‘Youth in a void’: sexuality,HIV/AIDS and communication in Kenyan public schools

The disappearance of traditional sex education during rites of passage in African societies has left many youth uncertain of where to look for information. Against this backcloth, the objectives of this study were to identify knowledge gaps amongst adolescents in Kenya regarding sexuality, HIV/AIDS and reproductive health. A thematic analysis was conducted of questions posed by 735 school youth aged 12–18 years from Meru and Kajiado Districts. Results show that many questions showed curiosity and anxiousness. Knowledge appeared to be fragmented and sometimes revealed misconceptions, which may put youth at risk. The raised themes differed by gender and age. Questions on saying no to sex, sexual violence and female circumcision were a great concern for girls. Boys were more concerned with managing boy–girl relationships, preventing STI/HIV infection, and condoms. Concern about transition to adulthood, sexuality, STI and HIV/AIDS, myths and misconceptions, and intergenerational communication cut across both genders. Older teens were more concerned with questions on boy–girl relationships, norms and values regarding sexuality, and STI. Younger teens ( < 15 years) wanted to know about reproduction, saying no to sex, HIV/AIDS, condoms, sexual violence and female circumcision. Compounding these challenges was the lack of intergenerational communication. The study identified important knowledge and communication gaps in sexual and reproductive health among in-school adolescents in Kenya. There is a need for sex education interventions for different age groups and genders. These interventions should work with parents, teachers and health professionals.     

Media education to improve adolescent sexual and reproductive health in Cambodia. RAS/98/P10

Through the use of interactive radio and other media, Health Unlimited through its implementing agencies, the Cambodia Health Education Media Services and Cambodia Health Education and Development is working towards increasing knowledge of reproductive and sexual health among Cambodian adolescents. It also seeks to promote the use of reproductive and sexual health services for the youth; improve youth involvement in developing information, education and communication (IEC) materials on reproductive health; and increase the capacity of nongovernmental organizations, government agencies and the private sector to develop IEC for the youth. The strategies being pursued include exploring the role of radio and using nongovernmental organization expertise in radio show production and sharing IEC messages with the media. The main activities being carried include the production of interactive radio magazine programs for the youth along with magazine supplements, training of health and media staff and providing them with work experience, and involving the youth in media production by using an interactive format and focus group discussion.     

Promotion of adolescent reproductive health and healthy living. Malaysia

This article discusses a 3-year project, "Promotion of Adolescent Reproductive Health and Healthy Living," which was implemented by the Federation of Family Planning Associations, Malaysia. The project seeks to achieve the following: 1) development of a reproductive health of adolescent module (RHAM) for trainers and educators; 2) training of trainers; 3) sharing of adolescent reproductive health experiences in Asian countries; and 4) setting up three service models in Sabah, Selangor, and Terengganu to provide reproductive health (RH) care to adolescents and youth. The first part of the RHAM with the trainer's manual has been finalized and will be tested in a workshop. The second part, a teacher's guide, is under preparation. A series of training on the use of the RHAM will be conducted including a 5-day national workshop, which will be followed by several state level workshops. The three service models being set up have specific orientations. The Sabah model is putting up a youth clinic for adolescents within its clinic network. The Selangor model is developing a Youth Resource Center for training and youth involvement in RH activities. Lastly, the Terengganu family planning association (FPA) has developed a Youth Center web site, which features the history, mission, and activities of the Terengganu FPA.     

