1997_1_editorial

Sexual Health Exchange, 1997 - no. 1

Intermediaries for youth: a vital target audience

Throughout the world youth are recognized as a vital target audience for HIV/STD awareness and prevention campaigns. Rural young people, who often have less access to information and prevention tools than urban youth, may be particularly vulnerable to HIV/STD infection. They are variously referred to as the window of hope, the AIDS-free generation, tomorrow's future and so forth. Many initiatives have consequently been organized by NGOs, governments, churches and other organizations to assist youth. They focus on life skills, sexual and reproductive health and other areas as well as directly on HIV/AIDS. The Exchange covered programmes targeting youth in its third 1996 issue, highlighting the imaginative and varied initiatives taking place in selected countries.

971Editorial However, this is only one half of the picture. The other half is the needs of the different adults - parents and other relatives, guardians, teachers, church and youth leaders, social workers, etc. - who are in a position to influence youth. How may they be helped to undertake the critical role of intermediary, e.g., between HIV/AIDS interventions and other youth-oriented programmes? This issue of the Exchange aims to provide that balance by focusing on programmes assisting adults to become effective mediators with youth.

Who are intermediaries?

Young people's primary socialization takes place within the home, with parents a natural target to act as intermediaries with respect to their own children. Yet parents may be ill-equipped to discuss sex-related issues or, indeed, other sensitive and serious matters with each other or with their children. Such a dynamic may not exist in their routine discourse. "A Parent's Tale" illustrates how even a trained reproductive health adviser struggled to discuss sex with his own son. It is deeply erroneous to assume that parents can fulfil the role of educator, motivator or socializer around sexual behaviour and related disease prevention, merely with the provision of appropriate factual information. Pointers are given on the training and inputs actually required in successful parent-focused programmes; these are illustrated and discussed in several articles.

In addition, children are not necessarily brought up by their parents; some rarely, if ever, see them because their parents work away from home or for very long hours. Children may be raised by other relatives, aunts and uncles or even older siblings. Some are brought up by elderly grandparents for whom educating children and youth about sexual relationships in the modern changing world is out of the question.

Significant numbers of children have no parents and are in institutional care, in some form of community care (fostering, for example), or they may be on the streets. The adults with whom they have most contact may be threatening figures of authority who may be able to intimidate children and youth into acceptable behaviour but who are likely to fail dismally with regard to developing their life skills. The critical issue is not curbing risky behaviour through external control or threat, but helping youth develop self-esteem, life skills and the motivation to make their own responsible decisions and to keep themselves and others safe throughout their lives.

How to target intermediaries

How should intermediaries with youth be targeted to achieve this aim? Sensitivity is needed to the problems that block adults from discussing sex and related matters openly. Serious cultural taboos may exist; adults may never have discussed sex openly among themselves, let alone with young people. This "silence" undoubtedly is partly because sexuality is a complex issue; achievement of a satisfying sexual life and the ability to "negotiate" about sex cannot be taught as simply as, for example, driving a car. Adults may also have incorrect ideas, i.e., that information will lead to increased early sexual activity among young people. They then act on faith that ignorance is safer.

Open discussion among adults themselves should be facilitated to help them get beyond the embarrassment associated with discussing sex and to ensure they have accurate and appropriate information to communicate. Equally important is helping them develop communication skills to bridge the generation gap and get through to children and youth in meaningful ways. Parents and other adults need encouragement to respect young people as partners and as the adults and leaders of the future. This requires that they help youth develop skills through discussion and debate and in recognition of human rights.

Targeting adults as intermediaries with youth does not mean ignoring peer pressure. On the contrary, this approach often seeks to engage adults to reach youth who can become peer educators. In addition, the approach may be a productive way to reach adults themselves. Many parents and other adults set poor role models for youth regarding sexual norms and behaviour, as illustrated in the article related to sexual abuse in primary schools in Tanzania. The adage "Do as I say, not as I do" applies only too frequently. In engaging adults as intermediaries with youth, an indirect but highly significant benefit may be that adults with risky behaviour themselves become motivated to change. Often these may be adults who would not be readily reached through programmes directly targeting them. More research is needed into this area.

As HIV and AIDS continue to escalate in many areas of the world, finding more effective, sustainable and replicable approaches to reaching youth becomes ever more essential. The articles here highlight important research and illustrate a variety of programmes and strategies that have worked in diverse communities, ranging from the primary schools in Tanzania to Hispanic immigrants in Los Angeles and impoverished, high HIV seroprevalence communities in New York. They suggest lessons learned, ways forward, and pitfalls to avoid in new programmes that urgently need to be developed.