Twenty-five years after the implementation of the first prevention programs against AIDS, the number of infections is still constantly on the rise despite the funneling of millions of dollars into numerous prevention programs. In 2003 alone, infection rates reached an unprecedented number of 5 million in the world. (UNAIDS 2004 Report on the global AIDS epidemic) Young adults and adults are the most affected category in the world and in the United States of America. According to the Centers for Disease Control and Prevention (CDC), about 40,000 people contract HIV/AIDS every year. In 2002, the number of infections was up to 42,000. Nearly half of the new infections occur among people aged between 13 and 19. People aged between 19 and 34 represent nearly 40 percent of AIDS cases in the United States. (CDC Surveillance Report 2001 Vol. 13, No. 2). Existing prevention programs have proven to be unsuccessful. They have led to increases in infection numbers especially among youth. This ineffectiveness urges us, as authorities like Edward C. Green suggest, to rethink AIDS prevention for the population in general and for youth more specifically given the devastation of the scourge in this group and the importance of the group for the future of the country and the world.

Despite the variety of reasons advanced to explain the inefficiency of existing prevention endeavors, the ineptitude stems more from the thinking behind the programs than in the application of those programs. The failure reveals lacks or flaws in the crafting of prevention programs. Given the existence of numerous programs, one can hardly make a case for a lack of thinking. This leaves us with flaws in the thinking process and the design of those programs. The challenge is how to create effective AIDS prevention for the youth, one that not only stops the infection of millions of youths but also helps them find fulfillment and happiness in life. The question of effective AIDS prevention goes beyond simple precautionary measures that disappear as soon as the danger seems manageable. The question equally goes beyond the embrace of behavioral patterns, which are quickly reversed when the fear that engendered them no longer exists, as is the case in many parts of the world. Effective AIDS prevention, especially for youth ought to help them resolve the paradoxes they encounter in their growth and development process. It must also open windows and opportunities to dream and actualize those dreams in their search for fulfillment and happiness. The crafting of effective AIDS prevention for youth has three main requirements. The first requirement is the understanding of the developmental needs and issues of older teenagers and young adults. The second requirement is the existence of solid theoretical foundations. The last requirement is the provision or creation of adequate context and prevention approach.

Understanding the Developmental Needs and Issues of Older Teenagers and Young Adults

As trivial as it may sound, the molding of successful AIDS prevention for youth and for any group requires a profound understanding of the characteristics, needs and issues of such as group. Existing prevention programs, researchers like Green argue, are largely incompatible with the groups they target. In their attempt to better understand the development of human beings in general, developmental psychologists organized their study of human beings in various groups and stages, including toddlers, children, young and older teenagers, young adults, adults and senior citizens. Our discourse focuses on older teenagers aged between 15 and 18, and on young adulthood, which refers to the group aged between 18 and 35 years. For the sake of clarity we will refer to both groups as young adults. Young adulthood is a generic expression referring to two or three successive periods in human life. The first period is a transitional period otherwise known as the "exploring period." It covers the last years of adolescence and entering in adulthood (between 18 through 25 years old). The second stage is called the "pioneering" stage and is made up of people in their mid-twenties. The last category, termed "householding", made up of people in the early thirties, because of its tendency toward settlement, family building, job securing and more responsible attitude in the community. (Robert Gribbon, Developing Faith in Young Adults. NY: The Alban Publication, 1992 p. 1-15). Young adulthood is said to be sensitive to the zeitgeist, the general intellectual, moral and cultural state of its era as this is a period of exploration, passion, discovery and adventure. As young adults grow and develop, they face many challenges in affirming their individuality and in building a personality. They have expressed and unexpressed needs. They are confronted with needs and issues more or less understood by their environment. Those needs are known in social sciences as psycho-social needs and issues.

Psycho-social Needs and Issues

Any existing being has needs that ought to be satisfied in order to guarantee its survival and proper development. Those needs are known as psychogenic needs. They originate from the mind and reflect mental and emotional conflicts in human life and experience. Young adult regardless of their contexts have both issues and needs. The issues are psycho behavioral and the needs are cognitive and intellectual.

