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MTV EXCLUSIVE--AIDS Abroad: Young People Take Up the Challenge in the Hardest Hit Places Around the Globe
The HIV/AIDS epidemic continues to expand in many countries all over the world. Currently the fastest growing infection rate is in Eastern Europe and Central Asia. As in the Russian Federation and the Baltic States, Central Asian republics from Uzbekistan to Lithuania to Azerbaijan are experiencing an explosive rise in recorded HIV infections, with young people carrying the heaviest burden of new cases. Most of these are attributable to the widespread practice of injecting drugs.
In addition to the widespread use of intravenous drugs, evidence suggests that young people in Eastern Europe and Central Asia are becoming sexually active at earlier ages, and that premarital sex is generally on the rise. But perhaps surprisingly, given all the cultural and political changes in the recent history of these countries, information and openness about safer sex and the consequences of sexual decision making hasn't kept pace with these new trends. Awareness and knowledge about HIV/AIDS is pretty limited in many places-places where teenagers and young adults are engaging in dangerous behaviors like having unprotected sex and shooting drugs.
In an effort to educate and encourage young people to get the word out about safer sex and STD prevention in their own communities, the United Nations currently sponsors several international programs to promote Peer Education Training,. One recent training took place in Estonia from February 28-March 9. Serving as a facilitator and trainer was Jane Bogart, the Director of Health Promotion at NYU's Health Center and an Instructor at Columbia University. We asked Ms. Bogart to describe her experiences in Estonia, collaborating with young peer educators from countries throughout Central Asia so that more young people can have the power to protect themselves and make informed decisions about sex and HIV/AIDS.
Of the sixteen young people participating in the UNFPA (the United Nations Population Fund) meeting in Estonia, half were Russian speaking and half were English speaking; they ranged in age from 19 to 28. Some of the topics covered over the course of the week and a half included briefings on safer sex, HIV transmission and strategies for facilitating discussions among other young people.
Cultural Challenges Facing Young People
Discussing the spread of HIV/AIDS can be hard enough even in comparatively open cultures like our own, where issues related to sex and sexuality are discussed everywhere from primetime television to the dinner table. In comparison, as Ms. Bogart describes it, "sexual orientation is not talked about in many countries in the region-in some there's even a denial that HIV is a problem." The public stigma attached to talking openly about sexuality and sexually transmitted diseases is often intense, and poses a significant barrier to getting information to people that might save their lives.
Compounding the challenges of silence on these taboo subjects is the fact that treatment for HIV and AIDS is literally unavailable in many countries in Eastern Europe and Central Asia. This means that young people are often reluctant to speak up and voice their concerns and questions about HIV; with no possibility of treatment, there's not a lot of concrete incentive for getting tested or coming forward as HIV positive.
Two Different Epidemics - Youth at the Center of Both
The HIV epidemic in Eastern Europe and Central Asia is largely characterized by intravenous drug use, in a way that our American epidemic is not. (Though of course it's important to note that HIV infection through needles is still a significant part of the story in the U.S.) In the Russian Federation, up to 90% of reported infections have been attributed officially to injecting drug use, and those people injecting drugs can be as young as thirteen years old.
Safer sex supplies such as condoms, while generally available, are more expensive in this region than they are in the States. This poses a particular challenge for young people, who tend not to have a lot of spare cash, no matter where they live. And things like dental dams, which can reduce your risk for STD infection during oral sex, are extremely difficult to obtain.
While many young Americans who are advocates for people with HIV/AIDS, or who are HIV-positive themselves, are familiar with stigma associated with the disease, Ms. Bogart describes a level of verbal and occasionally physical harassment directed against young people working as advocates and educators in that region that surpasses what most have faced in the U.S.
The Good News
On a positive note, the young people are up for the challenge. According to Ms. Bogart, there is a hunger for knowledge and information among her young colleagues in Estonia, and a powerful eagerness to work hard to slow the spread of HIV in their communities. And as she noted, many young people there have active roles in the national governments of their countries, which suggests that the issues which concern young people today, specifically the spread of HIV, will have a real fighting chance of becoming policy priorities tomorrow-not just among advocacy groups, but among governments themselves.
 Interested in learning more about the HIV/AIDS epidemic in Eastern Europe, and its impact on young people? Check out Staying Alive
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