Hiv/Aids Awareness Forum For Youths - 'Youth, Sex, Hiv/Aids & Society'

27 Jan 2005

By Dr Mohamad Maliki Bin Osman, Parliamentary Secretary For Health

Venue: Spring Singapore Auditorium

Good Afternoon

John Vijayan Vasavan,PBM, Chairman of the Organising Committee & Immediate Past President

Mrs Alice Tay - Administrator of SPPA

Ladies and Gentlemen

INTRODUCTION

It is my pleasure to be here today at the HIV/AIDS awareness forum for youths.

On June 5th 1981, the US Centre for Disease Control published a report about 5 men in Los Angeles. These menyyyyyys immune systems appeared to have been destroyed by an unknown virus. The CDC often reported mysterious disease clusters - but the 5 men in this report turned out to be the forerunners of the most devastating epidemic of modern times - acquired immune deficiency syndrome - AIDS.

Over 20 million people have died since those first cases of AIDS were identified in 1981. More than twice that number live with the human immunodeficiency virus or HIV - and the number continues to grow. In 2004, close to 300 Singaporeans were found to be infected with HIV - this is a new high and presents an extremely worrying trend.

Between 1985 and October last year, a total of 2,232 Singaporeans were diagnosed as HIV infected. Of these, one in five were diagnosed when they were between 10 and 29 years of age. Even though the most common age at diagnosis was between 30 and 39, current information suggests that about two thirds of those who acquire HIV are likely to get infected before they reach 25 years of age.

YOUTH & VULNERABILITY TO HIV

The Asia-Pacific region is home to about 60% of the world's youth - close to 700 million young people aged between 15 and 24. Each year, there are about 300 million cases of sexually transmitted infections, which include HIV. About a 100 million of these cases involve people under 25.

The 2004 Report on the global AIDS epidemic states that young people between 15 and 24 years old account for nearly half of all new HIV infections worldwide. In some Eastern European countries, more than 80% of people living with HIV are under the age of 30.

Young people across the world are particularly vulnerable to HIV infection - there are many reasons for this. They may not have the necessary knowledge, life skills and information to protect them against HIV. On the other hand, they may have the requisite knowledge, know all the risk factors and yet go right ahead and take risks - indulging in casual sex, unprotected sex or intravenous drug use - after all, youth is often an age of experimentation. Youth is the age when we think, 'It won't happen to me'.

In the worst-hit countries, there is an additional burden on young people. As parents and older children fall victim to AIDS, an extraordinary load is placed on the younger family members. They not only have to take care of their ill family members but also have to find employment to support their family.

THE ROLE OF YOUNG PEOPLE IN THE FIGHT AGAINST HIV/AIDS

When talking about HIV/AIDS, young people are often placed in the high-risk category. However, to quote a speaker at the recent International AIDS conference in Bangkok - "young people are not only part of the HIV/AIDS problem but also part of the solution." He also said that, "young people are not only targets, but viable and absolutely necessary partners" in the fight against HIV/AIDS.

Young people - like all of you here today - are in a unique position to make important contributions in the fight against HIV/AIDS. Research suggests that people are more likely to listen to and internalise messages if they believe that the messenger is like them. (This is why parents often have to contend with reactions of "You don't understand" when dealing with their teenage children.)

When faced with problems, young people more often turn to their friends - whom they think face the same concerns and pressures - rather than to an adult. A survey of a group of NUS students some years ago revealed that they were most comfortable discussing sexual matters and AIDS with their friends. They very rarely discussed these matters with their family members. You are, therefore, key agents for influencing your peers in a positive way. Other young people will see you as a credible source of information and are likely to look to you as a role model.

KNOWLEDGE & INFORMATION - THE 1ST LINE OF DEFENCE

So, where do you start - all of you being here today is a promising beginning.

In the fight against AIDS, prevention is the best defence - knowledge and information are the first line of defence against AIDS. So, you should arm yourselves with the facts about HIV/AIDS - you need to be sure that the information you have is accurate and up-to-date, and know how to separate the facts from the myths or misconceptions.

What are some of the facts -

You need to know that there has been a progressive rise in new cases of HIV/AIDS, both in Singapore and world-wide.

You need to know that HIV infection is an unbiased disease - it can happen to anyone, regardless of social class, race, IQ, sexuality. HIV/AIDS can happen to you whether you are gay or straight. In Singapore, heterosexuals make up most of the new infections.

There are 4 main modes of transmission, which I'm sure you are all familiar with - sexual transmission, intravenous drug use involving the sharing of infected needles, blood transfusions and from mother to unborn baby or from nursing mother to baby. I urge you to find out more about each of these modes of transmission and to think about what measures you can take to protect yourself against HIV/AIDS.

Know what puts you at risk of getting infected. In Singapore, casual sex and sex with prostitutes remain the main mode of infection. Casual sex, unprotected sex, multiple partners - all these put you at risk of acquiring HIV infection. Being young and otherwise healthy DOES NOT protect you against HIV/AIDS if you choose to indulge in risky behaviour. There are young people like you who have been infected with HIV. You may have read about the Poly student who was infected with HIV. She had sex with only 1 person - her boyfriend, whom she trusted enough to have unprotected sex with.

As important as knowing how HIV is transmitted is knowing how it isn't transmitted. HIV is not spread by mosquitoes or casual contact such as shaking hands or hugging, it is not spread by dirty toilet seats or through food.

Next fact - people infected with HIV don't look any different from you or me, and there is NO cure for AIDS and there is NO vaccine to protect against HIV/AIDS.