Psycho-behavioral Issues

Young adulthood is both a period of crises and paradoxes. As they grow, young adults encounter two main crises. Eric Eriksson summarizes in the "identity and identity confusion crisis" and the "intimacy and isolation crisis". The first crisis manifests itself through the search for understanding of oneself, the fostering of one's inner dispositions and their assertions. Young people strive to achieve a certain degree of independence and autonomy, putting order in their lives and discovering their true selves. They sort out the various characters that emerge and cultivate them. Lee Steele puts it well, when he says that, "Whereas adolescents are gathering the raw materials for framing the identity, young adults are putting on the finishing touch." (Lee Steele "Psychological Characteristics of Young Adults") In this search for identity, young adults question everything, any kind of authority that has been guiding them so far. Pushed to the extreme, they revolt and reject old patterns of thought and behavior. The young adult tends to look for more autonomy and independence of thought and action. The identity crisis often takes the form of "authority crisis." The young person begins to doubt the authority of his father; if he is religious, he may doubt the religious authorities. Through this crisis, the young adult expresses the need for self-affirmation. This is a logical outcome of a differentiation process, which demands of him/her that s/he separate from others and develop his/her individuality. The young person faces a tension between the emerging self, the family and the community within which s/he has so far been immersed. In short the identity and identity confusion covers two needs, the need for individuation and the need for self-affirmation.

The second crisis, the intimacy and isolation crisis manifest itself through the young person's capacity to attach him/herself to others and groups. Most importantly, s/he fosters relationships with the opposite sex. This development carries with it a certain apprehension, namely the fear of losing one's identity. Through this involvement, the young adult experiences new feelings and values such as loyalty, fidelity, trust and others that are relevant to his/her personality. This crisis is better understood through Scott Peck's "ego boundary and love concept." The individual is confined in his/her world. At the same time, s/he seeks to expand him/herself through the need to associate with others, the need to love and be loved. This push is a push toward self-expansion. As the individual seeks to extend him/herself, s/he faces two uncomfortable risks, the risk of losing him/herself and the risk of backsliding into dependence. S/he is afraid of the uncertain and the change. Explaining this dynamic, Scott Peck contends that

When we extend ourselves, our self enters new and unfamiliar territory, so to speak. Our selves become a new and different self. We do things we are not accustomed to do. We change. The experience of change, of unaccustomed activity, of being on unfamiliar ground, of doing things differently is frightening. It always was and always will be... Courage is not the absence of fear; it is the making of action in spite of fear, the moving out against the resistance engendered by fear into the unknown and into the future. On some level, spiritual growth, and therefore love always requires courage and involves risk. (Scott Peck, the Road Less Traveled, p. 85-138)

As s/he enters the sphere of relationships, be it with his/her parents, his/her siblings and his/her partner, the young adult is afraid of losing an identity s/he strove so hard to achieve. S/he is afraid of depending on his/her friend, on his/her parents, on his/her partner. S/he is afraid of taking risk, the risk to be hurt and the uncertainty accompanying it, that is the inability to connect again. The intimacy-isolation crisis reflects the need for connectedness without diluting oneself in the "mob" or in one's partner. It is the reflection of the dilemma of unity and separateness. It is the need to actualize love and love relationships.

Intellectual and cognitive needs

Young adults experience three needs pertaining to knowledge, morals, ethics and faith. Those conflicts are summarized in the words of young adults by two peers, William Mahedi and Janet Bernadi in "A Generation Alone" (p. 59):

We all have a primal intuition into the nature of reality. We know innately, instinctively, without recourse to reasoning or deduction, 'the way things really are.' This primal intuition is the foundation for our attitude and beliefs about everything. It is acquired simply by living. Though it can be altered throughout life, the experiences of childhood and youth are decisive.

Jean Piaget, Lawrence Kohlberg and Sharon Parks all note that on the intellectual and cognitive level, the young adult develops the ability to think abstractly and to make sound decisions. By age 18, the young adult has the mental stimulation that opens him to new ideas and thoughts. By the late twenties, and early thirties, he moves from authority bound, to relativism before establishing a clear conviction and commitment. This result depends mainly on two factors, the individuals and the environment that surround him. Sharon Parks explains that the young adult undergoes intellectually what William Perry calls the authority-bound. Here knowing is connected with some authority "out there." The authority takes the shape of a particular person or group or trend in society. The young adult experiences some dependency on others and mostly endures their influence. Here, certainty is impossible and the commitment that comes from it can only be relative given that there is room for change. The developmental process culminates with "ownership" and a sense of certainty. The young adult does not believe because he or she has been taught so but has a clear knowledge and understanding of his own, enabling him or her to fully commit himself. It is a stage of mature wisdom coming as the result of an ongoing development of the capacity and desire to reflect critically. While undergoing this development, the young adult moves successively from dependency to counter- dependency and finally to interdependence.

