ISSN 1363-8394<=
/i>
Journal of Adolescent =
Health
and Welfare
The Journal of the You=
th
Support
British Societ= y for Adolescent
Health and Wel= fare
Vo=
lume
14- No 2 –
Su=
mmer/Autumn
2001
In=
corporating
the Newsletter of the International Regional Chapter of the Society for
Adolescent Medicine=
![](3D"journal2001b_files/image015.gif")
Dear Colleagues,
As I put together this issue of the Jo=
urnal
world events are dominated by the terrorist tragedy in
It therefore seemed appropriate that we
should devote this issue of the journal to looking at some comments and wor=
ds
which resonate with this healing process. Our thoughts and sympathy are with
all those affected.
The pieces included are &=
#8211;
Check out our websites publications
www.youthsupport.net/YSBOOKS The journal is on line at
www.youthsupport.net/YSBOOKS/journal.htm Conference details are on
www.youthsupport.com Best wishes - &=
nbsp; Diana
Birch =
&nb=
sp; =
Director
Youth Support A comment from a young person who survived the tragedy.<=
/span> Youth Survives My name is Usman
Farman and I graduated from Bentley with a Fina=
nce
degree last May. I am 21 years old, turning 22 in October; I am Pakistani, =
and
I am Muslim. Until I’d like to share w=
ith you
what I went through that awful day, with the hopes that we can all stay str=
ong
together; through this tragedy of yet untold proportions. As I found out,
regardless of who we are, and where we come from, we only have each other.<=
/p>
I commute into the city e=
very
morning on the train from Had I taken the late trai=
n, or
gotten a bite to eat, I would have been 5 minutes late and walking over the
crosswalk. Had that happened, I would have been caught under a rain of fire=
and
debris, I wouldn’t be here talking to you. I’d be dead. I was in the lobby, and I=
heard
the first explosion; it didn’t register. They were doing construction
outside and I thought some scaffolding had fallen. I took the elevators up =
to
my office on the 27th floor. When I walked in, the whole place w=
as
empty. There were no alarms, no sprinklers, nothing. Our offices are, or ra=
ther,
were on the south side of building seven. We were close enough to the North=
and
My phone rang and I spoke=
with my
mother and told her that I was leaving, at that moment I saw an explosion r=
ip
out of the second building. I called my friend in I’ll spare the more
gruesome details of what I saw, those are things that no-one should ever ha=
ve
to see, and beyond human decency to describe. Those are things which will h=
aunt
me for the rest of my life, my heart goes out to
everyone who lost their lives that day, and those who survived with the pai=
nful
reminders of what once was. Acquaintances of mine who
made it out of the towers, only got out because 1000 people formed a human
chain to find their way out of the smoke. Everyone was a hero that day. Evacuation We were evacuated to the =
north
side of building 7. Still only 1 block from the towers.=
The security people told us to go north and not to look back. 5 city blocks
later I stopped and turned around to watch. With a thousand people staring,=
we
saw in shock as the first tower collapsed. No-one could believe it was happening, it is still all too-surreal to imagine. The=
next
thing I remember is that a dark cloud of glass and debris about 50 stories =
high
came tumbling towards us. I turned around and ra=
n as
fast as possible. I didn’t realize until yesterday that the reason
I’m still feeling so sore was that I fell down trying to get away. Wh=
at
happened next is why I came here to give this speech. I was on my back, facing =
this
massive cloud that was approaching, it must have been 600 feet off, everything was already dark. I normally wear a pendant
around my neck, inscribed with an Arabic prayer for safety; similar to the
cross. A hasidic Jewish man came up to me and h=
eld
the pendant in his hand, and looked at it. He read the Arabic out loud for a
second. What he said next, I will never forget. With a deep I finally stopped about 2=
0 blocks
away, and looked in horror as tower #2 came crashing down. Fear came over m=
e as
I realized that some people were evacuated to the streets below the towers.
Like I said before, no-one could have thought those buildings could collaps=
e.
