The need of sex education is need of the hour.

1. SEX EDUCATION – NEED OF THE HOUR
1ARISE ROBY

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Sexuality & Adolescent
Development
Social factors shape and interact with
biology.
Learn how to act out sexual feelings on
the basis of social attitudes, extracted from
cultural contexts.
ARISE ROBY

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Social Influences on Adolescent Sexuality
A. Proximal Social Influences
 Parents
Attitudes initially formed at home and so parental
models and Teachings are important.
 Peers
Later children are influenced by peer groups and
the wider social arena.
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I. Parents
 Psychological literature reveals the
profound influence that parents have on
the lives of their children. Parents are the
primary socializers of their children.
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Parents influence Adolescent
Sexual Behaviour through four different
avenues:
 Parental attitudes towards adolescent
behaviour influence adolescent attitudes.
 Marital and child rearing behaviour of parents
provide and support role models for young
people.
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 The Religious environment influence sexual
attitudes and sexual guilt.
 The education level and work experience of
the parents may influence attitudes and
present opportunities for sexual activity if
parents are away.
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Theories on Adolescent
Sexual Development
 Psychosexual Theorists such as FREUD,
BLOS attach great significance to the impact of
sexual drives on the psychological functioning
of the person.
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 Psychosocial Theorists like Erikson, Marcia,
Adams, take the position that “anatomy is
destiny” but takes into account social context
and their cultural factors that mediate sexual
conflict.
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 Erickson places a great emphasis on establishing a sense
of identity and a coherent sense of self in adolescent
sexual development.
 Difficulty in parent-adolescent particularly parent-
daughter conversation regarding Sexuality seems to have
a negative effect in delaying sexual activity. i.e. Greater
the difficulty, the earlier the initiation of sexual activity.
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 Non virginity in youth is associated with non-
authoritative parenting.
 Girls from single parent-families repeat this
cycle. It is unclear whether this is related to role
modeling or lack of parental supervision or to
parental absence.
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 Parents also influence via socialization of the child to
coping strategies in their personal life. Learned
Restraint was a factor in adolescent sexual expression
for boys. This was the ability by parents to delay
gratification, inhibit aggression, exercise impulse
control, display consideration of others and to act
responsibly.
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II. Peers (& Friends)
 Behaviour of peers have little impact on young
children - but importance of peers shifts at
adolescence.
 Peer influence and positive or negative pressure
can be through:
peer information
peer attitudes
peer behaviour
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Studies show in Adolescent sexual
activity and FP use
Peers have 70-73% of influence,
Mothers have 33-37% influence Fathers
have 15% influence
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 Theory of reasoned action:
– Perceived attitudes and values of
significant others have important effect on
shaping intention.
– Young women more than men were
influenced by attitudes of their peers
about pre-marital sex, contraception and
safer sex practices.
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B. Distant Social Influences
1. The Youth Culture
(a) Sets of beliefs
(b) Adult models of sexual behaviour
(c)Media models of sexual behaviour
2. Social Institutions
(a) School
(b) Religion
(c)The Law
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1.The Youth Culture
(a) Sets of beliefs: fashions, leisure,
music influenced by:
print, media, definitions of female femininity and
desirability, definitions of maleness, lyrics, etc.
Perceptions of peers about sexual experiences.