Without Sex Education: Exploring the social and sexual vulnerabilities of rural Bangladeshi girls and boys

In 1997, two organizations, BRAC (Bangladesh Rural Advancement Committee) and ICDDR,B (International Center for Diarrheal Disease Research), as part of their collaborative research model, developed an HIV/AIDS prevention strategy for rural Bangladeshi youth. Currently, HIV/AIDS is not apparent in rural Bangladesh. Other sexual and reproductive health problems are more pressing. Moreover, there are few inor out-of-school sex education programs for adolescents in Bangladesh. Therefore, preliminary qualitative research was conducted to understand the broad parameters of sexual and reproductive health within the sociocultural context of young people's risks and vulnerabilities. Exploratory research revealed that youth were vulnerable to sexual diseases, late-term abortions, sexual violence, reproductive tract infections, and premarital pregnancies. Adolescents and adults thought that youth today need sex education. Adults said that youth should not be educated about condom use because this would conflict with a girl's prospects for an arranged marriage. Bangladeshi youth today are being exposed to experiences unfamiliar to their parents. Lacking appropriate knowledge, information and awareness about sexual and reproductive health unduly heightens young people's fears, and increases their social and sexual vulnerabilities.     

Resisting risky sexual activity: SHINE project shows how. Philippines

This article presents the Sexual Health Initiatives through Networking and Education (SHINE), an 18-month project on reproductive health for young adults 13-25 years old by CARE/Philippines. SHINE targets the two most likely places to effectively reach large numbers of youth: the school and the workplace. Completed in December 1999, the project has made significant achievements in increasing the youth's knowledge of important reproductive health issues and enabling them to make informed decisions about their reproductive life. In addition, it has established a referral network of service providers to ensure sustainable access to quality reproductive health services. During its implementation, it addresses cultural constraints in promoting adolescent reproductive health in the Philippines. The SHINE Project encourages the involvement of the youth, school and community through the parents and other concerned organizations/agencies. It enables the youth to increase their knowledge and to focus on values that would guide them in making the right decisions about their reproductive life. Moreover, it provides supporting structures for the young, including youth-friendly medical facilities that offer counseling and medical services.     

The Davao Teen Centre empowers the youth of Mindanao. Philippines

This article discusses the Development and Family Life Education for the Youth (DAFLEY) Project in Davao City, Philippines. The DAFLEY aimed to make the youth enlightened citizens of the future by educating them on reproductive health care services, gender equality, and responsible parenthood. It was established by the Family Planning Organization of the Philippines and is being carried out through the Davao Teen Centre (DTC), which provides reproductive and sexual health care services through counseling, face-to-face or by telephone. In an effort to reach out to more teenagers in Mindanao, the DTC introduced radio programs offering on-the-air advice to adolescents with problems ranging from boy-girl relationships and unplanned pregnancies to more complex and serious problems. Public response to the programs has been enthusiastic. The youth that have benefited from the DTC counseling refute a conservative belief that sex education leads to promiscuity and sexual experimentation. They state the respect they have for their bodies and their sense of responsibility as proof of the value of the reproductive health education and services that they have received.     

Examining Sexuality Education Preferences Among Youth at Risk for Poor Sexual Health Outcomes Based on Social Determinants of Health Factors

ABSTRACT

At-risk adolescents may experience Social Determinants of Health (SDoH) that lead to higher rates of risky sexual behavior, including increased risk of pregnancy and sexually transmitted infections. These SDoH may include components such as unstable family structures, incomplete education, and poverty. Targeting at-risk youth for sexuality education is one way to work toward decreasing sexual health disparities. However, preferences for sexuality education approaches may differ among at-risk youth by additional factors including sex and sexual orientation. The purpose of this study was to describe sexuality education preferences among at-risk youth and how sexuality education preferences differ based on sex and sexual orientation in an at-risk sample of high school-aged youth in Texas. Results indicate sexuality education preferences differ based on sex and sexual orientation when examined by sexual health topics and methods of delivery. Implications of this study indicate including at-risk youth in sexual health programs may be a way to target those at-risk of adverse SDoH, but these groups also have specific preferences for sexuality education.     