We turned around and in shock and disbelief and began the trek to midtown. =
It
took me 3 hours to get to my sisters office at 3 avenue=
and We managed to get a ride =
to As the world continues to=
reel
from this tragedy, people in the streets are lashing out. Not far from my h=
ome,
a Pakistani woman was run over on purpose as she was crossing the parking l=
ot
to put groceries in her car. Her only fault? Tha=
t she
had her head covered and was wearing the traditional clothing of my homelan=
d. I
am afraid for my family’s well-being within our community. My older
sister is too scared to take the subway into work now. My 8 year old
sister’s school is under lockdown and armed watch by police. Violence only begets viol=
ence,
and by lashing out at each other in fear and hatred, we will become no bett=
er
than the faceless cowards who committed this atrocity. If it weren’t =
for
that man who helped me get up, I would most likely be in the hospital right
now, if not dead. Help came from the least expected place, and goes only to
show, that we are all in this together … regardless of race, religion=
, or
ethnicity. Those are principles that this country was founded on. Please take a moment to l=
ook at
the people sitting around you. Friends or strangers, In=
a time of crisis, you would want the nearest person to help you if you need=
ed
it. My help came from a man who I would never have thought would normally e=
ven
speak to me. Ask yourselves now how you can help those people in Brother take my hand My name is Usman
Farman and I graduated from Bentley with a Fina=
nce
degree last May. I am 21 years old, turning 22 in October; I am Pakistani, =
and
I am Muslim, and I too have been victimized by this awful tragedy. The next
time you feel angry about this, and perhaps want to retaliate in your own w=
ay,
please remember these words: <=
img
width=3D184 height=3D28 src=3D"journal2001b_files/image016.gif" v:shapes=3D=
"_x0000_s1175 _x0000_s1176 _x0000_s1177"> “Brother, if=
you
don’t mind, there is a cloud of glass coming at us, grab my hand, Resilience and A=
Butterfly * =
CONFERENCE ROUND UP * Our
conferences at the Royal College of Physicians in October 1996 and 1998 have
now both been published as proceedings books which are available – see
below. Get your personal copy now!! Proceedings of our conference 1996 Youth
- Our Resource for the Future Now available from Youth Support -£=
5 by
mail order – FAX 44 181 325 8647 or E mail us at Lisa@youthsupport.org Proceedings of our International conferen=
ce
October 1998 Youth – Conserving Our Resource for the Fu=
ture
<=
o:p> Available now from above address - £=
;8 Proceedings of our International conferen=
ce
October 2000 Youth – The Prom=
ise of
a new Millennium? Available now from above address - £=
;8 Sign up for London 2002 – www.youthsupport.com Working with what you have left On If you have ever been to a Perlman concert, you know that getting on stage is no=
small
achievement for him. He was stricken with polio as a child, and so he has
braces on both legs and walks with the aid of two crutches. To see him walk
across the stage one step at a time, painfully and slowly, is an awesome si=
ght.
He walks painfully, yet majestically, until he reaches his chair. Then he s=
its
down, slowly, puts his crutches on the floor, undoes the clasps on his legs,
tucks one foot back and extends the other foot forward. Then he bends down =
and
picks up the violin, puts it under his chin, nods to the conductor and proc=
eeds
to play. By now, the audience is used to this ri=
tual.
