Some people fear that educating young people about sex will encourage promiscuity. However, evidence shows that good-quality sex education can lower levels of sexual risk-taking and delay first sex. Sex education is most effective when given before young people begin their sexual lives. Well-planned sex education can help reduce the risk of contracting sexually transmitted infections, including HIV, and unwanted pregnancy.

While many boys and girls feel pressured to have sex, most are poorly informed about sexuality and reproduction. Parents need to talk more with their children about sex, sexuality and gender roles. Boys need to be taught that responsible sexual behaviour is a positive aspect of masculinity, and both boys and girls should be offered the chance to acquire the life skills needed to refuse sex or negotiate safer sex.

Apart from the family, there are other valuable sources of information and support for boys and girls. Teachers can provide information on pregnancy and sexually transmitted infections and help young people acquire useful life skills. Schools too can foster respect for all communities, equality between men and women and promote human rights.

Peer education can be an effective way of enabling frank discussions between people of similar age and backgrounds. Boys and girls can be trained as educators to inform and influence the behaviour of their peers.

Health care providers often require training to be able to discuss sexual health, HIV and life skills with boys and girls. An open and trusting relationship between doctors, nurses and young patients can be the beginning of building life long trust and communication -- the basis for medical care and support.

Men who are HIV-positive and are willing to speak openly about this can be a powerful force for change. From public figures such as Philly Lutaaya (a Ugandan singer), Freddie Mercury (a British singer), Magic Johnson (an American basketball player), Mr. Justice Edwin Cameron (a Judge of the High Court of South Africa) and Rudy Galindo (an American national figure skating champion) to unknown individuals living quietly but openly in towns and villages, men with HIV can and do lead fulfilling and exemplary lives.

Children and young people who do not attend school, who live on the streets or work from a tender age can be particularly vulnerable to HIV infection. Over a hundred million children, the majority of whom are from developing countries, lack access to primary education. They urgently need information on sexual health and HIV/AIDS and the skills with which to protect themselves from exploitation and abuse.

Ideas for Actions

• Train and support parents to talk to children about sex.
• Promote positive male role models in the youth media.
• Promote peer education, in a variety of settings, as a cost-effective and efficient means of education on sexual health and HIV education.
• Train boys and men as peer educators in life skills, sexual health, and AIDS education.
• Integrate life skills, sexual health and HIV/AIDS education into all curricula from primary school to tertiary education. Develop such programmes in consultation with parents, teachers and students.
• Ask people living with HIV/AIDS to talk to young people in schools and in community forums about their experiences of life before and after their HIV diagnosis.
• Train community workers to use techniques such as games and role-plays to teach young people about life skills, sexual health, and HIV/AIDS.

In addition to the violence that men perpetrate on each other, men inflict violence on women, some of it sexual. 35 studies from a variety of countries in Africa, Asia, Latin America, Europe and North America found that one-quarter to more than half of the women reported having been physically abused by a present or former partner. Sexually aggressive young men were themselves more likely to have been sexually abused, to have witnessed abuse of a family member, to have a sexually transmitted infection, and to have used drugs or alcohol.

Sexual violence may take place in relationships. A recent study in Northern India found that 46% of men reported abusing their wives, and that these men were more likely to engage in extramarital sex and have a sexually transmitted infection than non-abusive men.

Violence may also take place during dating. Studies among high school and college students in New Zealand and the United States. found that between 20 and 59 % of males and females said they had experienced physical aggression during a dating relationship. While nearly equal numbers of males and females reported that they had been subjected to violence, male violence against women tended to be more severe, and men tended to initiate this violence.

There are many difficulties in documenting sexual assault and violence by boys and men. People subjected to sexual violence are often afraid to report violations. Societal norms may portray sexual coercion as part of boys' normal sexual behaviour. For example, a widely publicized event in Kenya in 1991 in which 71 young women were raped and 19 died in a group attack from their male classmates, reportedly elicited the comment "boys will be boys".

Male violence drives the HIV epidemic in a number of ways. Rape and sexual abuse may place women and children at risk of contracting HIV. Sexual violence and mass migration are often the results of war, and not only are families split up, and husbands and wives separated, but in refugee camps and elsewhere women may become the subject of unwanted demands for sex, or may have to trade sex in order to survive. Innumerable instances of rape by members of the armed forces and paramilitary groups have been documented, and there is strong evidence that sexual violence, or the threat of it, is used as a means of terrorizing or subjugating both women and other men.

In addition to the possibility of HIV infection through sexual violence, other health consequences include physical injury, sexually transmitted infections and unwanted pregnancy. Some studies have shown that men and women who had been raped or forced to have sex during their childhood or adolescence were twice as likely to have multiple partners in a single year and to engage in casual sex. They were also four times as likely to be sex workers, and women who had been subjected to childhood sexual violence were twice as likely to be heavy consumers of alcohol and nearly three times as likely to become pregnant before the age of 18.

