Adolescence

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Gathering accurate data on adolescent abortions is almostimpossible given the level of secrecy and shame surroundingthe procedure, but the number has been estimated at1 million–4 million per year. 20 Many of the girls and womenwho seek abortions do so because they have had insufficientcontrol over their own fertility, whether because ofpoverty, ignorance, problems with male partners or lack ofaccess to contraception.HIV and AIDSHIV and AIDS are life-threatening challenges foradolescents in high-prevalence countriesPreventing the transmission of HIV is one of the most importantchallenges for adolescent survival and health. AlthoughAIDS is estimated to be only the eighth leading cause ofdeath among adolescents aged 15–19, and the sixth leadingcause among 10–14-year-olds, it takes a disproportionatelyhigh toll in high-prevalence countries. 21 It is the sheer scaleof the AIDS epidemic in Eastern and Southern Africa thatmakes this disease a prominent cause of death for womenaged 15–29 worldwide, as well as one of the leading causesof death for men in this age group. 22Many new HIV cases worldwide involve young people aged15–24. In four of the world’s seven regions, young femalesare more likely to be living with HIV than young males– around twice as likely. In Eastern and Southern Africancountries with adult HIV prevalence of 10 per cent or higher,prevalence among girls and women aged 15–24 is two tothree times higher than it is for their male peers. 23The risk of HIV infection is considerably higheramong adolescent girls than adolescent boysAdolescent girls are at far greater risk of contractingHIV than boys, as data from six countries in Eastern andSouthern Africa show. In Lesotho, for example, populationbased survey data show that HIV prevalence among malesaged 15–19 was around 2 per cent in 2004, compared with8 per cent for girls of the same age. The risks of HIV preva-Figure 2.5: Young males in late adolescence (15–19) are more likely to engage in higher risk sex than females of thesame age groupPercentage of young people aged 15–19 who had higher-risk sex with a non-marital, non-cohabitating partner inthe last 12 months in selected countriesSouth Africa9599Namibia849882Swaziland98Haiti7199Ukraine7096Guyana5996Kenya5698Moldova5494Lesotho5497United Republic49of Tanzania95Zambia4894UgandaDominican Republic44439496Malawi2992Central African Republic2883Zimbabwe2497Viet Nam 452FemaleCambodia 170MaleIndia 1630% 20 40 60 80 100Source: DHS, MICS and national surveys, 2003–2009.24THE STATE OF THE WORLD’S CHILDREN 2011
lence for both sexes continue to rise for the following twofive-year cohorts (20–24 years and 25–29 years). 24The higher incidence of the virus among girls and women isnot solely a result of their greater physiological susceptibility.In many settings, adolescent girls and young women face ahigh risk of sexual violence and rape, both inside and outsideof marriage. Child marriage, though often intended byfamilies to shield girls and young women from physical andsexual risks, often fails to protect them from HIV and othersexually transmitted diseases because condom use tends to belower in long-term relationships. Moreover, the available evidenceindicates that adolescent girls in child marriages, andwomen in general, have less say than their partners over theuse of contraception or over whether sex takes place at all.Enhancing HIV services and knowledge is essentialto empowering and protecting adolescentsInvestment in HIV prevention and treatment is criticalto reversing the spread of HIV in adolescence. Offeringadolescents and young people high-quality reproductivehealth services, and ensuring that they have sound knowledgeof sexually transmitted infections, empowers themin their choices and behaviours. Making such servicesand knowledge available in early adolescence, particularlyfor girls, is imperative; by late adolescence, the risk ofinfection for young people in high-prevalence countries isalready considerable.Encouragingly, efforts to enhance knowledge of HIV acrossthe developing world are beginning to bear fruit. Analysisof 11 developing countries with available trend data showsthat in 10 countries adolescent girls were more likely toknow where to go for an HIV test in the latter half of the2000s than they were in the early years of the decade. 25Testing remains low, however, among both sexes. Incontrast to testing, when it comes to comprehensiveknowledge about HIV prevention, adolescent males consistentlyedge ahead of their female counterparts; andclosing this divide is a particular challenge. For bothFigure 2.6: Young women in late adolescence (15–19) are more likely to seek an HIV test and receive their resultsthan young men of the same age groupPercentage of young people aged 15–19 years who have been tested for HIV in the last 12 months and received resultsin selected countries22Zambia10Kenya1813United Republicof Tanzania111514Malawi1113Namibia612Dominican Republic510Swaziland2Uganda59Guyana49Ukraine587South Africa5Moldova66ZimbabweHaiti3425Lesotho 13India212CambodiaFemale11MaleViet Nam 10% 5 10 15 20 25Source: DHS, MICS and national surveys, 2003–2009.realizing the rights of adolescents 25