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(b) Adult models of sexual behaviour
 Parents are not the only role models;
other adults in society
 How changing adult sexual norms
affect the youth is unknown
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(c) Media models of sexual behaviour
Movies and videos reinforcing roles and
messages -
 women as passive victims
 women as sexual beings
 women as play things
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2.Social Institutions
(a) School
 have an important role to play in informing young
people and providing a forum for values
exploration and clarification about sex
 school based sex education policy and
implementation
 whether sex education per se without supportive services
translates to behaviour change is less clear
–prefer to turn to peers for info
–do not trust teachers’ knowledge or discretion
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(b) Religion
Religiosity is negatively related to
premarital sexual behaviour. Sexual
conservation is greater among
religious youth
consequence of religious values
association of youth with similar values
may be other sources of values
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(c) The Law
Laws that deal with adolescent sexual
expression relate mainly to:
age of consent laws for sexual intercourse and
medical interventions such as FP and abortions
laws on homosexuality
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Arguments about adolescent sexuality
revolve around 4 central themes:
 Morality and responsibility (parents and
religions, especially related to sexuality
education)
 Desire - media representation
(responsibility vs. gratification)
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 Danger - public health approach and
medical models (fear related to pregnancy,
disease, HIV/AIDS)
 Victimization - power of women in
sexual encounters is limited and so is
responsibility
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Rationale for Addressing Adolescent
Sexual and Reproductive Health
 Number of Adolescents
• adolescents aged 10-19 constitute approximately 20% of the
world population
• half of all individuals are younger than 25
 The fertility level for this age group is decreasing but
decreasing more slowly than for other age groups
resulting in an increasing proportion of births being to
adolescent mothers
 Pregnant adolescents resort to abortion more often
than pregnant women of other age groups
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 Risk Factors in of Adolescence:
Psychosocial Risks
 the period during which sexual and reproductive
health issues are added to the health concerns of the
individual
 adolescents not knowledgeable about sexuality and
reproduction
 abstinence not encouraged
 gender equality not promoted
 healthy and responsible sexual and reproductive
behaviour not discussed
 sexual and reproductive risk-taking not discussed
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 Early Pregnancy Risks
 neo-natal mortality levels are higher
 infant mortality are higher
 an increase in the age of marriage
 a fall in the age of menarche
 no decrease in sexual activity
 a greater risk of adolescent girls becoming pregnant
outside of marriage
 social stigma prevent pregnant adolescent girls from
obtaining early prenatal care
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 Abortion Risks
 lack of information on contraception
 the cost of health services
 lack of confidentiality
 limited access to safe services
 delay in realising or admitting to the pregnancy
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 most susceptible to STDs due to
physiological and social factors
 5% of all adolescents contract an STD
 half of those infected with HIV are
younger than 25
 less developed physiological barriers
towards infection
 young women’s low decision-making power
STD Risks
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 Contraceptive Use
level of contraceptive use is often very
low among adolescents
 due to insufficient or incorrect
information
 to limited access to contraception
because of location, cost or social and
cultural barriers
 to the low social status and decision-
making power
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 The Sexual and Reproductive Rights of
Adolescents
Economic Benefits
the cost of contraceptive use is significantly lower
than the cost of medical care related to unwanted
pregnancies and treatment of STDs
 is a cost-saving strategy
 educational options limited
 economic opportunities curtailed
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 Meeting Adolescents’ Needs
The primary goal of ASRH programming and policy is to
enable adolescents to enjoy their sexual and reproductive
rights
 provide adolescents with knowledge and services
 sexual and reproductive health care for all
adolescents
 create an enabling environment to reinforce
preventive interventions and services
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 Preventive Interventions
 to promote responsible and healthy reproductive
and sexual behaviour, including voluntary abstinence
 to provide services and counselling
 to educate and counsel in the areas of gender
relations on equality
 to reduce violence against adolescents
 to promote responsible sexual behaviour
 to promote responsible family planning practice
 to promote family life and reproductive and sexual
health, including STD preventionTI
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 IEC
 IEC initiated before adolescents have
engaged in sexual activity give adolescents the
skills
• to postpone the onset of sexual activity and
• to engage in safer sexual practices once
sexual activity begins
 For sexually active adolescents, IEC and services
• raise the level of contraceptive use
• increase condom use