There are many more facts about HIV/AIDS - you should read widely and find out all you can. Be careful, though, about where or whom you get your information from. The Internet has many excellent websites on HIV/AIDS - the UNAIDS site and the CDC one, for example - and closer to home, the Ministry of Health's, the Health Promotion Board's and the Action for AIDS' websites. For each reputable website there're many more not so good ones which contain incorrect information - about miracle cures or how certain rituals can protect you against HIV/AIDS. You need to be discerning and learn how to separate the good evidence or facts from those which are anecdotal or unproven.

TRANSLATING KNOWLEDGE INTO ACTION - THE NEXT LINE OF DEFENCE

The next line of defence after acquiring knowledge and information is using this information - how do you use this knowledge to protect yourself against AIDS. This means using the knowledge you have to make healthy choices and saying 'No' - to casual sex, to unprotected sex, to drugs - walking away from choices that put you at risk. You also need to equip yourselves with the skills to say NO to the pressures that exist around you. Anecdotally, we hear of the pressures that young people face with regard to sexual behaviours. Indeed, adolescence is the age where acceptance and affirmation from peers is of paramount importance. It is this pressure that I think we should capitalize on. Rather than be the potential victims of those who pressure you to be sexually active etc, why not be the "pressure group" or more suitably, support group, to help your peers to stay safe.

This is where, once you've got the facts down - and you believe in them - it is important that you 'walk the talk' - start being a role model for the young people around you - at your school or JC or poly, or at NS or your workplace.

Young people often behave a certain way because they think their friends are doing the same thing. For example, a U.S. study reported students in a particular school thinking that the majority of their friends and classmates were sexually active. However, an anonymous survey of the students showed that the actual number of sexually active students was very small. The most effective way to dispel misconceptions like this one would be to have young people like yourselves provide your peers with accurate information. You are a far more credible source of information when compared with adult educators because you can communicate in a way that is readily understandable to your peers.

Peer education does work - and can provide the support needed to develop healthy norms and to make healthy decisions. In the United States, for example, a peer education programme significantly improved HIV/AIDS knowledge and preventive behaviour. Before the programme, 44% of sexually active participants reported not using condoms, compared to 33% after the programme. In addition, reports of sex in the previous 2 weeks fell from 21% to 14% after the programme. Many other peer education programmes in other countries have reported similar successes.

AIDS EDUCATION PROGRAMMES IN SINGAPORE

There are several ongoing AIDS education programmes for youth in Singapore. The Health Promotion Board conducts and facilitates programmes at the various educational institutions. The objectives are threefold - firstly, to raise the level of awareness of AIDS and other sexually transmitted diseases, secondly, to inform youth on how to protect themselves against these infections and thirdly, to discourage promiscuous behaviour.

Information on AIDS and sexually transmitted diseases (STDs) is incorporated in the science syllabus for secondary school students and AIDS is also mentioned as one of the transmissible diseases in the primary school health education syllabus.

The Ministry of Education has developed a sexuality education programme for schools called "The Growing Years". Different packages have been developed for the different educational levels. This programme aims to provide knowledge on human sexuality as well as on AIDS and STDs, enabling students to develop healthy attitudes and make informed decisions.

As part of a mass outreach AIDS education programme, talks are conducted for all Secondary 3 students annually - these include discussions on STD and AIDS, premarital sex, the role of abstinence, and the importance of prevention - including the use of condoms to reduce risk of infection.

Different video programmes and print material have also been developed for students in the various institutions. These videos and print material are useful starting points for discussions on AIDS and its prevention.

In addition to targeting students at educational institutions, AIDS education programmes also reach young people at their workplaces and those doing National Service.

AIDS education and prevention targeting youth is also an important strategy of organisations like Action for AIDS. AfA has organised many good youth-centred programmes which some of you may have participated in.

This year, the Health Promotion Board together with partner agencies is carrying out a survey of tertiary students and their knowledge, attitudes and behaviour related to HIV/AIDS. The results from this survey will be presented to the tertiary institutions - the survey should provide useful information for the planning of further AIDS education and prevention programmes.

The above extensive list of programmes aim at reaching out to young people like yourselves. While the intent is noble, we must ensure that these programmes actually achieve their desired outcomes. To ensure this, we need your active involvement in designing them. HPB, MOH, and other agencies may have the content and knowledge. But you are in the best position to advise them on the process. You are the experts on how the programmes should be designed to attract the young people to participate in and benefit from.

In line with the government's call for young people to step forward and make a difference, I urge you to do so in this respect too. So far, the Health Promotion Board has worked with university student groups to organise programmes where the students are involved in the development and implementation of the activities - much like what you will be doing here later this afternoon. Certainly there is much more scope for young people to be involved in this effort. I encourage you to give your honest feedback to the sleuth of programmes that are currently presented to young people, and if need be suggest changes that need to be made to these programmes. I look forward to hearing your bold and innovative ideas.

CONCLUSION

In conclusion, it is important for young people to be actively involved not just as participants in AIDS education programmes but also for you to provide your input and ideas as to the types of programmes and educational material that you would like to see and find useful to meet your needs.

Do not underestimate the power of your influence on your peers in the fight against HIV/AIDS.

Most of you would have read or heard about treatment for HIV/AIDS - it is expensive, and does not provide a cure. Never more true is the old saying, prevention is better than cure - HIV/AIDS has no cure. The more effective prevention is, the fewer people will be in need of treatment.

I am happy that the SPPA has named AIDS as one of its key focus areas. Combating AIDS is a community effort - the Ministry of Health or the Health Promotion Board cannot fight AIDS or educate on AIDS on its own.

It is commendable that SPPA has organised this forum which I understand is one of the first of its kind. Thank you for inviting me. I wish you all a fruitful afternoon and look forward to hearing how you are going to make a difference.

Thank you.