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Youth Forum on Pregnancy Prevention in a Time of AIDS

March 15–April 15, 2005
http://my.ibpinitiative.org/youth

This four-week forum provided an environment for discussion and sharing experiences and lessons learned on the subject of pregnancy prevention among youth.

Discussion Statistics


Number of participants: 654
Number of participants' countries: 86
Number of contributions: 129 contributions from 87 participants
% of contributions from developing countries: 87%
Number of countries contributing: 35 countries

Contributing countries: Finland (4), Nigeria (15), Ghana (3), Belize (2), Guatemala (2), Malawi (7), Madagascar, Kenya (8), UK (5), Vietnam, Uganda (8), India (2), US (17), Thailand (5), Swaziland, Tanzania (3), Sudan, Nepal (2), Mali (4), Pakistan, Mexico (2), Guinea, China, Dominican Republic (4), Ghana, South Africa (3), Switzerland, Cameroon, France, Trinidad and Tobago, Haiti (2), Macedonia (3), Brazil, Vietnam, Zambia, Unknown (13)

Purpose and Objectives

Purpose:

To provide a stimulating environment for discussion and sharing experiences and lessons learned on the subject of pregnancy prevention among youth.                                                                             

Objective:

Week 1: The Needs of Youth for Pregnancy Prevention in a Time of AIDS
Week 2: Especially Vulnerable Youth ― Focus on Young Women and Girls
Week 3: Medical Barriers and Accessibility Issues
Week 4: The ABCs of Pregnancy and HIV Prevention among Youth ― Country Perspectives and Lessons Learned                                                 

Week 1 

Objective:

The Needs of Youth for Pregnancy Prevention in a Time of AIDS                                                                           

Week 1 Summary:

Many postings throughout the week pointed out the inevitable connection of pregnancy and AIDS, as sexual behaviors are the key point that links the two. Social norms, sexuality and family life education, and the role of parents, faith institutions, and communities may not distinguish between pregnancy and HIV/AIDS prevention.

Two primary issues arose this week: 1) the needs youth have for information and services and 2) the importance of addressing social norms and the key stakeholders that influence youth with these norms (faith institutions, parents, etc.). Within these two general categories, three issues arose frequently: abstinence as an intervention, faith institutions/parents, and school-based sexuality education.

Week 2

Objective:

Especially Vulnerable Youth - Focus on Young Women and Girls 


Week 2 Summary:

Week two has delved into the realities for women and girls as they struggle to cope with the AIDS epidemic in their daily lives. Contributions underscored the crux of the issues fuelling the epidemic among young people – poverty, gender inequality, and socio-cultural practices. Striving to achieve the mutually reinforcing Millennium Development Goals, although daunting, is absolutely critical for making any significant and lasting headway against the epidemic. This week’s themes included the following:

  • Strong political will to recognize and confront the epidemic is essential.
  • Effective education among young people, including sexuality and life skills, is critical.
  • Voluntary and confidential counseling and testing for young people, especially when linked to sexual and reproductive health services, is very important.
  • Ensuring human rights for all is a fundamental goal. Without the ability to exercise rights, women and girls will not be able to protect themselves from HIV or mitigate its consequences.
  • Two fundamental elements in working with young people are recognizing that they are diverse and that they have the intrinsic right to fully participate in designing, implementing, and evaluating the interventions that will affect their lives.  

Week 3

Objective:

Medical Barriers and Accessibility Issues                                  

Week 3 Summary:

The issues raised this week lead us to a difficult quandary about recommending condoms as a preferred method of contraception for youth. On the one hand it is true that condoms have the added benefit of providing some protection from STIs. But some reservations about recommending condoms follow:

  • It is not necessarily true that any particular youth is at higher risk of STIs simply because they are young. They may be in very stable faithful relationships.
  • Condoms are only effective in preventing pregnancy if they are used correctly and consistently. Unfortunately, that is not the case probably for most people and is probably even less likely for many youth.
  • The protection from STIs also depends to a large extent on correct and consistent use. Again this is a real constraint. Inconsistent use may provide little protection.

    Again this is a real constraint. Inconsistent use may provide little protection.
    Contraceptive method choice - both for youth and older people – depends a lot on the individual. Factors such as the need for effectiveness, the actual risk of STIs, and the realistic potential to use a method correctly are all very important. We do not do youth any favors with unrealistic expectations.


Week 4

Objective:

The ABCs of Pregnancy and HIV Prevention among Youth - Country Perspectives and Lessons Learned 

Week 4 Summary:

Our focus for the past week has been on the theme of the “ABC” approach to pregnancy and HIV prevention among youth, and we have been fortunate to have much participation and thoughtful responses, even if they have not always been of one accord (as you would expect from any difficult and challenging subject)!

Most forum participants who posted comments liked the “ABC” paradigm overall, for its recognition that there are a variety of behaviors that can either eliminate (A) or reduce exposure (B and C) to the sexual transmission of HIV/AIDS and STIs. Most also favored a comprehensive ABC message, while recognizing the need to tailor the message to the individual or group being targeted.


Post-forum survey results

N of surveys completed - 77

% who have passed content to others - 60%

% who have or will use in their work - 81%

% very satisfied with forum content - 64%

Suggestions for improvement:


  • Have a topics guide at the beginning, or ask members to contribute to what topics they think would be useful and include these in the discussion. 
  • A notice before the start of the forum is effective in doing some homework for the forum and this makes participation effective and useful.
  • Sometimes I found the discussion a bit repetitive, but overall it was useful and thought-provoking. I would like to have seen more of an exchange of experiences, rather than just a sharing of opinions.  
  • The discussions were very satisfactory though participants needed to be more focused in terms of making contributions that were relevant to each topic. I felt some responses were so general and not in line with topics that were made available for discussion.                                                               

Additional  quotes/comments

  • Very timely and important especially for rural teenage mothers who lack access to HIV/AIDS information and treatment possibilities.
  • I liked the setting the scene section by "experts" at the start of each week's discussion as well as their summary at the end. This helped frame the discussions in a way that I have not seen other list serves do. Suggest the same format be followed in future.
                                                              
References and resources

Click here to see community library/list of references

Organizing groups

YouthNet/Family Health International (FHI) and INFO Project based at Johns Hopkins Bloomberg’s School of Public Health’s Center for Communication Programs (JHU/CCP) with support from partners of the Implementing Best Practices (IBP) Initiative

Contributing experts/facilitators 

Mr. Ward Cates, President of the Institute for Family Health, Family Health International

Dr. Lynn Collins, MD, PhD, MPH, a Technical Adviser on HIV/AIDS at the United Nations Population Fund (UNFPA)

Dr. James D. Shelton, MD, MPH, Senior Medical Advisor, U S Agency for International Development

Other acknowledgements

Coordinators – Bill Finger of YouthNet/Family Health International (FHI) and Peggy D’Adamo of the INFO Project based at JHU/CCP

Technical Assistance – Anjali Sanghvi, INFO Project (JHU/CCP)

Editorial Assistance – Tara Kachgal, YouthNet consultant

Evaluation Assistance – Saori Ohkubo, INFO Project (JHU/CCP)

WHO/IBP Liaison – Lou Compernolle

Moderators

Ed Scholl, YouthNet/FHI