Young men are more frequently studied as perpetrators rather than as subjects of violence. However, some research shows that young men are also subjected to violence. And when they are allowed to do so, young men express their fear of the potential for violence within themselves, the threat of violence from other men and of the violence inflicted on them.

Ideas for Actions

• Develop programmes that offer young men constructive ways of resolving conflicts, developing their identities and expressing their emotions.
• Develop programmes that discuss violence within relationships or during dating.
• Highlight sexual violence as a cause of HIV transmission.
• Highlight the link between sexual violence and the future behaviour of people subjected to violence and their increased risk of HIV infection.
• Offer opportunities to discuss the violence boys witness and to reduce the stress and consequences associated with being a subject of violence.
• Establish programmes in settings where violent and delinquent behaviour by boys is prevalent and sensitize boys from an early age.
• Find ways of engaging young men positively in their community, family and peer groups.
• Educate parents, teachers, health personnel and other youth-serving professionals about the origins of violent behaviour among boys, helping them to effectively tackle the boys rather than responding in punitive ways.

• Men in prisons may contract HIV through shared injecting equipment, consensual or forced sex with other prisoners or staff (usually male) or with visitors from outside (usually female).
• Men in the military, who may have sex with a relatively small group of women -- a situation which encourages rapid transmission of HIV -- and/or who may have sex with other men may contract HIV. There have been reports from some countries of high rates of HIV infection among military forces.
• Sailors and fishermen who spend weeks or months at sea with sex workers popularly known as "hostesses".
• Men and boys who sell sex or exchange sex for food or shelter. Male sex workers
• Homeless boys who have sex with other street children or who exchange sex for a meal, a bed or some emotional comfort, no matter how transient.
• Mostly underage boys who drop out of school because of poverty and are often employed in jobs where the working conditions are harsh.
• Migrants who have sex with men or women as a means of alleviating loneliness and stress.
• Boys in care institutions or boarding schools who have forced or consensual sex with other boys or staff members.

Special settings offer special challenges that require suitable responses. For example, those in charge of such settings, e.g. military leaders, governors of prisoner, boat owners, etc., are often resistant to the idea of change. In situations where forced sex is common, it is practically impossible to institute safer sex. Nonetheless, persistence can pay dividends; innovative HIV prevention programmes are now in place in the Zambian armed forces, prisons in Ukraine and for male sex workers in Morocco, Costa Rica and Brazil.

Ideas for Actions

• Use the success stories about prison-based HIV interventions to explain to prison warders, administrators and the government that the provision of sterile injecting equipment and condoms have not posed a threat to the safety of prison warders.
• Initiate debate on the human rights of prisoners (i.e. recognizing that people are in jail for a crime and their incarceration should not jeopardize their rights to health, security of the person, equality before the law and freedom from inhuman and degrading treatment).
• Promote debate on the need for HIV prevention programmes in prison that are rooted in the realities of prison life.
• Facilitate interventions approved by prison administrators and government and run by community organizations inside prisons. These should be sensitive to the specific needs of prisoners and their sexual and drug-injecting partners both within and outside of prison. Promote safer sex and ration out sterile injecting equipment and condoms to inmates or provide them in places where people can pick them up in private.
• Provide treatment for sexually transmitted infections for prisoners alongside counselling and voluntary testing services, and regular encouragement to use the services.
• Explain safer sex and provide sterile injecting equipment and condoms to boys in institutional care either as a ration, or in places where people can pick them up in private.
• Provide treatment for sexually transmitted infections for boys in institutional care, alongside counselling and voluntary testing services with regular encouragement to use the services.
• Request high-ranking military officers to take charge of implementing HIV prevention programmes which address the specific risks faced by members of the armed forces, such as sex with sex workers, rape and sex between men.
• Promote condom distribution among soldiers as well as voluntary and confidential counselling and testing for HIV. For example, the United Nations recently decided to issue all its peacekeeping personnel with one condom per day.
• Undertake peer education in workplaces where young boys may frequently be found, such as motorcycle stands, construction sites, gas stations, etc.
• Translate HIV prevention material into the languages used by migrants and ethnic minorities, and distribute it to migrant organizations, health service providers, NGOs, lawyers and others who come into contact with illegal migrants.
• Promote outreach and peer education programmes for immigrants and ethnic minority communities.
• Institute or support already existing programmes or organizations which work with migrants, itinerant workers, male sex workers and the homeless to include HIV prevention, care and support within their work.
• Provide HIV-related information, health services and prevention materials to boys in boarding schools, alongside the opportunity to talk about sex, sexuality and drug use.