India Times Health
By Dr. Patanjali Dev Nayar

It is seen that, globally, nearly half of the new HIV cases occur in the young people aged 15–29. Also a large percentage of new STD occurs in this age group.

The irony is that methods to empower these young people and to reduce their vulnerability are well known. Although promoting the use of condom is one of the visible strategies, imparting Sexuality and HIV related education and provision of health services is a proven strategy for prevention of HIV/STD.

Meeting the sexual and reproductive health needs of the adolescents and young people leads to an improvement in the level of information and skills and reduces their vulnerability. Many settings including homes, schools and the community are utilized to impart sexuality/HIV education.

Schools stand out as one of the important and most utilized settings. Many progressive schools requisition the services of health care providers, including doctors and NGOs to carry out workshops on the perceived needs of the students on their sexual health needs. This includes sensitizing them and arming them with correct information about HIV and AIDS along with relevant information on sexuality and training on life skills and information about the availability of Adolescent Sexual and Reproductive Health (ASRH) services in the community.

Furthermore the concept of “Adolescent Friendly Health services” (AFHS) that network with schools and colleges is becoming popular in most countries. We also have some examples in India now – Safrarjung Hospital, Hindu Rao Hospital – Delhi, and other centers in Kolkatta and Chandigarh.

Lack of Sexual health education contributes to the health and psycho–social problems of the adolescents. They are likely to be curious yet ill informed, bold yet vulnerable and have numerous myths related to sexual anatomy and functioning.

Many adolescents adopt high risk behaviour due to the numerous myths and lack of skills to deal with peer pressure. There is a near total absence of credible resources to carry out the task either in the school system or in the community as such. Adolescents have a poor access to reproductive health information and services and mainly rely on peers – who themselves may be poorly informed and the media to gain health related information.

They have to cross many “Gatekeepers” before they can even express their needs – especially that are related to sexual and reproductive health – including HIV/AIDS. Furthermore the reluctance on the part of parents and teachers to address the adolescent sexual health issues and their own ignorance regarding the various myths, misconceptions and about HIV and AIDS leaves only the medical practitioners and some voluntary agencies to fill in the gap.

Many parents and adults have misconceptions that providing “Sex education” would embolden the adolescents and prompt them towards sexual activity. The reality is just the opposite.

WHO reports that numerous studies – carried out world over – point out that providing sexual health education typically delays the initiation of sexual activity among youth, and helps them avoid risky behavior when ever sexual activity begins. Thus the provision of appropriate “Content and skills” at an appropriate age/time works as a “Protective factor” and reduces vulnerability of adolescents to HIV.

Several issues influence and impact on the necessity, need and quality of reproductive and sexual health programmes and services for adolescents, most of whom could be married (or be parents) and living in the rural areas. Their needs may not be restricted to education or IEC alone but may require services. Some of the factors that play an important role are:

Gender Perspectives – which are largely defined by social and cultural conditions and shape the way the adolescents (both male and female) view sexuality. They also play a role in providing or denying access to information and services including RCH (contraceptives, abortion, safe delivery) and counselling services by the society and service providers.

Psychological and Social pressures faced by the youth are important considerations to be kept in mind while planning IEC, programmes, interventions and services for the adolescents. These pressures also shape the “Health care seeking” behavior (ie. for what do they seek care, when do they seek care and from whom, and if not – why not) of the adolescents.

Youth programs which involve the parents, community leaders and adolescents as stake holders since the planning stage are more likely to succeed.

Media and its role, range and influence on various aspects of adolescent sexual behavior has to be kept in mind. A sensitized media can become a major partner and a stakeholder in adolescent reproductive health. Media can become a major instrument in removal of myths and positively shaping up the attitudes – whether on sex and sexuality, gender roles or about destigmatizing HIV.