They sit quietly while he makes his way across the stage to his chair. They
remain reverently silent while he undoes the clasps on his legs. They wait
until he is ready to play. But this time, the night I was there,
something went wrong. Just as he finished the first few bars, one of the
strings on his violin broke. You could hear it snap -- it went off like gun=
fire
across the room. There was no mistaking what that sound meant. There was no
mistaking what he had to do. People who were there that night thought to
themselves "We figured that he would have to get up, put on the clasps
again, pick up the crutches and limp his way off stage -- to either find
another violin or else find another string for this one." But he didn't. Instead, he waited a moment, closed his=
eyes
and then signaled the conductor to begin again. The orchestra began, and he
played from where he had left off. And he played with such passion and such
power and such purity as they had never heard before. Of course, anyone knows that it is impo=
ssible
to play a symphonic work with just three strings. I know that, and you know
that, but that night Itzhak Perlman
refused to know that. You could see him modulating, changing, recomposing the piece in his head. At one point, it so=
unded
like he was de-tuning the strings to get new sounds from them that they had
never made before. When he finished, there was an awesome
silence in the room. And then people rose and cheered. There was an
extraordinary outburst of applause from every corner of the auditorium. We =
were
all on our feet, screaming and cheering, doing
everything we could to show how much we appreciated what he had done. He smiled, wiped the sweat from this br=
ow,
raised his bow to quiet us, and then he said -- not boastfully, but in a qu=
iet,
pensive, reverent tone, "You know, sometimes it is the artist's task to
find out how much music you can still make with what you have left." <=
o:p> What a powerful line that is. It has st=
ayed
in my mind ever since I heard it. And who knows? Perhaps that is the defini=
tion
of life -- not just for artists but for all of us. Here is a man who has
prepared all his life to make music on a violin of four strings, who, all o=
f a
sudden, in the middle of a concert, finds himself with only three strings; =
so
he makes music with three strings, and the music he made that night with ju=
st
three strings was more beautiful, more sacred, more memorable, than any tha=
t he
had ever made before, when he had four strings. So, perhaps our task in this shaky,
fast-changing, bewildering world in which we live is to make music, at first
with all that we have, and then, when that is no longer possible, to make m=
usic
with what we have left. Jack Riemer=
, -
International Chapter News - News
of the International Regional Chap=
ter
(IRC) of SAM (Society
for Adolescent Medicine) Working with What You Have Left poignantly apt at this time when so many are working with what they h=
ave
left after disasters such as the
![3Dimage](3D"journal2001b_files/image003.jpg")
A man found a cocoon for a butterfly. One day a small opening appeared, he =
sat
and watched the butterfly for several hours as it struggled to force its bo=
dy
through the little hole. Then it seemed to stop making any progress. It
appeared as if it had gotten as far as it could and could go no farther. Th=
en
the man decided to help the butterfly.
He took a pair of scissors and snipped the remaining bit of the cocoon. The
butterfly then emerged easily. Something was strange. The butterfly had a
swollen body and shriveled wings. The man continued to watch the butterfly
because he expected at any moment, the wings would enlarge and expand to be
able to support the body, which would contract in time. Neither
happened. In fact, the butterfly spent the rest of its life crawling
around with a swollen body and deformed wings. It was never able to fly.
What the man in his kindness and haste did not understand, was that the
restricting cocoon and the struggle required for the butterfly to get throu=
gh
the small opening of the cocoon are God’s way of forcing fluid from t=
he body
of the butterfly into its wings so that it would be ready for flight once it
achieved its freedom from the cocoon. Sometimes struggles are exactly what =
we
need in our life.
If God allowed us to go through all our life without any obstacles that wou=
ld
cripple us we would not be as strong as what we could have been. Not only t=
hat,
we could never fly.
