Under the influence of substances like alcohol and drugs, the risk of unsafe sexual activity is high especially among youth. A significant number of young people engage in sexual intercourse as well as drug and alcohol use at an early stage in their lives. In India, respondents observed, it is easier for youth to obtain prescription drugs than getting beer or other drugs. Reduced inhibitions lower the likelihood of safe sexual intercourse. Some studies says that youth are three times as likely to have sex that is unprotected when they are drunk, than when sober.
There have gaps identified in knowledge and beliefs about alcohol and drug abuse and HIV among youth. Adolescents are either ill informed or not well informed about their health, sexuality or physical well-being. Youth often engage in unsafe sex as they consider condom mainly for birth control, respondents mentioned.
The need to educate teens is enormous as they are more likely to experiment and risk. It is easier to prevent changing behaviour pattern than to modify conduct once it becomes a habit. So, HIV prevention programmes for youth must focus on alcohol abuse as well as other drug abuse and sexual risk behaviour. It is important to conduct a multi-centric research study with analysis of data including the public health sector. In addition, we need to look at these issues in context of demographic and typical geo-social conditions. Child Line India Foundation gives statistics of the drug abuse among children, as well as, details of the interventions to address the issues.
The socio-economic determinants have an impact over HIV prevention and control. As, in the transition phase or conflict between traditional and modern values, media can play a vital role. Therefore, while designing interventions, the socio-economic groups one is addressing, must be taken into consideration.
Attitudinal change is not easy to achieve, members stated. Experts have experienced that when youth discuss the issue, reflect on their concerns and vulnerabilities, they change their behaviour. When they understand that they have the capacity to stop the spread of HIV, they start taking action. A continuous effort to train and create awareness would be one of the strategies to consider, besides strengthening law enforcement and policy as well as setting up and implementing institutional mechanisms. Similarly, UNODC in India targets young people, taking to them information on drugs and the related risks of HIV.
Parents and teachers face deep-rooted cultural constraints in discussing these issues with children. Systematic training of teachers and parents on developing communication skills to discuss culturally sensitive topics with adolescents is required. Open interaction with children within the parameters of cultural norms can instil strong values and develop social skills, which in turn can minimize their risk of abusing drugs or contracting HIV.UNODC in an Asian Country adopted a two-pronged approach, training and creating peer network and IEC or BCC campaigns. It distributed CDs to those parents who were working or had little time to spend with their young children.
Expert suggestions to deal with issues of substance abuse and HIV in youth:
• Inculcating healthy behaviour in youth through importance of fitness, sports, nature loving helps them live most productively.
• Using innovative cultural and artistic input in peer-education is cost-effective.
• Avoidance of words and terms which are not in accordance with a sensitive approach towards people, especially when the 'community' is a primary stakeholder of the proposed intervention
• Inputs from IEC division of NACO and SACS on the subject
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