General Articles

UNICEF Report on the State of the World’s Children Emphasizes Need for Comprehensive HIV-Prevention

On December 9, UNICEF released The State of the World’s Children 2005: Childhood Under Threat. The report describes the many challenges facing children worldwide. UNICEF found significant advances in meeting the needs of children but warns that this recent progress is in danger of reversal. While acknowledging that the challenges facing the international community in promoting child welfare are interconnected, the report provides in-depth analysis of three critical challenges: poverty, armed conflict, and HIV/AIDS. "These are not the only factors that undermine childhood, but they are certainly among the most significant, with profoundly damaging effects on a child’s chances of survival and development after the early years of life."

In looking at the variety of ways in which HIV/AIDS negatively impacts the world’s children and proposing responses, UNICEF lists "limit[ing] the spread of AIDS through forthright national leadership, widespread public awareness and intensive prevention efforts" as a critical intervention to protect children. The report explains that programming that keeps adults HIV-negative stabilizes families and that preventing HIV infection in women of reproductive age is the most effective way to decrease the number of young children infected with HIV.2 Furthermore, to suggests that lack of comprehensive prevention efforts leads to ignorance, stigma, and discrimination, and "children orphaned or made vulnerable by the disease continue to pay a heavy price as a result."3

The report also notes that adolescents are in need of "proven techniques and interventions"4 for HIV prevention. AIDS is the leading cause of death worldwide for people aged 15 to 49.5 Despite the scale of this crisis among adolescents, knowledge of HIV/AIDS is woefully low. UNICEF measures the percentage of young women and men (15-24 years) who have "comprehensive knowledge" of HIV/AIDS. Comprehensive knowledge is defined as correctly identifying the two major ways of preventing the sexual transmission of HIV (using condoms and limiting sex to one faithful, uninfected partner), rejecting the two most common local misconceptions about HIV transmission, and understanding that a healthy-looking person can have the AIDS virus.6 Where AIDS awareness has been measured, knowledge has been found to be scarce. For example, in Haiti, 24 percent of young men and 14 percent of young women have a comprehensive knowledge of HIV. In Tanzania, 29 percent of young men and 26 percent of young women have comprehensive knowledge of HIV. Of young women in South Africa, only 20 percent have comprehensive knowledge of HIV (figures for boys are unavailable). In Uganda, which has garnered media attention worldwide for its HIV-prevention efforts, comprehensive knowledge of HIV is only at 40 percent for young men and 28 percent for young women. In Uzbekistan, merely 7 percent of young men and 8 percent of young women have comprehensive knowledge of HIV.7

In these countries and the world over, adolescents are more vulnerable than adults to HIV-infection. According to the report, "as a result, they need comprehensive sexual health education and services to reduce the risk of infection, as well as relationships with caring adults through schools and faith-based or community organizations."8 UNICEF cites "social taboos that foster a culture of silence around sex and the risk of HIV transmission" as contributing to the risk of HIV infection, particularly for women and girls.9

These young people need comprehensive information, but delivering comprehensive programs to young people remains one of the great challenges in the fight against HIV/AIDS. With adults falling ill and dying, many children are forced to adopt adult roles. They are often deprived of their ability to obtain an education, recognized as a right under international law.10 Preventing children from being in school perpetuates a cycle not only of poverty but also of ignorance about HIV/AIDS. Young people who are not in school are unlikely to "receive important, often life-saving information on how to avoid HIV infection or access treatment for HIV/AIDS."11

Like many aspects of the pandemic, access to education and HIV-prevention information has a gendered dynamic that disadvantages women and girls. Due to stereotyped gender roles, girls are often the first to withdraw from school. UNICEF emphasizes that, "women need to have access to the knowledge and tools that will help them protect themselves from becoming infected."12

The report concludes, in fighting the HIV/AIDS pandemic, "the greatest headway is made when young people are given all the information and encouragement they need to protect themselves and can participate in planning and implementing the programs that support them."13

View the complete UNICEF report The State of the World’s Children 2005.


  1. The State of the World’s Children 2005: Childhood Under Threat (New York: the United Nation’s Children’s Fund (UNICEF), 2004), 1, accessed 13 December 2004.
  2. Ibid, 74.
  3. Ibid, 82.
  4. Ibid, 83.
  5. Ibid, 68.
  6. Ibid, 120-121 Table 4.
  7. Ibid.
  8. Ibid, 74.
  9. Ibid, 70.
  10. Ibid, 69.
  11. Ibid, 71.
  12. Ibid.
  13. Ibid, 82.