Sexuality education in South Africa: Three essential questions

Sex education is the cornerstone on which most HIV/AIDS prevention programmes rest and since the adoption of Outcomes-Based Education (OBE), has become a compulsory part of the South African school curriculum through the Life Orientation learning area. However, while much focus has been on providing young people with accurate and frank information about safe sex, this paper questions whether school-based programmes sufficiently support the needs of young people. This paper is based on a desk-review of the literature on sex and sexuality education and examines it in relation to the South African educational context and policies. It poses three questions: (a) what do youth need from sexuality education? (b) Is school an appropriate environment for sex education? (c) If so, what can be said about the content of sex education as well as pedagogy surrounding it? Through reviewing the literature this paper critically engages with education on sex and sexuality in South Africa and will argue that in order to effectively meet the needs of youth, the content of sexual health programmes needs to span the whole spectrum of discourses, from disease to desire. Within this spectrum, youth should be constructed as “knowers” as opposed to innocent in relation to sex. How youth are taught as well as how their own knowledge and experience is positioned in the classroom is as important as content in ensuring that youth avoid negative sexual health outcomes.     

贵州农村少数民族男性性行为现状分析

文章以贵州五个少数民族男性为对象,进行男性人口性行为现状进行研究。通过分层整群抽样法抽取苗族、侗族、布依族、仡佬族和水族男性人口,认为少数民族地区学生性观念相对保守;青少年性与生殖健康教育仍然是空白;而已婚人群性与生殖健康水平也有待提高。     

Telling Them Their Own Stories: Legitimizing sexual and reproductive health education in rural Bangladesh

Most people in Bangladesh are rural, poor and underprivileged. The incidence of sexual disease has increased, but little has been done to educate rural people about sexual and reproductive health. In 1997, a sexual and reproductive health project was initiated within a collaborative research agreement between the International Centre for Diarrhoeal Disease Research (ICDDR,B) and the Bangladesh Rural Advancement Committee (BRAC), an indigenous non-governmental organization which pursues integrated rural development strategies. Qualitative in-depth interviews with 65 different women, men, boys and girls revealed significant sexual health problems and a lack of knowledge of sexual and reproductive health. The interviews were transformed into composite problem-solving picture stories and information about sexual and reproductive health. Stories mirrored respondents' interpretations of sexual behavior. Those who had achieved or ascribed legitimacy to talk about sex, e.g. traditional health providers, were trained to utilize the methods and materials. Qualitative evaluations revealed important changes in health providers' self-confidence, business and personal interactions as well as changes in clients' behavior. This project found that sexual and reproductive health education can be integrated into indigenous health activities if the sociocultural context in which sex, relationships, risks, diseases and communication occur is reflected in a program's content and methods. Unquestionably, there is a great need for sex education in rural Bangladesh.     

Next time somebody asks: "Is it good for young people to watch TV?" say YA TV,the Young Asia Television: the eyes and ears of young Asians

This article presents a profile of the Young Asia Television (YATV) initiative by the WorldView International Foundation. The YATV channel brings news and analysis of Asia-focussed environmental concerns, current affairs, population and reproductive health issues, social problems including poverty and illiteracy, arts and culture, and other topics. In addition, it broadcasts programs produced by different countries on reproductive and sexual health, including AIDS and sexually transmitted disease prevention, and youth/adolescent awareness of sexual health. It was launched by the Foundation with a thrust stating that "television must encourage dialogue and debate; advance the creativity of people, especially the younger generation who will be the leaders of the future." In order to reach many more millions of viewers, YATV programs are networked with the Asian Broadcasting Union and 1000 other organizations through the Foundation's own NGOs network. This network provides the medium for value-based broadcasts in an entertaining fashion. The International Office of Worldview International Foundation in Colombo monitors the program activities on a continuing basis and uses the information gathered for impact assessment and long-term planning.     

Adolescents’ conceptions of learning and education about sex and relationships

Abstract

In order for adolescents to learn about sex and relationships, the education must be of significance and meet their needs and interests. The study investigated adolescents’ conceptions of learning and education about sex and relationships. A phenomenographic approach was used. Six focus group interviews were conducted with adolescents ages 18–19 in Sweden. The results showed that stable ground for learning implies select issues of importance, that is, values and prejudices, up-to-date knowledge, and practical skills. These issues should be dispersed throughout the school years in relation to the students’ own maturity. This seemed to enable internalization of different aspects of sex and relationships. Learning about sex and relationships can create meaning for youth and generate progress by fostering autonomy and identity, correcting misconceptions, counteract prejudices, not in isolation rather in society in a defined culture.     

