage.
Spermicides and Nonoxynol 9
Condoms and lubricants sometimes contain a spermicide called Nonoxynol 9. Adding Nonoxynol 9 to condoms was thought in the past to help to prevent pregnancy and the transmission of HIV and other STDs, but it is now known to be ineffective.

Some people have an allergic reaction to Nonoxynol 9 that can result in little sores, which can actually make the transmission of HIV more likely. Because of this, you should only use condoms and lubricants containing Nonoxynol 9 if you are HIV negative and know that your partner is too. However, using a condom (even if it contains Nonoxynol 9) is much safer than having unprotected sex.
What shapes are there and which should I choose? What about flavoured condoms?
condom
Condoms come in a variety of shapes. Most have a reservoir tip although some do have a plain tip. Condoms may be regular shaped (with straight sides), form fit (indented below the head of the penis), or they may be flared (wider over the head of the penis).
Ribbed condoms are textured with ribs or bumps, which can increase sensation for both partners. Condoms also come in a variety of colours.
It's up to you which shape you choose. All of the differences in shape are designed to suit different personal preferences and enhance pleasure. It is important to communicate with your partner to be sure that you are using condoms that satisfy both of you.
Some condoms are flavoured to make oral sex more enjoyable. They are also safe to use for penetrative sex as long as they have been tested and approved.
What about the condom size?
Condoms are made in different lengths and widths, and different manufacturers produce varying sizes.
There is no standard length for condoms, though those made from natural rubber will in addition always stretch if necessary to fit the length of the man's erect penis.
The width of a condom can also vary. Some condoms have a slightly smaller width to give a "closer" fit, whereas others will be slightly larger. Condom makers have realised that different lengths and widths are needed and are increasingly broadening their range of sizes.
The brand names will be different in each country, so you will need to do your own investigation of different names. There is no particular best brand of condom.
So when do you use a condom?
You need to use a new condom every time you have sexual intercourse. Never use the same condom twice. Put the condom on after the penis is erect and before any contact is made between the penis and any part of the partner's body. If you go from anal intercourse to vaginal intercourse, you should consider changing the condom.
Where can I get condoms?

There are no age limitations on buying condoms. Buying a condom no matter how old you are shows that you are taking responsibility for your actions. Family planning and sexual health clinics provide condoms free of charge. Condoms are available to buy from supermarkets, convenience stores and petrol/gas stations. Vending machines selling condoms are found in toilets at many locations. You can also order then online from different manufacturers and distributors.
How can I check a condom is safe to use?
Condoms that have been properly tested and approved carry the British Standard Kite Mark or the EEC Standard Mark (CE). In the USA, condoms should be FDA approved, and elsewhere in the world, they should be ISO approved. To find out more about condom testing see our Condoms history, effectiveness and testing page.
Condoms have an expiration (Exp) or manufacture (MFG) date on the box or individual package that tells you when it is safe to use the condom until. It's important to check this when you use a condom. You should also make sure the package and the condom appear to be in good condition.
Condoms can deteriorate if not stored properly as they are affected by both heat and light. So it's best not to use a condom that has been stored in your back pocket, your wallet, or the glove compartment of your car. If a condom feels sticky or very dry you shouldn't use it as the packaging has probably been damaged.
How do you use a condom?
condoms
Open the condom package at one corner being careful not to tear the condom with your fingernails, your teeth, or through being too rough. Make sure the package and condom appear to be in good condition, and check that if there is an expiry date that the date has not passed.
Place the rolled condom over the tip of the hard penis, and if the condom does not have a reservoir top, pinch the tip of the condom enough to leave a half inch space for semen to collect. If the man is not circumcised, then pull back the foreskin before rolling on the condom.
Pinch the air out of the condom tip with one hand and unroll the condom over the penis with the other hand. Roll the condom all the way down to the base of the penis, and smooth out any air bubbles. (Air bubbles can cause a condom to break.)
If you want to use some extra lubrication, put it on the outside of the condom. But always use a water-based lubricant (such as KY Jelly or Liquid Silk) with latex condoms, as an oil-based lubricant will cause the latex to break. Click here to see picture of lubricants.
The man wearing the condom doesn't always have to be the one putting it on - it can be quite a nice thing for his partner to do.
What do you do if the condom won't unroll?

