It is no coincidence that young people are angry and speaking up on AIDS. They are among the most vulnerable to infection with HIV/AIDS. Each day 8,500 children and young people around the world are infected with HIV/AIDS.

HIV/AIDS is spread through behaviours that often take place in private, such as through unprotected sex (sex without a condom) and drug injecting with shared needles. It can also spread from a mother that has the HIV virus to her child during pregnancy, labour or through breast-feeding.

When a person becomes infected with HIV, it can take up to ten years before there are any signs of illness. These signs occur when the individual’s immune system breaks down and can be easily attacked by diseases common in the community. Because the symptoms, such as respiratory or skin infections, can be mistaken for other diseases or appear much later after exposure to the virus, HIV is invisible. The invisibility of HIV allows some people to question its existence. But HIV is real, and it is important to protect oneself, as everyone is at risk.

In addition to behaviors that put people at risk of HIV infection, there are social and economic factors that place some groups in society, such as young people, injecting drug users, homosexuals, and refugees, at even greater risk. Such factors and conditions include lack of education, lack of income-generating opportunities, cultural norms and practices that limit opportunities to benefit from social and economic development.

It is important to view the AIDS epidemic from these two perspectives – the behavioural risks and the social and economic environment – if we are to shape a broader response.

In the words of United Nations Secretary-General Kofi Annan, the "impact of AIDS is no less destructive than that of warfare itself, and by some measures, far worse." The area most severely affected by the epidemic is Sub-Saharan Africa, where most transmission occurs through unprotected sex between men and women. The impact of AIDS on African societies has reached such dramatic proportions that for the first time ever, in January 2000, the United Nations Security Council discussed a development issue – AIDS – in its meeting.

AIDS is ravaging the continent: the average lifespan in some African countries has gone down by 15 years; vast numbers of workers are unable to work, thus reducing productivity of many companies; family units are breaking down; and generations of orphans are raising themselves, often without education.

In Asia, the infection rates are not as high as in Africa, but they are alarming as well. The region has three of the most populous countries in the world – China, India, Indonesia -- and even low prevalence rates mean that huge numbers of people live with the virus. In India, Cambodia, and Myanmar, the epidemic is concentrated at critical levels in certain groups, such as injecting drug users and prostitutes. It is misleading to focus solely on the prevalence in the general population because it may just be a matter of time before infections begin to spread more widely.

In Latin America and the Caribbean, the AIDS epidemic is highly diverse. In some countries such as Honduras, Guatemala and Belize, countries on the Caribbean Coast and Brazil, most transmission is through sex between men and women. In Costa Rica and Mexico, however, most transmission is through drug users and through men who have sex with other men. Changes are, however, providing hope in the region: young Brazilian men between 16-25 report using condoms 87 per cent of the time with casual sex partners. Argentina, Brazil and Mexico are attempting to provide antiretroviral therapy (medicines that reduce the amount of virus in the blood) to all people in their countries infected with HIV.

In Eastern Europe and Central Asia, the epidemic took off with the rise of injecting drug use. In the countries of the former Soviet Union, the highest rates of HIV cases are heavily concentrated in injecting drug users (IDUs). An HIV outbreak can occur in any country with unsafe drug injecting practices.

In Europe and North America, new HIV infections are mainly concentrated among injecting drug users and gay men. Although needle exchange programs have proven highly effective in reducing transmission among drug users, countries such as the US have refused to implement them because of political opposition.

Countries that have shown commitment to facing AIDS have been able to reduce their burden significantly. In 1993, experts predicted that Thailand would have between two and four million cases of HIV by the year 2000. Thanks to full-scale prevention measures, Thailand had just under one million cases in the year 2000.

Uganda, with broad based political and community support was able to stabilize its epidemic at 8 per cent instead of joining its neighbours at over 20 per cent. There is hope when Governments make HIV a public issue by sponsoring TV, radio and print announcements, and when community groups, including people living with HIV are supported in their efforts. At the 13^th International AIDS Conference in Durban, South Africa, in June 2000, African leaders acknowledged their AIDS problem and joined hands with activists to intensify action against the silent disease.

As Governments begin to recognize AIDS as a development issue, they have become more proactive in their responses and in initiating expanded, multisectoral programes. Whereas the epidemic was initially viewed as strictly a health issue, more countries now realize its sociocultural, economic, and political relationships. Thus, in many countries, the full range of development sectors, such as education, labour, agriculture, local government, are being mobilized to include AIDS-related actions within their programmes. In addition, the role of civil society, notably non-governmental organizations, has been an important element in the expanded response, because of their capacity to engage communities in developing locally relevant activities.

Businesses are also mounting their response. Many have understood that they are losing their strongest workers to the disease, seriously affecting their business. Many companies now have AIDS programmes that include medical services for staff living with HIV, distribution of condoms, provision of AIDS education , and community outreach activities.

Another area that has been a source of hope has been for babies born to mothers with HIV. Treatments with a medicine called AZT given to a mother shortly prior to the birth of her child allow the risk of transmission from mother to child to be reduced by 50per cent. This means that women need to be tested to find out whether they are positive in order to protect their babies. Although in some countries such testing may increase their chances of receiving care and support, in others it may mean rejection by their families and communities.

The involvement of HIV-positive people in HIV/AIDS prevention and care programmes has become more visible in recent years. The principle of greater involvement of people living with HIV/AIDS or GIPA has become increasingly recognized as essential in the fight against the epidemic and must constantly be strengthened. Their experiences in meeting the challenges in prevention and care/support have inspired actions that have benefitted both those living with and affected by the epidemic, such as increased access to antiretroviral therapy and advocacy for non-discrimination of HIV-positive people.

Young people across the globe account for 50 per cent of all new HIV/AIDS infections each year. They are also the ones more open to talking about sex and taking concrete action to prevent HIV as peer educators. They have received information and training on HIV/AIDS and transmitted their knowledge to their peers at schools, social gatherings, sports clubs, etc. They have also acted as reporters for local newspapers, community trainers, and link doctors and young patients in health services, such as in clinics for sexually transmitted diseases.

An effective approach for young people has been through their role models, such as outstanding sports figures. Football teams exert pressure on team mates to protect themselves so that they can stay strong, and world known celebrities such as soccer star Ronaldo, have stepped up to tell players to "Play Safe!" All these actions are having desired results, with young people waiting longer to have sex and having safe sex when they do.