‘putting the young person first’ means that not adult-determined priorities, but rather young people’s primary concerns and interest should lead the work.

Claire Maxwell and Deep Purkayastha

Throughout Asia, young people are increasingly recognised as being vulnerable to HIV and other poor sexual health outcomes. However, certain groups of youth find themselves especially vulnerable by virtue of their gender, age, sexuality and socio-economic circumstances. These include young women, young homeless people, young people who inject drugs, young sex workers, young men who have sex with men, and young people living in particularly impoverished circumstances.

In 1999, the UK Department for International Development (DfID) funded a major programme of research into young people’s sexual and reproductive health in poorer country settings. Coordinated jointly by the Centre for Sexual Health Research at the University of Southampton, the Thomas Coram Research Unit at the Institute of Education, University of London, and the Centre for Population Studies at the London School of Hygiene and Tropical Medicine, the Safe Passages to Adulthood Team have produced a number of best practice guides and publications that will be of interest and use to policy-makers, practitioners and researchers working in the field of sexual health and HIV. The publications offer others the opportunity to critically reflect on how to make their own services even more relevant to young people, while further increasing the impact their work can have.

Practitioners, policy-makers and researchers working with and supporting young people in challenging contexts across South and Southeast Asia may find the projects reviewed in HIV prevention with especially vulnerable young people - case studies of success and innovation useful. The case studies offer descriptions of how organisations developed good practice initiatives to meet the specific needs of their community, and include reflections on how good programmes of work need to develop and change over time. In developing this, the Safe Passages to Adulthood Team selected five projects working with young people living in contexts of special vulnerability from across the world: young people living in a slum community in Nairobi, Kenya, and, Lagos, Nigeria; young male sex workers in Buenos Aires, Argentina; injecting drug users in Tehran, Islamic Republic of Iran; and boys and young men living in a residential care home, West Bengal, India. Despite the geographical and organisational variation in the different projects five core principles emerged as forming the basis of successful programmes of work:

· Putting the young person first
· Promoting meaningful participation
· A commitment to rights
· Promoting gender equity
· Tackling risk and vulnerability

All of the projects used a ‘bottom up’ approach, ensuring young people were actively involved in helping to shape the type and delivery of services offered, and all remained flexible to ensure emerging needs could be incorporated into the programme of work. The research also found that ‘putting the young person first’ meant that not adult-determined priorities, but rather young people’s primary concerns and interest should lead the work.

To illustrate how some organisations implement these ‘principles into action’, this article will focus on the work of Praajak, a community organisation committed to promoting the rights of children, based in Kolkata, West Bengal, India. One of the projects Praajak ran is an initiative called the ‘Festival Wheel’, at a residential care home in West Bengal for boys and young men. The residential care home offered support, accommodation and education to 150 boys and young men, most of whom had previously been homeless.

The boys and young men would often arrive at the residential care home having experienced physical and sexual violence, either during their experiences of living with family, or while surviving on the streets. Drug dependency, untreated physical injuries, and difficulties in forming relationships of trust with others were all issues Praajak had to take into consideration when developing appropriate initiatives for promoting young people’s sexual health.

Given the background of most of the boys and young men Praajak worked with, the organisation decided the over-riding aim of their work should be to support the residents to reflect on their past experiences, and examine how the context in which they had grown up, as well as the current environment in which they were living, might have influenced their aspirations and the skills upon they could draw on during their transition to adulthood. Prajaak wanted to develop the young men’s communication and assertiveness skills; support them to gain a sense of personhood; increase their self-confidence; while offering them the opportunity take part in activities that were enjoyable and non-threatening. The time to reflect upon and explore what it could mean to be a ‘man’ was considered by Praajak to be central to meeting the broad needs of the boys and young men, as well as the more specific objective of promoting their sexual health. A further reason identified for the importance of examining gender identities and roles, was that many of the boys and young men appeared to have been involved in (sometimes sexually) abusive relationships with other residents. These types of ‘brotherly relationships’ (as the boys and residential care home categorised them) appeared many times to have started when the young men lived on the streets where several younger boys (bhai) would enter into a relationship with an older young man (dada) for the purposes of ‘protection’.

Working from the principle of ‘putting the young person first’ and due to the residential care home’s reluctance to tackle sexuality and sexual health issues openly, Praajak developed an initiative which engaged the young residents in discussing, writing and performing six to eight community shows, using the various festivals popular in West Bengal as the basis for their performances. Using the storylines and hero and demon characters, the workers found they could get the boys and young men to discuss, draw and act out how these ancient stories related to their own experiences and the kinds of ethical values they might wish to use in the way they lived. Praajak found that over time, the boys and young men developed a level of trust within the small groupwork settings used, which enabled them to discuss more personal experiences, as well as talk about subjects which they had previously felt were taboo or ‘unspeakable’.

Praajak’s commitment to ‘meaningful participation’ and young people’s ‘rights’ (as lain out in the United Nations Conventions on the Rights of the Child, 1989) led the organisation to also work with the young residents to develop a children’s council or Kumar Parishad at the home. Council members were drawn from all age groups and elected to represent the views of residents at the weekly home meetings. Staff at Praajak believed that their work on the ‘Festival Wheel’ programme had been crucial in fostering the boys’ and young men’s confidence and skills to participate in the Kumar Parishad. The residents’ council enabled the boys and young men to raise issues about the way the residential home was being run directly with the managers and staff, thereby facilitating the children and young people’s ability to lay claim to their ‘rights’. One of the issues the council members raised was the need for regular sessions on sexuality and tackling non-consensual sexual activity between residents within the home.

The wider research study by the Safe Passages to Adulthood Team on which this article draws, found that the projects visited were involved in HIV prevention and risk reduction work, but also had a strong focus on reducing vulnerability. Thus, while Praajak worked to explore issues related to sexuality and sexual health with the boys and young men, they did this under the broader aim of working to support the residents to become skilled and assertive citizens, who understood what impact their previous experiences had had on them, treat themselves and others with respect, and learn how to assert and claim their rights. To maximise the impact Praajak’s work could have, the organisation not only ran the ‘Festival Wheel’ programme, but also campaigning on behalf of the residents to the local government, increased the capacity of the home staff to meet residents’ wider needs, and supported the young men to develop their own voice through the children’s council.

¹The Safe Passages to Adulthood Team have published HIV prevention with especially vulnerable young people - case studies of success and innovation, and also a number of other guides and toolkits, whose focus includes: working with boys and young men; a new approach to undertaking needs assessments; developing HIV education initiatives in schools, out-of-school contexts and higher education; and tackling HIV stigma and discrimination. All resources are free and can be downloaded from www.safepassages.soton.ac.uk

Claire Maxwell is a Research Officer at the Thomas Coram Research Unit, Institute of Education, University of London. Her research interests include young people’s experiences of intimate and sexual relationships, sex education, sexual coercion, young women and agency, and international sexual health promotion initiatives.

Deep Purkayastha works for Praajak, in Kolkata, India. His area of work focuses on advocating for the rights of children and youth. He makes extensive use of art and theatre to address a wide range of issues including gender-based violence, crime and substance abuse among boys and young men.