Context
The HIV epidemic is now almost two decades old and it has emerged as one of the most serious public health problems in the country. India is ranked as the third highest country with the most people living with HIV (PLHIV) worldwide, behind South Africa and Nigeria. Currently, an estimated of 2.47 million PLHIV live in India, while an estimated 160,000 AIDS cases are also recorded. India, with its large sexually active population, illiteracy, poverty, poor awareness on HIV, male migration, gender disparity and high prevalence of sex workers, is highly vulnerable to HIV. Alarmingly, one million out of 2.47 million PLHIV in India are women, while 31 per cent of the total number of HIV cases in the country is between 15 to 29 years old. 86 per cent of HIV infections are due to sexual transmission.

In India about two-third of the population is below 29 years of age. Population in the age group of 15-29 is considered as youth. Today nearly 9 million people of Kerala are between the age group of 15 and 29 years. The Youth with its specific psychological and social attributes is more susceptible to sexual curiosity and behaviour that make them particularly vulnerable to HIV infection and also they lack adequate and relevant information to protect themselves.

Physical, psychological, and social attributes of adolescence make young people particularly vulnerable to HIV and other sexually transmitted infections (STIs). Adolescents often are not able to comprehend fully the extent of their exposure to risk. Societies often compound young people's risk by making it difficult for them to learn about HIV/AIDS and reproductive health. Moreover, many youth are socially inexperienced and dependent on others. Peer pressures easily influence them—often in ways that can increase their risk.

Recent declines in incidence of HIV/AIDS in a few countries, accompanied by signs that young people are changing their risk-taking behavior, give hope. AIDS today is widely seen as a social crisis as well as a problem of individual behavior. The AIDS epidemic is complex, and thus only a combination of approaches can succeed. It is increasingly clear, however, that youth must be at the center of strategies to control HIV/AIDS.

Voluntary Blood Donation is another major area of concern in the context of HIV. In Kerala 30% of the required blood only available. Each potential youth must be part of the donor chain and there will not be any shortage of blood for transfusion. Many of the organizations and clubs are aware about the importance of blood donation and much of them were involved in blood donation activities. The major lack noticed is that there is no conceptual clarity of regular voluntary blood donation.

Two one-day workshops conducted for the youth club representatives from Eranakulam and Kozhikode are the basis of this document. The workshops bring into being a result of addressing the youth in the context of HIV awareness through different programs and increasing the participation of youth in regular voluntary blood donation.

Building support for AIDS prevention and increasing Voluntary Blood Donation:
Until more leaders speak out about the AIDS crisis and importance of VBD among youth and give it top priority for action, there is little hope of a solution.

Offering education and communication
Young people need help to become aware of risks for HIV/AIDS and how to avoid them. Education and communication programs must go beyond merely offering information to fostering risk-avoidance skills as well, such as delay of sexual debut, abstinence, and negotiation with sex partners. HIV/AIDS education should begin early, even before children become sexually active.

Addressing cultural and social norms
Many traditions and cultural practices increase risks for young people more than adults and for young women even more than young men. Efforts to involve communities and to change social norms are as crucial as efforts to reduce individual risk-taking.

Making services youth-friendly
To serve young people better, health care providers must do more to make young people feel welcome and comfortable. Services, including treatment of STIs and voluntary HIV counseling, testing, and referral, should be provided confidentially and sensitively.

Reaching out
Programs need to reach out to vulnerable youth, including the rural, coastal and urban area. Most programs for youth work better when young people help plan and run them. Programs must also find more effective ways to reach parents and other adults who can influence young people's lives.

Urban youth
The urban youth can be divided into two categories such as urban and suburban groups. The accessibility of urban youth to kinds of mass media is different than the rural youth. Also the urban youth group gatherings are not in view of social development/involvement based except some faith based youth gatherings. There are different kinds of gangs with highest technologies rather social groups. The suburban group gatherings are more or less social groups and they can be addressed through youth clubs, faith based organization and sports & arts related clubs or forums.

Rural Youth
Rural youth can be divided into two one is the mobile population and the other one is the static group in the village itself. There are different kinds of youth in the mobile group. A major group is the group with regular visits to the urban centres for daily jobs. They are moving from the village at morning and coming back to the village at late evening or night. The others are staying at the work place for one week or one month and visiting their source villages at a frequency of once in a week or once in a month. The mobile group is at more risk than the static group, at the same time the mobile group is difficult to address.

