In many countries 60% of all new HIV infections are among 15-24 year-olds. Also the highest rates of STDs are usually found in the age range 20-24 years, followed by 15-19 years.

Does education about AIDS make young people more sexually active?

It is commonly supposed that talking to young people about sex will make them do it. Such anxieties prevent many teachers, youth workers and parents from talking about sexual matters. Alternatively, they may encourage an over-emphasis on the negative aspects of sex - unwanted pregnancy, sexually transmitted diseases, AIDS - rather than positive aspects such as intimacy, sexual love and pleasure. Likewise when drugs are talked about the emphasis is often on the damage they can cause. This kind of unbalanced approach is often seen through by young people. In consequence, they may reject all that adults have to say, seeking guidance and role models from peers and from the media.

Contrary to what might popularly be believed, research looking at the effects of sex education on young people's sexual behaviour offers little evidence that it hastens the onset of sexual experience, or increases sexual risk among those who are already sexually active. Indeed, several studies from different countries show that good quality sex education can actually decrease the likelihood that young people will have sex, and increases condom use among those who are already sexually active.

What type of education works best in school?

It is widely recognised that the best approaches to sex and drug education in schools are broad based and have several components. These include the provision of factual information about biology, sexual development, and sexual and drug-related risks; a concern with personal relationships, feelings and values; an emphasis on the acquisition of relevant negotiation skills (including but not restricted to how to say 'no'); and a consideration of wider social pressures and cultural expectations.

Successful sex education programmes have several key qualities. These include the provision of information, exercises to encourage an appraisal of values, and role play rehearsal to teach sexual negotiation skills. Programmes that aim to reduce specific sexual risk-taking behaviours and which reinforce group norms against unprotected sex and discuss social pressures to have unprotected sexual activity have been shown to be particularly successful. School curricula with these qualities have been shown significantly to reduce the likelihood that students who have not had sex prior to their exposure to the curriculum will have had unprotected sexual intercourse eighteen months later. Click here for more about sex education that works.

What works out of school?

Ideally, services for young people should be provided in a variety of ways - through specialised clinics, through youth advisory services, through general practitioners (doctors) and through local outreach work. The kind of services that are found most acceptable and appropriate by young people are those that offer a range of integrated services, are accessible at evenings and weekends, are close to public transport, have an appropriate image and atmosphere, and have approachable, non-judgmental and reassuring staff.

Studies show that peers can be well respected sources of information and support on AIDS-related concerns. Peer-led education has been shown to be effective in the field of substance abuse, and there are studies demonstrating its ability to bring about changes in HIV-related knowledge and attitudes. Studies focusing on risk behaviours are harder to come by. The best peer-led education programmes have clear objectives, provide training, support and supervision for peer educators, are accompanied by service provision or referral to appropriate services, and include regular monitoring and evaluation.

Other successful out of school programmes include those that provide culturally appropriate opportunities for learning through videotapes, games, exercises and other materials. These have been shown to be effective in reducing the incidence of unsafe sex and promoting intentions to use condoms.

How can we meet the needs of special groups?

Some groups of young people have special needs in relation to HIV and AIDS. Perhaps the most obvious of these are related to gender. Young women in particular may require support in acquiring the assertiveness and sexual negotiation skills that may enable them to avoid unwanted or unprotected sex. Young men on the other hand may need encouragement to listen carefully to what young women have to say and to respect their wishes in relation to sex and drug use.

The needs of young lesbians and young gay men may be missed by programmes and interventions that assume that all young people are heterosexual. There is evidence from the US at least that some young gay men may be at special risk of HIV. A variety of factors may cause this including the perception that AIDS is a disease of older men, a sense of low self worth caused by the reactions of parents and society, and less experience negotiating safer sex. Effective interventions among young gay men include risk-reduction counselling followed by peer education and referral to appropriate health services, and community based programmes using social, outreach and small group activities organised and run by young men themselves.

Young Black people and young people from minority ethnic communities may also have special needs when it comes to the promotion of safer sex and safer drug use. These may include access to materials and messages that are linguistically and culturally relevant, as well as what some writers have called 'culturally relevant learning'. These include activities and videotapes that engage directly with the interests and anxieties of the young people concerned.

Young homeless people may have special needs when it comes to HIV prevention. Some may have unsafe sex in order to obtain food and clothing, and in order to have somewhere to live. Some may share syringes and needles when injecting drugs. For many such young people, HIV and AIDS may seem less important than finding food and shelter. In order to be effective, intervention programmes among homeless young people need to address these concerns as well as AIDS-related issues. Providing access to health care and other resources, training in coping and sexual negotiation skills, and video and art workshops have been shown to be effective in reducing high risk patterns of sexual behaviour and promoting consistent condom use among members of this group.