Co Chairs - Diana Birch Gu= stavo Girard Treasure= r Aric Schichor
&=
nbsp;
&=
nbsp; =
Workshops SAM meeti=
ng
March 2001 Luncheon -
International Regional Chapter (IRC) SAM ‘Strengths of Youth – Protective Factors?’=
In this se=
ssion
we considered a variety of different challenges which Young People face in
growing up and entering adulthood. Rather than looking at the problems and
difficulties from the common perspective of the fate of those who have
‘fallen by the wayside’ we considered the positive attributes of
those who weather the storms of childhood and adolescence and emerge as
fulfilled and productive adults. ‘Strengths of Youth –
Protective Factors?’ Notes on the International Regional Chapter workshop 2001 During the workshop we consider a variety of different challenges
which Young People face in growing up and entering adulthood. Rather than looking at the problem=
s and
difficulties from the common perspective of the fate of those who have
‘fallen by the wayside’ we will consider the positive attribute=
s of
those who weather the storms of childhood and adolescence and emerge as
fulfilled and productive adults. Why do teens NOT become young mothers? Why do abused children NOT
follow the paths of the victim or allow themselves to be carried along the
‘cycle of abuse’ to harming their own kids? What factors help a
young person from a deprived or abusive background to avoid the fate which
statistics and professional experience would tend to commit to them. We will in the main be dealing with universal fa=
ctors
applicable to youth throughout the world-albeit influences by local cultures
and values. And lastly, but the most importantly - How can we enhance and
encourage these factors? How can we bring them to the fore in our less
fortunate kids? How can we utilize these strengths in helping youth as a wh=
ole
to survive the world, which we have created for them? Questions and General
Considerations Resil=
ience - Can we use another word? What do we mean? Coping skills / Are we lo=
oking
at survival – but quality of life important Inherent characteristics =
or
developed responses – Resilience to what? Regarded loosely as a universal panacea the “resilience̶=
1;
of youth, but basically you develop resilience by being knocked, resilience=
is
in relation to the assaults and problems in life. Just as our bodies develo=
ps
somatic strength from physical challenge, training, weight lifting etc. so =
our
psyche develops emotional strength from learning to survive hurt and
pain.– This sentiment is expressed in phrases such as “creating
opportunity out of challenge”
(psych – make use of your breakdown – make use of your
crisis) Is there a
‘passive’ and ‘active’ model? Is the process necessarily
positive? Is it desirable to be “emotionally strong” implying In order to develop emotionally one does not need to take this to
extremes, the child does not need to be abused, neglected or abandoned. The lower the ‘energy
level’ i.e. less able to adapt, lower resilience and flexibility R=
11;
the higher the passivity with more internalization of feelings – anger
hatred, lower self worth, lower coping skills and thus the more likelihood =
of
self hatred, self harming behaviors. Classic
view Bob Blum describes 8 risk behavi=
ors
for development of resilience - emotional distress, =
&nb=
sp; =
alcohol
use, suicidal thoughts and attempt &=
nbsp; marihuana
use. cigarette use, =
&nb=
sp; =
&nb=
sp; Violence
involvement, age of sexual debut or first intercours=
e and pregnancy. What are the things that are associated with protection?. Family f=
actors
connectedness with parent, Parent expectations. familie=
s
suicide attempts, family income, family structure, (family disconnectedness=
) School
factors + ve connectedness at least one adu=
lt who
cares and treated fairly in school. -ve Risk doing poorly at school, attention
problems on school, held back in school physically out of synch, early and =
late
maturers much high risk school failure is a maj=
or
public health problem. Individual factors wo=
rking
more than 20 hrs per week associated with every negative risk behavior. Looking at it from a different persp=
ective
– Coping mechanisms / Survival skills … =
Passive =
&nb=
sp; =
&nb=
sp; =
Active =
&nb=
sp;
………. =
® energy ®
………. Order &=
nbsp; =
&nb=
sp; =
&nb=
sp;
=
Chaos Retreat &=
nbsp; =
&nb=
sp; =
&nb=
sp; =
Action Status
quo =
&nb=
sp; =
&nb=
sp; =
Change =
‘Belonging’
– Feeling part of – Conventional =
&nb=
sp;
Unconventi=
onal
(find own group) =
=
&=
nbsp; &nbs=
p; =
Parenting From
parent =