The condom should unroll smoothly and easily from the rim on the outside. If you have to struggle or if it takes more than a few seconds, it probably means that you are trying to put the condom on upside down. To take off the condom, don't try to roll it back up. Hold it near the rim and slide it off. Then start again with a new condom.
When do you take off the condom?
Pull out before the penis softens, and hold the condom against the base of the penis while you pull out, so that the semen doesn't spill. Condom should be disposed properly for example wrapping it in a tissue and throwing it away. It's not good to flush condoms down the toilet - they're bad for the environment.
What do you do if a condom breaks?
If a condom breaks during sexual intercourse, then pull out quickly and replace the condom. Whilst you are having sex, check the condom from time to time, to make sure it hasn't split or slipped off. If the condom has broken and you feel that semen has come out of the condom during sex, you should consider getting emergency contraception such as the morning after pill.
What condoms should you use for anal intercourse?
With anal intercourse more strain is placed on the condom. You can use stronger condoms (which are thicker) but standard condoms are just as effective as long as they are used correctly with plenty of lubricant. Condoms with a lubricant containing Nonoxynol 9 should NOT be used for anal sex as Nonoxynol 9 damages the lining of the rectum increasing the risk of HIV and other STD transmission.
Is using a condom effective?
unrolled condom
If used properly, a condom is very effective at reducing the risk of being infected with HIV during sexual intercourse. Using a condom also provides protection against other sexually transmitted diseases, and protection against pregnancy. In the laboratory, latex condoms are very effective at blocking transmission of HIV because the pores in latex condoms are too small to allow the virus to pass through. However, outside of the laboratory condoms are less effective because people do not always use condoms properly. To find out more about the effectiveness of condoms, go to our Condom history, effectiveness and testing page.
How do you dispose of a used condom?
All condoms should be disposed of by wrapping in tissue or toilet paper and throwing them in the bin. Condoms should not be flushed down the toilet as they may cause blockages in the sewage system and pollution.

Latex condoms are made mainly from latex with added stabilizers, preservatives and vulcanizing (hardening) agents. Latex is a natural substance made form rubber trees, but because of the added ingredients most latex condoms are not biodegradable. Polyurethane condoms are made from plastic and are not biodegradable. Biodegradable latex condoms are available from some manufacturers.
How can I persuade my partner that we should use a condom?
It can be difficult to talk about using condoms. But you shouldn't let embarrassment become a health risk. The person you are thinking about having sex with may not agree at first when you say that you want to use a condom when you have sex. These are some comments that might be made and some answers that you could try...
EXCUSE



Read more!

Aids and Hiv cut your goal and hope, Click to read more

How are HIV and AIDS for people around the world
A virus has been sweeping the world for the past two decades, causing a disease which has killed millions of people and which looks likely to kill millions more. The virus is called HIV, which stands for Human Immunodeficiency Virus. After a period of time this virus damages the immune system, and this causes a variety of symptoms known as AIDS. This time period varies, depending on factors such as access to AIDS drugs, and possibly such factors as nutrition, the presence of other medical conditions, and stress. In the absence of treatment, the average time between HIV infection and progression to AIDS is around ten years.
Understanding the epidemics
The term epidemic is used when HIV and AIDS are widespread in a community. In order to understand the many epidemics of HIV that are spreading around the world, and the AIDS epidemics which follow in their footsteps, it is necessary to look at certain figures. The figures we need include the number of people living with HIV, the number of new infections, and the number of people who have died of AIDS.
HIV/AIDS is a complicated and hugely important world issue. There has been a great deal of study into the medical and social aspects of the world's epidemics, which has generated a great deal of data. This information is often presented as long numbers, graphs and tables, and sometimes the terminology used can be quite technical. In order to turn such information into an understanding of the epidemics, you need to know where the data come from and what they really mean.
There are two main types of national HIV and AIDS statistics:
* Reports of actual cases tell us the minimum number of people who are affected, but are of limited use if many cases go unreported.
* Estimates based on surveys give the proportion of people living with HIV, as well as other statistics, according to certain assumptions.
Reported HIV diagnoses
With reported diagnoses, each number indicates an actual positive result for a person's HIV test. This method of looking at an epidemic can give an extremely clear picture in terms of real people who have been affected by the virus, especially when looking at smaller areas. However, it is often not a reliable way of assessing wider trends because many people living with HIV have never taken an HIV test, and not all diagnoses are reported.
In general, national totals of reported HIV diagnoses are only really useful when they come from places with well-developed voluntary testing schemes, such as the USA, Western Europe, Canada or Australia. However, even in these countries, one in every three or four people living with HIV has never taken a test, and some test results go unreported. Some states of the USA do not report any HIV statistics through the name-based system used to compile national surveillance reports.