Young Cypriots on sex education: sources and adequacy of information received on sexuality issues

Introduction: In the absence of standardised sex education and because schools usually limit their teaching to the ‘health’ aspects of sexuality, young people in Cyprus rely on their peers and the media for information on sexuality. This study examines the sources and adequacy of the information received by young people from various sources on matters related to sexuality and sexual health.

Method: Twelve in‐depth interviews were conducted in Cyprus in 2005 with purposively chosen boys and girls aged 15–18 years using a semi‐structured discussion guide. The interviews focused on participants' knowledge of HIV/AIDS and other sexually transmitted infections, safer sex, contraception and abortion. They also explored attitudes and beliefs concerning relationships, homosexuality and mutual consent.

Results: Information about sexual health is primarily received from school in classes that interviewees considered dull or irrelevant. Television, and to a lesser degree magazines, were the main sources of information on sexual relationships, the sexual act, homosexuality and abortion. Sexually transmitted infection knowledge was limited and often erroneous, while attitudes towards contraception use, abortion and homosexuality suggest that negative stereotypes are widespread.

Conclusions: Because the information young people receive on sexuality appears to be inadequate, there is an urgent need to implement comprehensive, evidence‐based sex education in the public schools. It should also address the nature and content of the sexual and reproductive health messages received from peers and the media.     

The challenge of changing drug and sex risk behaviors of runaway and homeless adolescents

OBJECTIVE: To assess HIV-related drug and sex risk behaviors and evaluate factors associated with change in risk behaviors among runaway and homeless adolescents, 244 street youth were recruited from a community drop-in center serving high-risk youth. METHOD: Using a cross-sectional design, approximately half of study participants received training in a peer-based intervention that included principles derived from the health belief model, while the remaining subjects received no intervention. Subjects were interviewed at baseline, immediately following the intervention (for those receiving the training) and 3 months later. Logistic regression and analysis of covariance were used to analyze intervention effects. RESULTS: Compared to youth in the control condition, runaways receiving the intervention significantly increased their knowledge about HIV. Contrary to the health belief model, in multivariate analyses knowledge and greater perceived chance for HIV were associated with high risk behavior. On the other hand, lower concern about HIV infection was also associated with high risk behavior, supporting the health belief model. CONCLUSIONS: Despite the intervention's success in increasing knowledge of HIV and AIDS, the association between knowledge, perceived likelihood of infection and high risk behaviors suggest that, without other alternatives, runaways will maintain their risks. The association noted between lower concern and high risk behaviors underscores the challenge faced in developing effective interventions with this population.     

Zina and the enigma of sex education for Indonesian Muslim youth

Sexuality and sex education cannot be divorced from the moral values of the societies within which we must negotiate our sexual identities and relationships. Rather than pandering to the moral panic that is too often associated with the provision of sex education in non‐secular societies where religion is more visibly active in shaping sexual ideals and norms, this article takes up the challenge of investigating a relationship that is often represented as being innately contradictory. It explores the Islamic notion of zina (illicit sex) in relation to the provision of comprehensive sex education for Muslim youth in contemporary Indonesia. The article initially establishes the demand for sex education among Indonesian youth from the overlapping perspectives of health, human rights and Islam. It then explores the notion of zina in detail and exposes how Islamic stipulations against premarital sex are not necessarily in conflict with the provision of sex education. The final section of the article refines the argument in favour of utilizing Islam as a framework for developing religiously appropriate sex education and describes a suitable approach and content for Islamic sex education curricula for Indonesian youth.     