&nb=
sp;
From other –Fagin type &=
nbsp; &nbs=
p; =
&nb=
sp;
From Child (including role reversals) Resilience
in practice – Richard
Mackenzie and his team from <=
/span> Jena =
Bauman,
MPH, is the HTCP Project Director. Facts=
- The &=
#8226; HTCP is funded by=
The
California Wellness Foundation as part of its ten-year teen pregnancy
prevention campaign -to reduce rates of teen pregnancy in &=
#8226; The division of
Adolescent Medicine at Children’s Hospital Los Angeles is the lead ag=
ency
for HTCP. &=
#8226; &=
#8226; Hollywood was cho=
sen
due to its status as a hot spot” for teen pregnancy and its demonstra=
ted
capacity to respond to this issue with organized community leadership,
commitment and involvement of public officials, agencies, businesses and ci=
vic
groups, and high quality services for youth and their families. &=
#8226; To reduce teen
pregnancy in 1. Young people must receive
comprehensive sexuality education and information that values healthy
adolescent sexuality (e.g. responsibility for own behavior, expressing love=
and
int 2. Teens must have access to and=
know
how to use family planning services and contraception. 3. Teens must have opportunities=
to
develop new skills and be exposed to expanded life options that allow them =
to
develop a vision for their future other than parenthood at an early age. 4. Teens must have adult and com=
munity
involvement and support (e.g. open lines of communication with adults about
healthy sexuality). &=
#8226; To accomplish the=
se key
changes, HTCP: ~Provides
education and information related to healthy sexuality ~Engages
adults and the community in teen pregnancy prevention activities and promot=
es
adult-youth communication about sexuality and decision-making ~
Increases access to family planning and contraceptives ~ Promotes opportunities =
to
motivate and expand life options for youth so youth can develop a vision for
their future other than parenthood at an early age. &=
#8226; HTCP is driven by=
the
commitment, hard work and vision of all sectors of the Hollywood community,
including youth and adult residents, schools, agencies, businesses, faith a=
nd
civic groups, and political officials. Tracy=
Levine,
MPH, is the HTCP Community Coordinator. Work
with Youth in =
FACTS: TEEN
PREGNANCY IN &=
#8226; &=
#8226; 83% of • 94%
of &=
#8226; 92% of adults thi=
nk
that information about how to talk to their children about sex education, t=
een
pregnancy, and family planning issues would be very useful &=
#8226; 86% of adults do =
not
know any places, classes or workshops for adults where they can learn about=
sex
and sexuality &=
#8226; 50% of teens have=
not
talked to their parents/caregivers about sex, birth control or pregnancy. Of
those who did, the teen was the one more likely to initiate the conversatio=
n &=
#8226; 92% of adults and=
94%
of teens believe that teens should be given information to protect themselv=
es
from pregnancy and STDs &=
#8226; 96% of adults and=
98%
of teens reported they believe children should receive age-appropriate
sexuality education in the schools &=
#8226; 96% of teens thin=
k sex
education should discourage teens from having sex, yet 95% of those teens a=
lso
think that sex education should encourage teens that are sexually active to=
use
protection to prevent pregnancy and disease &=
#8226; 61% of teens and =
70% of
adults do not know where to go, or where to send a teen for birth control
&=
#8226; Over 70% of adult=
s and
48% of teens do not know anyone they could ask, or any place a teen can go =
for
help in finding a job or choosing a career * Information from the There is a need to look at the individual and the population level
– the need to work on improving conditions in the community and
environment and at the same time to work with individuals The program is a community wide facility – on an individual lev=
el
it instills confidence in the youth and that is enhanced by youth sharing a=
nd
presenting in meetings such as this and to the media. Youth are involved by
‘working’ for the project, by becoming peer educators, by helpi=
ng
produce a magazine and being involved in youth theatre projects. We need to look at the entire environment and the whole community in
terms of considering the multiple contexts in which youth engage. The whole lives of the young peopl=
e need
to be taken into account rather than focusing on individual behaviors. Work can be with the individual and with the family or parents. Youth and adults can be brought to=
gether