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 Sexual and Reproductive Health
Care
 access to services for treatment and
care
 treatment of complications of self-
induced or clandestine abortions
 pre-and post-natal care
 counselling and contraceptive service
provision
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 Service Provision
the provision of adolescent-friendly
preventive services is a key element
in enabling adolescents to engage in healthy
responsible sexual practices
 special hours
 special centres,
 peer distribution of condoms
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 Enabling Environment
Gender
• enhance gender equity and equality
• eliminate discriminatory practices, laws
and policies against women and girls
• introduce appropriate laws for legal age of
consent and minimum age of marriage
• promote a focus on men’s role by inclusion
• promote concept of shared responsibility
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 Significant Adults
IEC and advocacy initiatives should address
 parents, teachers and local leaders
 religious leaders
 national level policy-makers
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 Research
 Research is important to understand
adolescent sexual and reproductive health
problems and the underlying socio-cultural,
economic and other development factors
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Limitations of
Evaluation in ARH Studies
 Self report techniques (problematic areas in
research):
– verification of validity
– gap behaviour between knowledge and
behaviour
 Conscious and unconscious distinction of
respondents (pressure, privacy, confidence and
anonymity issues)
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 Unreliable measures (test - retest the reliability)
 Memory (recall)
 Inadequate definition of the construct under
consideration e.g. in utilization of FP knowing the
methods is as important as knowing where to
receive services
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 Using qualitative methodologies may
produce richer data (thought harder to
interpret)
 Triangulation is important
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 Inappropriately worded questions (no
formal terminology, no ambiguities, no
double negatives)
 Differences across survey presentation
mode: mail out, surveys, self-administered,
etc.
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 Types of Studies:
Surveys and correlation studies (describe and
compare group)
– Experiments to establish causality
– Case materials - ethnographic studies through
participant or non-participant observer
techniques:
• individuals
• groups
Generalizability is extremely limited
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Networking
 Involvement of all stakeholders
 networking at all levels
Involving Adolescents in programming
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 Advocacy
 National Capacity-Building in Advocacy
 Innovative approaches in Advocacy
 Advocacy against Sexual Violence
 Advocacy for Adolescent Sexual and
Reproductive Rights
 Advocacy to Establish an Enabling
Environment
 Advocacy to Promote Gender Equality and
Equity
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 Information, Education and
Communication
 Needs Assessment and IEC Content
 Peer Education and Peer counsellors
 Parent Education
 Gender Training
 Innovative approaches
 Involvement of Professionals
 National Curriculum
 Strategies for Implementation
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 Training
 Health Care Providers
 Teachers
 Strategies for Training
 Institutionalisation of Training
 Sustainability of Training
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Lessons Learned by Youth for Youth
 Execution by youths at the national level was a
successful approach;
 Youths preferred topics which affected them directly
such as human sexuality, STDs, including AIDS, and
contraception over general issues such as
“population”;
 Its difficult to decide at the global level what will
happen at the national level;
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Lessons Learned by Youth for Youth (CONT’D)
 Networking is easier at the peripheral level;
 The involvement of stakeholders in project design
triggers positive attitudes and deep commitment to the
project;
 Governmental institutions and NGOs can successfully
be involved in the same project;
 It is important to build trust among youths and their
organisations;
 Youth learn better from other youth.
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The Youth Perspective
“[Youth] tell us they want information on reproductive health
and sexuality education, preferably from their parents. They
want this information early and in a form appropriate to their
psychological and physical development. They want accurate
information so they can empower themselves to make
choices and take responsibility for those choices.
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The Youth Perspective (cont’d)
They also say they want to have at their disposal - and this
does not mean they will automatically use those services -
family planning information and supplies that will allow
them to avoid early and unwanted pregnancy, and abortion,
and to protect themselves from sexually transmitted diseases,
including HIV/AIDS”.
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 Challenges for the Future
 Advocacy
 Research
 Evaluation
 Indicators
 Upscaling of programmes
 Gender awareness
 Segmentation of Target Group
 Management
 Sustainability
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Key References: Adolescent Sexuality
1. S. Moore & D. Rosenthal, 1993 Sexuality in Adolescence.
Routledge London & N.Y.
2. UNFPA Technical Report No. 43 1998 The Sexual & Reproductive
Health of Adolescents: A Review of UNFPAAssistance
ARISE ROBY