To many, focusing on children and youth is associated with focusing on our future: "today's young people are tomorrow's adults". In matters of sexual and reproductive health (SRH), young people are often considered to be still "untouched", as they do not yet – or for many, at least aren't supposed to – engage in sexual activity.

At the same time, children and adolescents can be especially vulnerable to a wide range of SRH problems, including HIV/AIDS. Girls can be particularly vulnerable, as they are (often forced into) having sexual relations at a much earlier age than boys, leading to unwanted teenage pregnancies, sexually transmitted infections (STIs), including HIV and other physical or psychological trauma. Often, SRH problems have a strong and lasting impact on young people's lives: e.g., in many countries, pregnant girls are sent away from school, minimising their chances on the labour market and exacerbating their future dependence on men. Due to culture-based gender inequities, girls are often more vulnerable than boys.

Many children – boys and girls – become orphaned by AIDS, rendering them vulnerable and dependent on others in many ways: they lack income, access to education, food, housing, and become vulnerable themselves to sexual health problems, including sexual abuse and exploitation. Furthermore, SRH services are often not youth-friendly: as a result, young people have less access to information and education on sexuality, contraceptives, maternal and other reproductive health services.

Young people as agents of change

However, it would be wrong to over-emphasise young people's vulnerability: young people are often more open, more creative and flexible, and less hindered by prejudice and norms than adults. As they are less bound by established behavioural or social patterns, SRH programmes can have a greater impact among youth. Strengthening their sexual and reproductive health – above all – means working with the enormous potential young people have to become their own agents of change: rather than just working for young people, programmes should be developed and implemented with and by them. Rather than seeing youth as objects – a target group for interventions – they should be subjects of their own lives and sexuality.

Therefore, the key words for adolescent sexual and reproductive health are respect, autonomy and empowerment. At the same time, young people need a supportive physical, social and legal environment: access to youth-friendly services including sex education, legal protection from sexual abuse, social support and guidance on SRH matters and the right to be young in a safe environment.

This issue of the Exchange shows examples of how programmes from around the world work with young people to offer them opportunities to protect and promote their own sexual and reproductive health and lives through (peer) education, strengthening self-care and respect, training life-skills, providing access to youth-friendly services, and protection against violence and the impact of the AIDS epidemic. While the settings are different, they all share the belief that young people are our most valuable resource for the future.