The second group of needs is what Parks calls imagination and creativity. She explains that young adulthood is "the critical period of forming a conviction of threshold existence and passion for the ideal." The driving force for this is a strong exercise of creativity and imagination among young people. These needs express the urge for actualization of the power to hunch, to reflect, to analyze, to create, in short, the actualization of the powers of the mind. (Sharon Parks, The Critical Years, pp. 29-42)

The last developmental area is the area of faith. Sharon Parks defines faith as the" activity of seeking and composing meaning in the most comprehensive dimensions of our experience. Faith is a broad, generic human phenomenon." As an activity of the human mind, faith is an aggregation and an endeavor to achieve the largest possible spectrum of understanding. James Fowler defines the development of young adults in terms of individuation and conjunction. By individuative reflexive faith, Fowler means that faith is seen as a relative system. The individual's acceptance of affiliation is mostly motivated by intellectual stimulation. At this point, the young adult tends to question everything and may most likely drop out of the church where he was raised but remains a spiritual seeker, looking for a faith that responds to his needs. It is a period of belief without belonging characterized by a higher level of faith and a low level of involvement (Robert Gribbon, Developing Faith in Young Adults) Passed these years, the young adult moves in to a conjunctive level of faith. This level is dominated by a paradox and consolidation. Conjunctive faith accepts the tension between conflicting loyalties, that is the acceptance of the paradox as essential characteristic of truth. This paradox ends up with the consolidation or affirmation of one faith and the re-affiliation to a faith group that enables growth and development to take place within the individual. The individuation- conjunction paradox is therefore, a search for a faith to live by, one that better appeals to one's mind and provides the young adult with the most comprehensive understanding of the enigmas surrounding human life. Young adults thirst for meaning and a way to escape the various paradoxes of life, such as, love and hatred, good and evil, suffering, and death. The moral and ethical decision of the young adult will most likely rely upon his understanding of these paradoxes.

In summary, in the process of their growth and development, young adults exhibit three fundamental needs, the need for self-actualization, the need for self-affirmation, the need for love and connectedness and the need for imagination and creativity.

Any AIDS prevention program that targets youth should incorporate these characteristics, needs and issues. It should address in a positive manner the paradoxes and searches. Such a program is not a mere enumeration of laws and predicaments nursed by the cultural and random philosophical trends. It should feed on the overall understanding of the nature of young people and reposes on solid conceptual foundations.

Foundations of an Effective Prevention Program for Youth

The Need for Theosophy of Education and Prevention

An effective prevention program for youth should comprise three components, strong conceptual foundations, a clear goal that aims to help young men and women actualize their potentials. Such a program should finally be universal.

Current and future AIDS prevention programs are and will be educative in nature. Whether we consider prevention in the strict sense, prevention through vaccine, behavior change and universal precautions, prevention refers to the process of helping people gain understanding on how they can protect themselves. Because it is an educational project it should be based on a set of ideas and guiding principles. It should be based on what we term "theosophy of education or prevention." Theosophy of education is a paradigm of education grounded in the divine and the logical. It draws into the mystical and spiritual nature of the human being to provide an understanding of education that responds to the core nature of the human being. If education is considered to be applied philosophy, it further enriches itself by becoming applied theology. It is hence a conjugated effort of truth, depth, wisdom, meaning and practical sense. A theosophy of education and prevention appeals to the expression of the spirit and mind but also to the modes exertion of those powers. In education these trends have often taken opposite paths as if they were competing with one another. Their role is complimentary. Theosophy of education concerns itself with an aim, a goal, a system and a frame of reference or context. The goal of such an educational or prevention program is to enhance the nature of the human being, providing him with a frame for the blooming of his spiritual powers of creativity, of love, connectedness to name but a few. The goal here is to educate the whole person. Joseph McMahon explains that "to educate the whole person, then, means to assist the human in the process of becoming aware of the biological, psychological and spiritual dimensions of their beings and to assist them in acquiring the art of using their knowledge for their own self-creation and the creation of the world" (Joseph McMahon, Discovering the Spirit). The educational project here takes on two forms, the form of a spiritual education and the form of moral and character education.