Page 2 and 3: © United Nations Children’s Fund
Page 4 and 5: AcknowledgementsThis report was pro
Page 7 and 8: THE STATE OF THE WORLD’S CHILDREN
Page 9: GLobal challenges for adolescents 1
Page 12 and 13: large cohort of unemployed youth, w
Page 14 and 15: FOCUS ONEarly and late adolescenceR
Page 16 and 17: ment and active participation. Disa
Page 18 and 19: age at which individuals are legall
Page 20 and 21: the rights of adolescents or to pro
Page 22 and 23: The Convention was sufficiently ins
Page 24 and 25: Adolescents are often consideredthe
Page 26 and 27: HALLENGES ANDRealizing the rights o
Page 28 and 29: FOCUS ONDemographic trends for adol
Page 30 and 31: country are particularly serious, g
Page 34 and 35: sexes, there is still a considerabl
Page 36 and 37: PERSPECTIVEFacing the challenge:Rep
Page 38 and 39: FOCUS ONInequality in childhood and
Page 40 and 41: ADOLESCENT VOICESAct responsibly:Nu
Page 42 and 43: past decade, though not all of them
Page 44 and 45: Yet other initiatives against child
Page 46 and 47: PERSPECTIVEChernobyl 25 years later
Page 48: Adolescents are deeply concernedabo
Page 51 and 52: OPPORTUNITIESrisk of climate change
Page 53 and 54: Poverty, unemploymentand globalizat
Page 55 and 56: PERSPECTIVEThe effects of climate c
Page 57 and 58: high-level competencies that are in
Page 59 and 60: a window for possible economic deve
Page 61 and 62: ADOLESCENT VOICESReclaim Tijuana:Pu
Page 63 and 64: are exacerbating those risks, inclu
Page 65 and 66: sentencing wherever possible, inclu
Page 67 and 68: e stranded in poverty by conflict o
Page 70 and 71: HALLENGES ANDOver the course of the
Page 72 and 73: gated by age, disability, sex, ethn
Page 74 and 75: FOCUS ONPreparing adolescents for a
Page 76 and 77: the Ministry of Education, in colla
Page 78 and 79: exactly ‘youth participation’ l
Page 80 and 81: spaces as part of Aprendiz, the ‘
Page 82 and 83:
PERSPECTIVEAdolescent girls:The bes
Page 84 and 85:
ADOLESCENT VOICESFrom victims to ac
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ReferencesCHAPTER 11United Nations,
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19United Nations Children’s Fund,
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STATISTICAL TABLESEconomic and soci
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Under-five deaths (millions)Region
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STATISTICAL TABLESapproach is not t
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TABLE 1. BASIC INDICATORSCountries
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TABLE 1. BASIC INDICATORSUnder-5mor
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TABLE 2. NUTRITIONCountries and ter
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TABLE 2. NUTRITIONCountries and ter
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TABLE 3. HEALTHCountries and territ
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TABLE 3. HEALTH% of populationusing
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TABLE 4. HIV/AIDSCountries and terr
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TABLE 4. HIV/AIDSEstimatedadult HIV
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TABLE 5. EDUCATIONCountries and ter
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TABLE 5. EDUCATIONPrimary schoolNum
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TABLE 6. DEMOGRAPHIC INDICATORSCoun
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TABLE 6. DEMOGRAPHIC INDICATORSPopu
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TABLE 7. ECONOMIC INDICATORSCountri
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TABLE 7. ECONOMIC INDICATORSCountri
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TABLE 8. WOMENCountries andterritor
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TABLE 8. WOMENCountries andterritor
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TABLE 9. CHILD PROTECTIONChild labo
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TABLE 9. CHILD PROTECTIONChild labo
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Summary indicatorsAverages presente
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TABLE 10. THE RATE OF PROGRESSCount
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TABLE 10. THE RATE OF PROGRESSUnder
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TABLE 11. ADOLESCENTSCountries and
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TABLE 11. ADOLESCENTSAdolescents po
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TABLE 12. EQUITYCountries andterrit
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TABLE 12. EQUITYBirth registration
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AcronymsAIDSCEDAWDHSFGM/CGDPHIVIUCW
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United Nations Children’s Fund3 U
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Adolescence

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