Another point to remember is that looking at the years in which people tested HIV positive does not tell you when they were infected - the test itself may come many years after infection occurred. And when looking at HIV reports, it's important to keep in mind that there might be more than one reason for trends in the data. An increase in diagnoses might not mean that more people are becoming infected with HIV than in previous years - it might mean, instead, that HIV testing has become more easily available than in recent years, or that stigmatisation of people living with HIV has declined, so more people are willing to be tested.
In terms of characteristics (such as age, gender, race, etc), HIV reports are not necessarily entirely representative of all HIV infections because some groups of people may be more likely to be tested than others. It is worth remembering this limitation when interpreting reported statistics by exposure category in particular.
Reports from the most recent years are usually affected by reporting delays (see Glossary, below).
Reported AIDS diagnoses and AIDS deaths
Most countries have a long history of reporting AIDS cases and in many places - including the USA, Canada and much of Africa - reporting of all diagnoses is compulsory.
A problem with AIDS case reporting is that different countries have different definitions of what actually constitutes AIDS. While a definition of AIDS is becoming standardised, there is still the problem that some resource-poor areas lack HIV testing facilities, and therefore have to diagnose AIDS on the basis of symptoms alone. Another problem is that people with AIDS do not commonly have this disease for long - it either kills them or, given access to antiretroviral medication, they frequently cease to have symptoms.
Antiretroviral treatment has made it difficult to interpret trends in AIDS diagnoses and AIDS deaths in countries where most people have access to the drugs. This is why, in recent years, reliable HIV reporting has become even more important in the richer parts of the world.
If someone is thought to have died from AIDS then this should be recorded on their death certificate. However, it is acknowledged that such records are less reliable in countries where AIDS is highly stigmatised, because doctors are sometimes inclined to spare shame to a family by mis-recording the cause of an AIDS death.
The World Health Organisation says of AIDS case surveillance that, "While giving a general idea of the increase of AIDS in a population, the figures do not reflect the actual prevalence of AIDS disease so much as the accuracy of detection, diagnosis and reporting of the disease syndrome". The proportion of AIDS cases reported varies from less than 10% in some countries to almost 90% in others.1
Estimated HIV prevalence
'HIV prevalence' is given as a percentage of a population. If a thousand truck drivers, for example, are tested for HIV and 30 of them are found to be positive, then the results of a study might say that HIV prevalence amongst truck drivers is 3%.
For the purpose of producing a national or international HIV prevalence figure, researchers include all people with HIV infection who are alive at a given point in time, whether or not they have progressed to AIDS.
In most cases, HIV prevalence cannot be accurately determined from reported cases because many infections are undiagnosed or unreported. The best estimates are mainly based on the results of surveys of large groups of people.
In a country with a generalised epidemic (a high level of infection in the whole population), the national estimate of HIV prevalence is usually mainly based on surveys of pregnant women attending antenatal clinics. Because antenatal clinics are well-attended in most such countries, these data provide a good basis for comparisons; they are also very reliable indicators of trends in prevalence. Surveys collect blood over a short period from all women attending a clinic for the first time (to avoid duplication). All identifying details are removed from the samples, except age group and location of clinic, before they are screened for HIV to determine prevalence.
Many studies have shown that HIV prevalence among pregnant women attending clinics is generally very similar to prevalence in the adult population as a whole. Often some small adjustments are made - for example to compensate for underreporting in the most rural areas, or for large differences between male and female rates of infection. Such refinements are made according to the findings of separate surveys of the general population.
Population based surveys are useful because they tell us how prevalence varies according to gender, race or other characteristics, but they are usually not the main source of national prevalence estimates. One reason for this is that population based surveys are much more complicated and expensive than antenatal surveys. Nevertheless, population based surveys are becoming more frequent, and their influence on national HIV prevalence estimates is increasing. Between 2001 and 2007, thirty countries in sub-Saharan Africa, Asia and the Caribbean conducted national population based surveys. The results of these surveys have led to significant revisions of HIV prevalence estimates for several countries - most notably India in 2007.
In a country with a low-level or concentrated epidemic (where high levels of infection are found only in specific groups), the national estimate of HIV prevalence is mainly based on data collected from populations most at risk - usually sex workers, injecting drug users or men who have sex with men - and on estimates of the sizes of the populations at high risk and at low risk. Reports of HIV diagnoses and AIDS deaths may also be taken into account.