by doing things and learning together – for example adults and youth
involved simultaneously in sexual education, learning about condom use and
overcoming barriers and embarrassment together. Often the programs act as catalysts for action. Monica
– Monica considered her life style and her
aspirations in relation to the experiences of her peers and friends who had
become pregnant and decided that this was not for her. She had younger sisters and wanted=
to
ensure that they had advice and services so that they also would be
protected. Monica found herse=
lf in
a situation where she could have joined a gang and gone on a different path
– but made a positive decision to avoid that and wanted to better
herself. She studied and got
herself computer literate and has been involved in the project and peer cou=
nseling. She had a vision for what she want=
ed out
of life and was not going to be diverted from this vision by the problems
around her – she had other ideas. Discussion - discussion of
Monica’s points centred on the need to be open and honest with teens =
and
allow them to achieve their potential.&nbs=
p;
Some have capacity to pull themselves out of difficult situations and
others need our support. But
without trust they cannot accept that support. Arlene
– aged 18 Her turning point was when she realized that her mother was unwell and
suddenly understood how severely her mother was affected – she realiz=
ed
that she had put her mother through a great deal of stress and that because=
of
her, mother had spent a birthday in court and had to put up with many hards=
hips
caused by her daughter’s behavior. It was at this point that she made a conscious decision to change and
could pinpoint the day that she made this change in 1998. She then became a good student, is
aiming at becoming a neuro-psychologist – like the one who treated her
mother. She is actively engag=
ed in
the program and is proud that she is not pregnant, she has goals in life, s=
he
is a peer educator and a leader and people look up to her – she chang=
ed
her life. Arlene showed she had the potential and ability to make positive chan=
ges
in her life. She believes in
herself. Discussion
focused on - What do we do for
teens who do not have the ability to make that decision for themselves? Question? Why did Monica decide not to join gang?=
What was the factor that made the
difference? She felt that her own goals were more important – that she want=
ed
to ‘make good’ and better herself to be able to ‘get
out’ of her environment to something better – gangs and such wo=
uld
detract from her goals and ideals which were too valuable for her. The question remains – how did she come to believe in those goa=
ls
and how can we foster them in others? For
Arlene – she became tou=
gh and
disruptive because she was bullied and so needed to be tough back -–t=
here
was an element of revenge in what she did – paying back and being tou=
gh
back. Comments
– intervention at this =
level
might vary depending on the level of family support. Do the youth have any support syst=
ems? Both
Monica and Arlene contribute to the magazine ‘UNITY’ UNITY Magazine: A • UNITY
is a publication of The Hollywo=
od
Teen Community Project at the division of Adolescent Medicine, ChildrenR=
17;s
Hospital Los Angeles. • UNITY magazine was envisioned, written =
and
designed by HTCP youth with support from volunteer community consultants and
HTCP staff. =
• UNITY s produced quarterly and is writt=
en by
and for =
• The UNITY mission=
statement, created by HTCP youth =
on =
We the y=
outh,
want to reflect the hearts and minds of our peers in this community. Through =
UNITY
magazine we want to pro vide youth with information dealing with life issues
like sex, drugs, school; work and families. We want to help people be
open-minded~ make healthy decisions, and understand how to maintain
self-respect and awareness. We are doing this because we care about the =
• The inaugural iss=
ue of
UNITY was launched =
• UNITY s disseminated free of charge, wi=
th an
anticipated circulation of 5,000. It has been
distributed widely in =
• The response to U=
NITY
has been overwhelmingly positive from community youth and adults, and from
local youth-serving agencies interested in receiving additional copies of
UNITYand getting involved with a UNlTY productio=
n. =
An Article by Monica An
Article by Arlene The following press state=
ment was
issued by the AAP in connection with a press conference on "AAP UPDAT=
ES
POLICY ON ADOLESCENT SUICIDE In 1997, there were 4,186
suicides among individuals ages 15 to 24 years o=
ld.
