HIV/AIDS are becoming apparent, many national governments and international organizations have turned their attention to young people as key to defeating the pandemic. Because the issues surrounding HIV/AIDS deal with sensitive issues about what is appropriate for young people to know and to do, interventions are often highly controversial. Yet the effectiveness of various prevention strategies is not a political or moral question, but an empirical one. The evidence suggests that a combination of strategies—increasing knowledge of mechanisms of transmission and of the three principal means of preventing infection (abstinence, monogamy, and the use of condoms), providing youth-friendly services, promoting voluntary counseling and testing, providing diagnosis and treatment of sexually transmitted infections, implementing public education campaigns to reduce stigma, and creating safe and supportive environments—is more effective than any single strategy for reducing risky sexual behavior, the most important transmission mechanism in developing countries. Clearly, national policy strategies to reduce HIV/AIDS must have as an essential component a sustained information and prevention program that begins before puberty and continues through the transition to adulthood.


Some of the most important interventions to improve the reproductive health of young people may lie outside the health sector. For example, improvements in school quality, particularly those elements relating to the treatment of girls by their teachers, can have important reproductive health benefits.


The prevention of tobacco use among young people must be a priority for developing countries. This is an area in which much research in developed countries has been done and in which lessons learned could usefully be applied in developing countries. For example, increasing the price of cigarettes through taxes has been shown to be the most effective strategy for deterring young people from smoking.


The disparity in maternal risk between developing and developed countries can be reduced with appropriate interventions. The use of skilled attendants at delivery and access to emergency obstetric care for the treatment of pregnancy, delivery, and postpartum complications are key actions to reduce maternal health risks. Safe abortion in countries where it is legal and postabortion care everywhere are also essential components of maternal health programs. The provision of contraceptive services in the context of postpartum and postabortion care is an important means of increasing young women’s ability to space births and to avoid unwanted pregnancies.



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