Better understanding of the nature of an HIV epidemic allows better prevalence estimates to be produced. This is why, each year when a new set of estimates is brought out, the figures for previous years may change.
Estimated HIV incidence
'HIV incidence' is the number of new HIV infections in the population during a certain time period. People who were infected before that time period are not included in the total, even if they are still alive.
Unfortunately, directly measuring HIV incidence is a complex and expensive process, so incidence data for many resource-poor areas, and some rich ones, is difficult to find. However, one example is that (according to USAID) in the Masaka region of Uganda, HIV incidence fell from 7.6 per thousand per year in 1990 to 3.2 per thousand per year by 1998.
National estimates of HIV incidence are usually produced by computer models and are based on estimates of HIV prevalence. Such models apply a set of assumptions such as the survival time of those infected with HIV and the mother-to-child transmission rate. Trends in HIV prevalence among teenagers and young adults can give a rough idea of incidence because infections among this group are likely to have been recently acquired.
Estimated AIDS deaths
Computer models are also used to produce estimates of the number of people to have died of AIDS, based on HIV prevalence, according to the same set of assumptions.
The accuracy of the assumptions is monitored using surveys of the general population, and the estimates may be compared with reports of AIDS diagnoses, census records or death certificate data. Organisations like UNAIDS/WHO constantly review and improve their methods and assumptions, taking into account the latest research findings.
Margin of error
This is a phrase used to explain the precision of an estimate. Because the groups looked at by surveys can never be entirely representative of the wider population, and because no computer model is perfect, there will always be some degree of uncertainty attached to figures derived from them. For this reason, an estimate is often accompanied by a range or 'plausibility bound', and the width of the range is an indication of the uncertainty of the estimate. The wider the range, the greater the uncertainty.
The size of a plausibility bound is affected by the quality of the data and the number of steps and assumptions used to arrive at the estimate. Also, ranges tend to be larger when the numbers being estimated are smaller, because it is then likely that fewer people are included in surveys.

Another property of HIV-related plausibility bounds is that they tend to be wider in countries with low-level or concentrated epidemics. This is because, in low-level or concentrated epidemics, one needs to estimate both the numbers of people in the groups at higher risk of HIV infection and HIV prevalence rates in those groups.
Arguably the most important estimates in the world are the national ones produced by UNAIDS/WHO. These organisations say of their own estimates that they "are confident that the actual numbers of people living with HIV, people who have been newly infected or who have died of AIDS lie within the reported ranges".
Understanding HIV prevalence and incidence trends
Changes in HIV incidence statistics can give an idea of whether prevention strategies are being successful in reducing the number of new infections. A society that shows regularly declining incidence figures is one that is experiencing fewer and fewer new infections, which is certainly desirable.
Trends in HIV prevalence are less easy to interpret.
In the early years of a typical HIV epidemic, prevalence increases rapidly because more and more people are becoming infected and few are dying. But prevalence cannot increase forever - eventually the death rate (number of deaths per year) rises to equal the incidence rate (number of new infections per year), and so prevalence reaches a peak.
In some African countries, HIV prevalence appears to have stabilized at a very high level. This means that two things are happening at the same time: many new infections are occurring and many people are dying. And if a country's total population continues to grow then the number of people living with HIV increases even while the prevalence rate remains stable.
A rise in HIV prevalence is not necessarily a sign of failing prevention campaigns. Besides a rise in incidence, it could result from any of the following:
* The death rate has fallen because of improvements in treatment and care (this has happened in high-income countries).
* The death rate has fallen because fewer infected people are dying as a result of war, famine or other causes that had disproportionately affected people living with HIV.
* The death rate has fallen as a result of an earlier drop in incidence (on average, people survive for a number of years after becoming infected, so incidence trends have a delayed effect on death trends).
* More people living with HIV are imigrating than are emigrating (this affects a number of high-income countries).
* The survey bias has changed.