And a 1995 National Youth Risk Behavior Survey of students in grades 7 thro=
ugh
12 indicated that nearly one-fourth of students had seriously considered
attempting suicide during the 12 months preceding the survey, nearly 18 per=
cent
had made a specific plan and nearly 9 percent had made an attempt. Firearms
were used in 67 percent of all adolescent suicides and are the leading caus=
e of
death by suicide. The updated AAP policy, t=
o be
released at a news conference April 3 in Adolescents at high risk =
of
suicide often have a history of depression, previous suicide attempt, a fam=
ily
history of psychiatric disorders (especially depression and suicidal behavi=
or),
family disruption, and certain chronic or debilitating physical disorders or
psychiatric illness. Alcohol use has been associated with 50 percent of
suicides. While suicide affects young people of all races and socioeconomic
groups,15 to 19 year-old males have a suicide ra=
te six
times greater than females. Native American males had the highest suicide r=
ate;
African American females, the lowest. Homosexual and bisexual youth also ha=
ve a
high rate of suicide and attempted suicide. A statewide survey of students =
in
grades 7 through 12 indicated that 28.1 percent of bisexual and homosexual
males and 20.5 percent of bisexual and homosexual females had reported
attempting suicide. Pediatricians are urged to work closely with families a=
nd
health care professionals involved in the management and follow-up of those
youths at risk of suicide, or those who have already attempted suicide.&quo=
t; WHO report on Teenage Prosti=
tution. Sex trade expanding in=
Asia The Journal of Adolescent Health and Welfare is published by:- Youth Support, Tel
No 0181 325 8162 =
Charity No 296080 =
Fax No 0181 325 8647
Introduction
![](3D"journal2001b_files/image006.jpg")
![](3D"journal2001b_files/image008.jpg")
=
![](3D"journal2001b_files/image010.jpg")
![](3D"journal2001b_files/image017.jpg")
![](3D"journal2001b_files/image014.jpg")
A note on=
Teen
Suicide
13 August 2001
The sex trade is spreading from traditional red light areas to suburbs,
highways and international borders - wherever there is a high density or
movement of people. Often, this growth is not accompanied by rising AIDS
awareness. Indeed, it is believed that most commercial sex in
The report, presented in
Although substantial improvements have been noted in Cambodia (HIV infectio=
ns
level are decreasing among young sex workers) and Thailand, sex workers rem=
ain
highly vulnerable to HIV infection - in some urban areas in these countries=
as
well as in India and Myanmar, nearly half the sex workers are infected.
The report notes that most sex workers are unable to insist on condom use. =
This
is especially the case if they are victims of trafficking, migrants or are
young, which is all too common across Asia:
·There is a high demand for the young, with the premium age for sex
workers in Asia between 12 and 16. This partly reflects cultural norms as w=
omen
marry in their teens in many parts of
·In
·In
·A study in
Profitable business
Greater mobility and changing sexual attitudes and economies have led to the
sex trade expanding across
The spread of consumer cultures has had a dramatic impact, with sex becoming
increasingly commercialized. "As economies develop, more men have grea=
ter
spending power. They can spend this on commercial [sex]," the report
notes.
The huge resurgence of prostitution in
Although sex tourism is highly visible, particularly in
The domestic market is much larger but far less visible. Regular clients are
often men separated from their families - transport workers, seafarers,
soldiers, businessmen and migrants.
The industry is extremely profitable:
·In
·In
·Between 1993 and 1995, profits from the Thai sex industry were beli=
eved
to be three times as great as from the drugs trade.
Part-time work
The report notes that in all Asian countries, there is a clear move away fr=
om
direct sex work towards "indirect" prostitution, where selling se=
x is
a part-time occupation. Bars, fitness centres, clubs, massage parlours, kar=
aoke
bars, restaurants and hotels are now typical venues. Sex workers increasing=
ly
operate in private houses in suburbs, carry mobile phones and may themselve=
s be
mobile.
While many enter the trade because of economic hardship, a rising number se=
ll
sex because of relative deprivation - students, for example, may become
part-time sex workers to help fund their education. Many of these women do =
not
see themselves as sex workers or at high risk of HIV infection, and thus do=
not
use condoms.
Prevention efforts are made especially difficult because with sex work ille=
gal
in virtually all of the region, it is often clandestine and hidden, making =
it
difficult to disseminate condoms and advice about HIV/AIDS.
For more information, contact Mr Charles Raby, Public Information Office=
r at
(632) 528 9983 or email: rabyc@wpro.who.int