Spiritual Education

Spiritual education is not the infusion of a quantity of knowledge and belief in the human being. To educate spiritually means to foster the spiritual powers with the human being. The spirit is not an "id" that can be shaped or fashioned like clay. The spirit is freedom and free energy that burst in the external world. It is the source of truth, freedom, and creativity and most importantly of love. Spiritual education is the endeavor to "discover the ways of activating our spiritual powers so that they can become and remain the directional forces of our daily life." (Joseph McMahon, Discovering the Spirit) These spiritual powers include, the power to self-reflect, the power to intuit, to choose and be free, the power to create and most importantly the power to love. Love is the most fundamental dimension of the human being and should be the wellspring of all other powers. Jean Mourroux affirms in this sense that "liberty has brought us to the centre of the person; but liberty too has its centre which is love. And so with love, we are at the very centre of man's being, and we can say that the man will be worth what his love is worth." (Jean Mourroux, the Meaning of Man, p. 182) Love is power, energy, catalyst, inspiration, connectedness, concern, attention and care. Thus, love should be recognized as the supreme value and given the proper attention and place it deserves in our education and prevention program. Spiritual education is hence the actualization of love and making it the center of human life and activity.

Moral and Character Education

Moral and character education is the other essential component an effective education program should focus on. They seek to transform the "brute human being" into an authentic human being, in a genuine social being. Moral and character education are concerned with three goals, namely, helping young adults develop an ethical foundation for knowledge, helping them develop an understanding of the dynamics of consciousness, and finally, help them develop a disposition to fulfill their destinies as human beings. The developments of an ethical foundation for knowledge helps young adults sift their thoughts, their inclinations, and help them select, differentiate and choose accordingly. The ethical foundation endows the young adults with three dispositions. The first disposition is the disposition to know and distinguish between right and wrong. Distinguishing right from wrong this is critical in decision-making. The second disposition is the disposition of to choose the right. The last disposition is the disposition to do the right and stand for the right. The development of this triple function discard the state of moral confusion and set the young adult on a track that guarantees a spiritual censorship to his thoughts, behavior and actions.

Human beings all possess a conscience. Love ought to be the paramount consciousness of a human being. Love within a human being and within a society should equally obey a certain dynamic young adults ought to develop a conscience of. It is the conscience of the interdependence of the relationship in a community, of the necessity of the observance of some principles for each typology of relationship; it is finally a conscience of the sentiment and standard of each relationship. Within the heart of each young adult should exist the awareness of the dynamics that ought to prevail among what Confucianism calls the five great relationships, that is the dynamics and standards between parents and children, between brothers and sisters (younger and older), between husband and wife, between friends and finally between the "ruler" and the "subjects." The cultivation of human character is the cultivation of these relationships and their principles of respect, honor, attention, filial piety, fidelity and virtue, love and service.

The last endowment education should help young adults develop what would be the disposition to realize their destinies as human beings. (Tony Devine, Joon Ho Seuk and Andrew Wilson, Cultivating Heart and Character, pp. 77-133.) This disposition takes three forms, the realization of a "divine-manhood", the formation and development of a personality, and a public mind set. For Nicholas Berdyaev divine-manhood is achieving God likeness by being both divine and true human. Today we refer to that kind of person as a person of character that is a responsible and well-balanced person. The shaping of education and prevention into these tenets equips young adults with the ability and techniques to make good choices and adopt productive behavioral patterns. Premature relationships, substance abuse, and unsafe bodily manipulations become obvious to young adults for they are rightly equipped with the understanding that enables them to distinguish right from wrong, to choose and act right. Tenets such as abstinence or delayed gratification cease to be imported and imposed lifestyles at worst, or lifestyle nursed by fear.

Clear goal and Universality

Edward C. Green declares in "Rethinking AIDS Prevention" that "AIDS prevention program designed by Western experts have been to large extent incompatible with the cultures of Africa and other resource-poor parts of the world." (Rethinking AIDS Prevention. In so doing, he suggests that prevention programs ought to be contextualized. The basis an effective prevention program should be universal. A simple look at infection modes shows that the same causes produce the same effect. What is true of young adults in America is true for young adults in Africa. Development needs and issues are the same for rich and less favored. Young people all over the world go through the same stages, yearn for the same aspirations. They are all idealistic and aim for the best. When they receive the proper help they are capable of making good decisions and adopting productive lifestyles and behaviors. Effective programs ought not to be concerned with culture and context. They may be concerned with methodology but the result remains the same. Abstinence and fidelity for instance are undisputed ways of preventing the sexual transmission of HIV. The question is not that of a message against, for and in the culture or context, but the decision making process of young adults. Hence critical to the success of an effective prevention program are the existence of the appropriate niche for education and prevention and the use of the appropriate methodology.