How and where we live,learn, and play matters: An introduction to the special issue

Abstract

A holistic approach to providing health education and services integrates the Social Determinants of Health (SDH)—an approach Healthy Teen Network calls Youth 360°—to recognize that where youth live, learn, and play matters. Long promoted by such stalwarts in the public health field as the World Health Organization and Centers for Disease and Control, the SDH are now broadly recognized, including in the field of adolescent sexual and reproductive health (ASRH), as the only way to engage and address the needs of all youth. But stating this and truly understating how to make this happen are very different animals.     

未婚青年生殖健康现状及对计生服务的需求

采用问卷调查方式，调查内容包括未婚青年生殖健康现状、对婚前性行为、人工流产的态度与看法、对计生服务的需求状况与期望；结果表明：1、农村未婚从业青年婚前性行为、人工流产有明显增多趋势，人流经历确实造成了身心伤害；2、未婚青年迫切需要生殖健康与避孕节育措施服务；3、计划生育部门应有效转变观念，拓宽服务领域，提高服务质量。     

Giving adolescent reproductive health and population issues a world view. Sri Lanka

This article reports on the production of 52 video programs addressing reproductive and sexual health and reproductive rights issues by the Colombo-based Worldview International Foundation. The UN Population Fund (UNFPA) and relevant NGOs and institutions chose the themes. Following the production, the video programs will be broadcast through Young Asia Television, which covers 18 countries in Asia and reaches over 385 million viewers, and other channels. This advocacy program is under the Television Advocacy Program for Adolescent Reproductive Health and Population Issues project, which complements special strategies under the European Commission/UNFPA Initiative for Reproductive Health in Asia. By promoting the global dissemination of information and education, the Worldview project aims to 1) strengthen young people's participation; 2) advance TV media advocacy; 3) advocate the inclusion of population, gender, sexual and reproductive health issues; 4) provide extended knowledge of adolescent reproductive health to all concerned groups; 5) encourage positive attitudes towards preventive methods among the target groups; 6) promote the importance of incorporating gender perspectives and child abuse issues; and 7) establish close cooperation among organizations at the national, regional and international levels.     

Bangladesh: recognizing adolescents as a great resource

This article presents the initiatives undertaken by the government and other organizations to improve adolescent reproductive health in Bangladesh. The Health and Population Sector Programme under the 5-year Health and Population Sector Strategy (HPSS) of Bangladesh targeted married youth and soon-to-be-married adolescents. It has provided training of field workers so they can provide health services in an adolescent-friendly atmosphere. The Government has also collaborated with nongovernmental organizations and agencies that could help in the formulation of well-planned policy for adolescent health. These agencies include the UN International Children's Emergency Fund, UN Population Fund and WHO. In addition, on-going multisectoral coordination of various sectors, such as education, labor law and justice, youth and social affairs, has been developed and has contributed to the success of the Programme.     

Patterns of adversity and pathways to health among White,Black, and Latinx youth

Research has demonstrated the negative impact of Adverse Childhood Experiences (ACEs) on long-term trajectories of mental and physical health. Yet existing literature on this topic is limited in its understanding of outcomes among youth samples, optimal measurement items and methods, and differences in adverse experiences across race/ethnicity. The current study used a person-centered approach to measure ACEs and their impact on youth health outcomes across three different racial/ethnic groups from a large national database. Patterns of exposure to adverse experiences among Black, Latinx, and White youth (N = 30,668, ages 12–17) were determined empirically using latent class analysis (LCA). Significant differences in class membership by demographic indicators (age, household income, sex) and concurrent health outcomes were identified. Different models emerged for Black (2 classes), Latinx (3 classes), and White youth (3 classes). Older and lower-income youth were more likely to have experienced adversities, but there were no differences in adversity likelihood by sex. Additionally, racial/ethnic minority youth were at greater risk of experiencing higher levels of adversity, poverty, and poor health when compared to their White counterparts. Rather than occuring in meaningful clusters, adverse experiences among youth reflected a cumulative risk model such that classes were defined by the overall intensity of adverse experiences (i.e., low, moderate, high). Findings provide greater knowledge regarding the relationship between ACEs and health and future research directions to inform more targeted and culturally-appropriate screening, prevention, and intervention programs.