The theme for International Youth Day 2021 is; “Transforming Food Systems: Youth Innovation for Human and Planetary Health”, which highlights that the success of such a global effort will not be achieved without the meaningful participation of young people. This day is celebrated on the 12th of August each year. This year, events to celebrate International Youth Day 2021 will take place all around the world through youth education, engagement, innovation and entrepreneurial solutions.
In Eswatini, the high level of youth unemployment is reported at over 65% within this population, with limited opportunities to develop skills, limited tertiary institutions to absorb all the children and virtually few technical skill facilities in the country, all together force youth to a world with no opportunities to advance themselves. Even for those youth who have been lucky to attain tertiary education, there are increasingly more and more graduates at home with no jobs or opportunities to use their skills to contribute to the development of the country.
Due to these factors, youth and adolescents are forced to travel to foreign lands where they are met with various challenges which increase their vulnerability to HIV. And despite all the HIV prevention efforts across our countries, the level of knowledge, awareness and attitude towards safe sex, among the youth, about HIV and AIDS, is below satisfactory. The lack of job opportunities coupled with the propensity to find employment often forces females to take up sex work as a profession and thus placing them at high risk of HIV. This further increases the risk of perilous and unprotected sex in paid intercourse or transactional sex.
Young men on the other hand elevate their vulnerability by indulging in risky behaviours like alcohol, casual and commercial sex under the influence of peer pressure or in order to find an alternative support outside the family. Many youth initiate sexual activity in their adolescence and engage in sexual risk behaviors that can result in getting HIV, sexually transmitted infections (STIs), and/or becoming pregnant. In addition to risk behaviors, there are a number of environmental and structural factors that put youth at higher risk for getting HIV.
Due to the lockdown and unprecedented closure of schools in March last year, Eswatini experienced the most alarming outcomes of Sexual Reproductive Health as we recorded high rates of unplanned pregnancies amongst adolescent girls. This also presented with it a high prevalence of sexually transmitted infection and new HIV infections amongst girls. Without a doubt, such challenges might force young women and adolescents to flee their homes in fear of stigma and discrimination for falling pregnant prematurely.
This also enhances their vulnerability, as in fear of identification, stigma and discrimination, they do not go for treatment or testing even when their health is compromised by these risky situations.
It is therefore clear that poor SRH outcomes are heightened among girls and women, many of whom are pressured into risky decisions for their survival, while having limited choices and sexual and reproductive rights. This presents the need to put in place mechanisms to ensure the availability of combined SRH and ART services when youth are faced with such challenges. This would mainly assist People Living with HIV, who end up defaulting on ART with nobody to follow them up.
What Puts Youth at Risk for HIV?
Youth who engage in specific behaviours are at higher risk for getting HIV. The following are ways that youth are currently engaging in high-risk behaviours:
- Low rates of condom use. The recency survey is proof that high school students reporting sexual intercourse in the previous 3 months did not use a condom.
- Substance use/abuse and sex. Youth who engage in substance abuse such as alcohol or use drugs before sex are more likely to engage in risky sexual behaviour which exposes them to HIV acquisition.
- Multiple sexual partners. Most teenagers do not have multiple sexual partners at one time. Instead they may have multiple sequential partners which can, in turn, put them at higher risk for getting HIV.
- Low perception of risk. Youth have a low perception of risk for getting HIV and therefore may not feel the need to protect themselves.
- Older partners. Young women are more likely to choose older sex partners than those of their own age for various gains, and yet older partners are more likely to be infected with HIV.
- High rates of STIs. Having an STI puts youth at higher risk of getting and transmitting HIV.
That said, there are many ways youth can reduce their risk for getting HIV, such as:
- Talking with their partners about STIs and HIV
- Getting tested with their partner before initiating sexual activity
- Using condoms before engaging in sexual activity
- Becoming informed about the risks associated with different types of sexual activity and how to use protection
As a country we celebrate the achievements Eswatini has made as the only country in Africa to reach the 95-95-95 target much earlier than the set global target of 2030. However, this achievement places a challenge for galvanised effort for all EmaSwati in order to uphold this milestone and not regress .Central to retaining this milestone is ensuring access to HIV services.
Young people should be given proper knowledge on how to protect themselves from HIV. This involves the use of new technologies to break new ground on how best we can reach critical populations to provide HIV information on mobile devices and smartphones in a quest to address issues of stigma and misconceptions about HIV, as well as dealing with feelings of isolation that could lead to risky behaviours among the youth and adolescents.