It is even possible for HIV prevalence to increase at a time when HIV incidence is decreasing - for example, in a society that is rapidly scaling-up antiretroviral treatment provision while making only small improvements to prevention activities. The drop in the number of new infections might then be outweighed by the effect of people living longer.
Glossary
HIV and AIDS epidemic statistics use particular terms in particular ways, and sometimes with special meanings. Here, you can find explanations of the terms used in our pages.
Adults
Adults in most reports are defined as men and women aged 15-49. This age range captures those in their most sexually active years. While the risk of HIV infection continues beyond the age of 50, the vast majority of people with substantial risk behaviour are likely to have become infected by this age. Since population structures differ greatly from one country to another, especially for children and the upper adult ages, the restriction of 'adults' to 15-49 has the advantage of making different populations more comparable.
When a report refers to 'men' or 'women', it is usually referring to males and females within these age ranges.
Children
Most reports define children as males and females aged between 0 and 14 years.
Cumulative figures
A 'cumulative' figure gives a total number, from the time that recording of data first began, until a specified date.
Exposure category
This term is used when talking about the ways in which people were infected with HIV. It is often very difficult to say for certain how someone became infected with HIV - for example, an injecting drug user might be infected sexually, or a man who has sex with other men might become infected by a woman. The term 'exposure category' refers to the assumed most probable means of HIV transmission.
Orphans
In UNAIDS/WHO reports, and for most others, an 'orphan' is defined as being someone aged 0 to 17 years, who has lost one or both parents to AIDS. Most other studies also use this definition.
People living with AIDS

Statistics giving numbers of people living with AIDS can sometimes make confusing reading because different countries and agencies have different definitions of what AIDS actually is. For example, in Europe an AIDS diagnosis must be based on the diagnosis of an AIDS-related illness, but in the USA it may also be based on a low CD4 cell count. However, most people who have a low CD4 count will go on to develop an AIDS-related illness anyway.
When testing is unavailable, the presence of AIDS, as opposed to HIV, is determined on the basis of a number of clinical symptoms or signs associated with immune deficiency.
Estimates of the number of people living with AIDS are usually based on the estimated number of people living with HIV and estimated survival times, but minimum estimates may be derived from case reports.
People living with HIV
Many reports and tables give figures for the 'number of people living with HIV'. This number represents all people living with HIV infection, whether or not they have developed symptoms of AIDS, who are alive at the time given.
Estimates of the number of people living with HIV are usually based on the estimated HIV prevalence and total population size, but minimum estimates may be derived from case reports.
Reporting delays
A problem with reported data is that it is sometimes hard to detect trends over time, especially when looking at recent years. Reports of HIV or AIDS diagnoses can sometimes take months, or a few years, to reach a central agency that compiles the total figure.
Statistics experts know from experience roughly what proportion of reports will arrive late. They are therefore able to produce estimates in which the most recent figures have been adjusted to cancel out the effect of reporting delays. The table below illustrates the way in which reported and estimated data can differ, especially in recent years.
Year Reported cases
of HIV Estimated cases
of HIV
2000 154 155
2001 171 173
2002 250 260
2003 259 302
2004 169 333
You can see from the table that the apparent drop in 2004 is probably due to reporting delays, and that the true number of new diagnoses probably continued to rise.
From.. www.avert.org/



Read more!