Coastal Youth
The coastal areas of Kerala have different social system than the rural and urban groups. Intervention must be designed differently to address them.

Proposed activities
The possible activities as per the result of the workshops are given below. Mass media intervention especially through the FM radios, internet and mobile phone SMS in all the mobile service providers will give more accessibility among youth.

Mass media interventions
• FM radio
FM radio has a tremendous influence among the urban groups. Slots can be found out at the regular live programmes

• Mobile SMS services
The popular and both individually and massively influenced media, the cellular phones have a major impact among the youth both urban and rural. The individuality of the messages and the nature of mass media propaganda will produce effective communication campaign.

• Internet communication groups
The internet communication groups can be useful to cover a high percentage of the urban youth and a low percentage of rural youth, who are working in the area of information technology.

• Helpline (telephone) service for sex related issues (not directly HIV)
A telephone helpline system exclusively to understand sex and sexuality related issues will give more attraction to the youth, particularly vulnerable male folk among the youth. Through this way, messages of both the regular voluntary blood donation and HIV prevention can be disseminated. The HIV prevention messages will be more effective along with the sex and sexuality messages. Meantime it must not be a HIV helpline.

• Film show
Film shows are useful in rural areas for awareness generation

Folk media interventions
The folk media such as Street theatre, Puppetry, Villu-pattu, Kadhaprasangam etc. are very effective in both the urban and rural community. Use of folk media with the messages of Regular Voluntary Blood Donation and HIV awareness will address a sector of the youth who are interested in these art forms. One folk team for one district will work properly. This team must be ready for all the clubs to perform as and when required.

General Group Programmes
Given following is the list of general group programmes.
• Panchayath level survey of vulnerable youth
• Awareness building classes on Regular Voluntary Blood Donation and HIV awareness
• IEC materials to address both the topics
• Volunteer development: it is important to develop volunteers to work for the awareness generation and blood donation activities.
• Mouth to mouth propaganda: It will be a group to individual (many to one) communication in which the messages will carry both the topics. This activity can be conducted by a group of volunteers. The receiver may be an individual or a group of youth suitable to the situations. House wise campaign will also workable in this mode.
• VBD speakers: The concept of VBD speakers is that there are some volunteers prepared to talk about Regular VBD and HIV awareness topics in any events, where the club gets a slot. It may be a gramasabha meeting, youth gatherings, sports events, local festival etc. These people will be the spokes persons of the club for these topics.
• Observing Blood Donation week or month etc.
• Awareness building competition events like marathon race, sports, arts etc.
• Positive speaking: This is a tool to reduce stigma attached with sex and HIV. The positive speaker must be a HIV positive, preferable a female, and s/he must be able to disclose his/her HIV status to the public. This will be a touching session by the presentation of his/her own life experience as a positive. This will be helpful to reduce the stigma.
• Preparation of Blood donors’ directory in ward level: The clubs can initiate this activity and the required blood for every individual can be ensured from their neighbourhood.
• YUVA-Douthyam committee/AIDS cell in each clubs with 5 youth both male and female members. This team will be the implementation tea, for the whole programs designed for the promotion of Regular Blood Donation and HIV awareness building programs in the
•Blood donation camp in all main functions - As a part of all the celebrations and observances voluntary blood donations can be conducted to disseminate the message.
• Lucky draw for youths: to address the specific youth some questionnaires can be administered for awareness generation. The questionnaire must contain the awareness topics in brief and a column for giving the complete details of the individuals including blood group in the first page. In the other side of the questionnaire will be with the possible questions for the answers from the first side and the person must answer all the questions. This way, the creation of blood group directory and awareness generation will happen simultaneously. The need of blood group determination camp also can be finding through this method. There will one or two winners, who have been selected by lucky draw from the all members those were answered all the questions correctly. Attractive prices like mobile phones, DVD players etc. will attract them.

Structure of the Programme
The structure of the YUVA-DOUTHYAM is visualised in the diagram given below. It is a joint venture of NYK and KSACS.

Conclusion
The programme designed for the youth is a conceptual designing, the product of the two one-day workshops conducted with the NYK affiliated youth club representatives. The quantity of each activity is not proposed in this document as it depends up on the local conveniences and the availability of funds. The programmes can be divided into two major heads as Primary level initiatives and Secondary level initiatives in accordance with the availability of funds. The important activities like structure formation, VBD promotion activities etc. can take up primarily and the other category activities can be done in the secondary level.