Context and Prevention Approach

The last requirement for an effective AIDS prevention program is the creation of the proper context for education and the adoption of adequate approaches.

The Family as the Primary Niche of Education

The family is the primary and axiomatic niche for education. Young adult are aware of their destinies. Back to their early childhood they dreamt of children they would have, of the contribution they would make. The fundamental question remains how? How do I love, how do I live in harmony with others? Growing up in broken and dysfunctional families, in the streets, with machines and gadgets does not provide answers to such questions. Janet Bernadi echoes the cry of millions of today's youth when she says: "our generational priorities have shifted out of economic necessity but even more out of a powerful desire to have in adulthood what we lacked growing up. We do not need a BMW. We do not need a summer cottage. We do not need tailor-made clothes. What we do need and want is A COHESIVE FAMILY UNITY!" (William Mahedi and Janet Bernadi, A Generation Alone). As young adults grow up, they ought to learn how to love, how to relate with parents and peers, how to build a family and become productive and successful citizens. The family offers the best frame of reference and the best opportunities to learn how to fulfill one's destiny. Through its organization, the family helps set personal boundaries, establish discipline and foster quality and interpersonal relationships. In a cohesive family, the young adult experiences all sorts of relationships. At the same time, he develops a sense of belonging that provides him or her with practical models and examples of being human. As the training ground for love, the family provides the young adult with models of various types of love, parental love, conjugal love, and sibling's love. The young adult captures the essential standards of relating to the individual, to units and larger groups. In the family the young adult learns to make meaning. He receives advice and counseling. The family should be the sole decision-maker regarding the type of education the young adult receives, the kind of materials he is exposed to, not the church or the schools. Given the role of the family it is critical to empower parents to help them fulfill their role and responsibility. The society should provide them with the knowledge, information, tools and means to become better parents, to understand the needs and issues of their children and how to address them. Practically, this calls for helpers such as family counselors and family ministers who can train and assist parents in their roles.

Supporting role of community and faith-based organizations

Civic, community or faith organizations, ought to play a supporting role to the family. Their role is to reinforce, support and complement the education of the family. Those institutions are the secondary educators. As such they ought to take no initiative that undermines the endeavors of the family. In a prevention program, they are the secondary prevention providers, assisting and helping parents and families.

Adequate didactic approaches

Finally, adequate didactic approaches play a key role in the crafting of effective education program. Didactic approaches have a double nature. They are active and passive. Passive learning refers to understanding from examples and models. Teachers (parents, sibling and counselors) should exemplify the teaching they endeavor to help the young adult understand. They ought to be role models; their lives should reflect the message they want to communicate. Teachers should manifest the dispositions they strive to foster in the learners. They should activate the powers of their minds and hearts to provide students with vivid pictures and concrete examples of the goals they seek after. The transmission of genuine knowledge requires not only a deep understanding of the subject but also a first hand experience of the subject. Helpers should be the exemplification of the true human being they want to help raise.

The choice of didactic approaches should address young adults' needs for meaning making and dispositions gaining. To help young adults make meaning, we should make use of experience-based learning. Experience based learning is a self-discovery process that encourages human creativity. Such learning requires introspection and the unearthing of previously unknown realities. This method of learning enables the learner to establish a deep connection between his personality and the object of learning. Experiential learning also occurs through the interaction with the objective reality. The effect is almost the same. The interaction with people and life situations generate feelings, ideas, and hunches about oneself, about people, and about the environment. Discovery here is a two-way process. Mingling with others, the learner turns within to understand the dynamics within. He also discovers dimensions of his being by seeing them reflected or better actualized in others. The role of the teachers here is to help the learner realize these experiences.

Problem based learning (PBL) helps young adults develop various dispositions, the disposition to discern, to analyze and to synthesize by presenting them with paradoxes, complexities and imbroglio. With these methods, students learn how the knowledge they acquire can be utilized. Young adults don't learn to store information, but see how they work in certain situations. PBL equip young adults with the mentality to deal with issues and problem. It gives them the disposition to recognize and confront difficulties instead of providing with answers they disagree with. (Richard Prawat in Problem Based Learning).

In addition to these models of learning, we ought to adopt techniques that respond to the characteristics and the inclinations of young adults such as the use of technology, performing arts, sports, science and innovative tools that stimulate young adults' minds.