London School of Hygiene & Tropical Medicine

David Ross and a number of colleagues from within the School have been actively involved with colleagues in the World Health Organisation (WHO) and others in a UNAIDS Task Team on Young People review of HIV prevention interventions which was launched at the Toronto AIDS Conference yesterday.

Every day, 5-6000 young people aged 15-24 become infected with HIV, which adds up to 2 million new infections a year. In sub-Saharan Africa more than half of all new infections are among young people, with girls being particularly affected and, globally, 10 million of the estimated 40 million people with HIV are young people.

When national policy-makers, programme planners and donors are allocating limited resources for AIDS prevention, they need to know what works and what doesn't. To respond to this need, the UNAIDS Inter-agency Task Team on Young People supported a review of the effectiveness of interventions among young people in developing countries, the results of which are published in the WHO Technical Report Series No. 938 entitled Preventing HIV/AIDS in young people: a systematic review of the evidence from developing countries.

The authors reviewed the evidence from 80 studies of interventions delivered through the major settings which reach young people - schools, health services, the mass media, geographically-defined communities, as well as strategies to reach young people who are most at risk, such as young sex workers, drug users, and men who have sex with men.

The interventions were then grouped into three classifications - GO!, Ready, and Steady, a system which was aimed at making it easier for those with responsibility for funding, developing or researching HIV prevention strategies to reach informed decisions. GO! means that the evidence for this type of intervention was considered strong enough to recommend that it should be implemented widely; Ready means that the there was positive evidence for the effectiveness of this type of intervention and it should be implemented, as long as it is accompanied by further evaluation; Steady means some of the evidence is promising but there needs to be further development, pilot-testing and evaluation before this type of intervention should be widely implemented.

The authors write: 'The choices that face policy-makers and programme managers are complex. Not only do they need to consider different settings and different population groups, but also within each of these settings they need to choose between several types of interventions. It is hoped that these reviews will go some way towards facilitating these difficult decisions'.

They add: 'Acting on the recommendations of this review will have a significant impact on preventing the transmission of HIV among young people, which in turn will have wide-ranging implications for the health and development of individuals, families, communities and countries around the world'.

David Ross is one of the guest speakers at the launch event, which also includes representatives from the Ministry of Health of Thailand, the Global Youth Coalition, the Asia Pacific Network of PLWHA, UNAIDS, and UNFPA. It will be Chaired by Joy Phumaphi, Assistant Director General of WHO.