1. Youth, Difference and the Right to Education: Challenges and Opportunities in Reducing Vulnerability of Young People. Robert Carr Associate Director of Policy and Advocacy - ICASO International Council of AIDS Service Organizations

2. International Council of AIDS Service Organizations (ICASO)  Data  Roots Policy Conflicts  Stigma  Social Exclusion  Solutions

3. Global percentage of young people who have first sex before age 15, by sex 4.6 5 10 15 20 0 1998-20022003-2007 Year % MaleFemale Source: Measure DHS. International Council of AIDS Service Organizations (ICASO)

4. Russia 75 percent of new HIV infections by the end of 2007, were among young people aged 15 – 30. 66.2 percent of young women and men aged 15 – 24 could not correctly identify ways of preventing the sexual transmission of HIV and reject major misconceptions about HIV transmission.

5. Caribbean International Council of AIDS Service Organizations (ICASO)

6. Policy Conflicts Despite epidemiological evidence, the responses remain weak. International Council of AIDS Service Organizations (ICASO) Comprehensive knowledge of HIV among young people (ages 15–24), 1999–2007 1999–200320102004–2007 0 20 40 60 80 100 % Year Male Female 2005 Target 2010 Target Source: MEASURE DHS (2008) 4.3

7. Roots of policy conflicts? ChildhoodChildren Adolescence Adolescents Youth Competing & conflicting ideas International Council of AIDS Service Organizations (ICASO)

8. General agreement that … International Council of AIDS Service Organizations (ICASO) adolescence is a passage from childhood to youth we need to ensure ‘safe passage’ there are many opportunities, decisions & possibilities where life may go wrong

9. International Council of AIDS Service Organizations (ICASO) Moral response & judgment of premature fertility & drug addiction Moral response & judgment of premature fertility & drug addiction Human nature & the effect of providing information

10. Premature fertility International Council of AIDS Service Organizations (ICASO) Already a reality in many settings Outside or apart from pregnancy evidence in social debates indicates that society understands t hat young people are sexually active Opposite moral directions for boys and girls … the ‘studs’ and ‘sluts’ response

11. Drug Use International Council of AIDS Service Organizations (ICASO) Drugs are part of every society – some legal, some illegal Drug addiction is a clinical condition, with predisposing social and genetic factors People who use drugs or are addicted, have a ‘drug career’… eventually, most will simply stop of their own volition.

12. Important context for how people and systems react to youth who are prematurely fertile or addicted to drugs. International Council of AIDS Service Organizations (ICASO) Fear Stigma Image © IRIN

13. SPOILT DAMAGED IMMORAL UNCLEAN BAD INFLUENCE SPOILT DAMAGED IMMORAL UNCLEAN BAD INFLUENCE International Council of AIDS Service Organizations (ICASO) “ ”

14. Goffman (1963) …“spoilt identity” “Stigma and Discrimination” Stigma: Notes on the management of spoilt identity Abomination of the body Blemish of the individual character Membership of a despised social group International Council of AIDS Service Organizations (ICASO)

15. Das (2001) … in local moral worlds … including policies and programmes of larger social actors “Stigma, Contagion, Defect: Issues in the Anthropology of Public Health.” “Stigma and Discrimination” Contagion Defect Disability International Council of AIDS Service Organizations (ICASO)

16. HIV Prevention Pre-empts need for treatment Reduces risk, strengthens communities Makes communities less vulnerable Pre-empts need for further mitigation Treatment and Care Makes people less susceptible to infection Addressing the Impact on Human Development Strengthens systems for delivery and care Pre-empts need for future mitigation STIGMA HIV/AIDS: Implications for Poverty Reduction, UNDP 2001 International Council of AIDS Service Organizations (ICASO)

17. Public Policy Debates on HIV and Youth Education International Council of AIDS Service Organizations (ICASO) Providing information on condoms and sex, triggers sexual activity Providing information on drugs, triggers drug experimentation, leading to addiction These stymie programs for youth through established institutions: schools, church, family etc. So left to peers.

18. Out of School Youth International Council of AIDS Service Organizations (ICASO) POVERTY Already stigmatized, as predisposed environmentally. Often come from communities where teenage pregnancies and drug use are common. Often no sense of a meaningful future.

19. Out of School Youth International Council of AIDS Service Organizations (ICASO) Inequalities + neo-liberal strategies mean erosion of social safety nets. Failures in education and employment opportunities exacerbate disconnection from wider society. ‘Problems’, ‘misfits’, ‘troublemakers’ of whom society aught to be afraid of or disdain. Behavior of police, security forces and justice system, through incarceration and length of sentencing.

20. HIV Prevention Pre-empts need for treatment Reduces risk, strengthens communities Makes communities less vulnerable Pre-empts need for further mitigation Treatment and Care Makes people less susceptible to infection Addressing the Impact on Human Development Strengthens systems for delivery and care Pre-empts need for future mitigation SOCIAL EXCLUSION HIV/AIDS: Implications for Poverty Reduction, UNDP 2001 International Council of AIDS Service Organizations (ICASO)

21. Solutions Respect the rights of the child and young people Get past the myth that information leads to risky behavior and that ignorance or morality lectures are effective

22. International Council of AIDS Service Organizations (ICASO) IT’S A LOT MORE DIFFICULT THAN IT SOUNDS

23. Use an age-appropriate staggered approach to ways in which issues are discussed. International Council of AIDS Service Organizations (ICASO) BUT, always evaluate if intervention is working.

24. Appreciate that young people, like everyone else is embedded in family, community, society & global systems that shape youth realities, opportunities & choices. International Council of AIDS Service Organizations (ICASO)

25. The role of education & human development for all youth, including those who are stigmatized The role of education & human development for all youth, including those who are stigmatized International Council of AIDS Service Organizations (ICASO)

26. Education & Development International Council of AIDS Service Organizations (ICASO) Choices, freedoms and capabilities central to development Sexual & Reproductive Health and drug education build resilience when coupled with effective systemic interventions. Good governance means social inclusion and citizen rights of everyone, including young people.

27. The International Council of AIDS Service Organizations (ICASO) THANK YOU!

28. Individual Relationships (e.g. parents, sexual partners, sex work clients, drug use partners) Community and organisations ( e.g. leadership, networks, gender norms, social capital) Structural/Societal (e.g. cultural values, residence patterns, policies and laws) Reached through local gatekeepers, employers, educators, local government, kin groups, neighbours etc. Reached through political groups, lawmakers, religious leaders etc. Ecological models illustrate “levels” or “layers” of influence that affect individual opportunities and choices. Different stakeholders operate at these different “layers” and all must be reached using appropriate channels and activities in order to shift the barriers to universal access. Reached by and through individuals and their networks Nested Realities International Council of AIDS Service Organizations (ICASO)