Youth not putting HIV prevention lessons into practice

First the good news. Young Liberians know about AIDS, how they might contract the disease and what they can do to protect themselves. Now the bad news. They are not putting that knowledge into practice. A study commissioned by the United Nations Children's Fund (UNICEF) found while nine out of 10 respondents knew HIV could spread through sexual intercourse, and six out of 10 knew a condom would protect them, only one in 10 used it the first time they had sex. "Despite high knowledge rates, the sexual practices of too many Liberian youths include high rates of unprotected sex," said Angela Kearney, UNICEF's representative for Liberia. "This contradiction is profoundly disturbing and requires all of us to redouble our efforts to effectively communicate with young people about the very real threat of HIV/AIDS," she added. Almost 1,500 children aged between 10 and 25 were surveyed across the West African nation whose health infrastructure is struggling to rebuild after 14 years of civil war, which sent professionals fleeing and left hospitals peppered by mortar rounds and bullets, and stripped of any equipment. Everyone agrees that the fight against HIV/AIDS is important in a country where the prevalence rate is estimated at 8.2 percent, according to the study. But Liberia is in such a ruined state that aid agencies and the government are having to focus on restoring the most basic of health facilities before thinking about rolling out testing centres and antiretroviral (ARV) drugs. The UNICEF study takes a look at the prevention side of the conundrum. Conscious of the fact that more than half of Liberia's population is aged under 18, it tries to pinpoint attitudes and knowledge about the disease. "Young persons should be a priority because they are at the centre of the HIV epidemic in terms of transmission, vulnerability, impact and potential for change," the study said. One of the main conclusions to emerge from the survey - carried out during the first five months of the year and published this week - is that work must be done on getting young people to use condoms. "There is an urgent need to use innovative tactics to promote both the male and female condom use among young persons," it said. "To be used widely, a specific brand of condom must fulfil three "Ps", namely price, place and promotion." Weak spots While the health experts praised the generally good level of understanding about HIV/AIDS nationwide, there were weak spots. In the northernmost county of Lofa, for example, more than a third of those surveyed said they had not heard of AIDS, whereas everyone in Montserrado county, which includes the coastal capital Monrovia, said they had heard of it.

"This may be due to the fact that this area was less accessible to NGOs working on HIV/AIDS prevention during the civil war," the study said. Lofa, a heavily-forested county wedged between Guinea and Sierra Leone, was nearly emptied of its civilian population during the latter years of the war, when it served as the headquarters for the main rebel group. "Priority attention must be given to citizens from this area when intervention programmes are being planned for young persons in the country," the study said. More than 80 percent of respondents nationwide said they would be willing to take an HIV test but that is easier said than done. Of the 30 voluntary testing centres operational since the end of civil war in 2003, all but one are in the capital Monrovia, according to the government-run National AIDS Control Programme. "Use of VCT (Voluntary Counselling and Testing) services needs to be promoted since many young persons had positive disposition towards it," the study said. But it is difficult for doctors to test people, if there are no drugs to offer them. "The government, together with its partners, needs to increase access to affordable ARV drugs," the report said. "Because ARV drugs are currently not readily available in the country, the promotion of VCT must be done with some caution." Another problem that came to light in the survey was discrimination against people living with HIV/AIDS, with some youngsters saying they should be "isolated, killed, or treated in AIDS camps". The report suggested that more training be offered not only to health workers, but also to traditional leaders, religious leaders and parents. It also advocated people living with AIDS be involved in education campaigns to reinforce the fact that HIV is an infection for which there is treatment.