Adolescent reproductive health SEXUAL EDUCATION PROGRAM gSRHR course 2010 Pia Olsson, Midwife, Ass Prof IMCH, Uppsala University

Needs assessment… Love ? Talking sex ? Sexual orientations ? Sex education program ?

Sources of inspiration Implementing a sexual and reproductive health and rights approach. Resource Pack. IPPF Youth peer education toolkit. Training of trainers manual. Youth Peer Education Network New lessons. The power of educating adolescent girls. Population Council

What does it mean to be young? Adolescents; y Young people (YP); y (10-30 y) Youth;15-24 y (10-30 y) What main challenges do young people face with regard to sexuality and sexual health?

YP are 1,7 billion ! Largest in history Healthier More educated Face challenges, particularly young women Choices hindered by poverty, lack of access to schooling, gender disparities and SILENCE

Sexual and reproductive health problems in YP Half of all new HIV infections Highest rate of STIs 20% women U24 HPV infected – cervical cancer 14 million adolescents pregnant/y teenage girls marries/DAY

Young women and pregnancy related risks Complications from pregnancy, childbirth and abortions are the major cause of morbidity and death of girls 15-19y in the developing world U16 are 5 times more likely to die in childbirth than women in their 20s U20 are twice as likely to die as in their 20s

What is sexuality anyway …. Sexuality is a central aspect of being human throughout life and encompasses sex, gender identities and roles, sexual orientation, eroticism, pleasure, intimacy and reproduction. Sexuality is experienced and expressed in thoughts, fantasies, desires, beliefs, attitudes, values, behaviours, practices, roles and relationships. YP Resource Pack

Sexuality is influenced by… …the interaction of biological, psychological, social, economic, political, cultural, ethical, legal, historical, religious and spiritual factors

Communicate with YP on sexuality issues Exercise: To practise answering sensitive question on sexuality to young people

‘Difficult questions’ exercise Each participant gets a paper with a question Sit opposite a classmate One is ‘Adolescent’- the other is ‘Educator’ ‘Adolescent’ reads one question on a paper ‘Educator’ answers the question Switch roles; read and answer the next question Discuss how it was to handle the ‘difficult questions’ what made asking/responding easy/difficult

Discuss! How it was to handle the ‘difficult questions’ What made asking/responding easy/difficult

Sexual orientation is Who we are attracted to Not a choice we make Bisexual Heterosexual Homosexual ….

Diversity - Discrimination What does it mean to be different? ‘Guided tour’ in your imagination…… ……… Why do people discriminate? What can we do to avoid it?

On diversity…. Our differences, our diversity is what makes every human life irreplaceable. Which is why we must never forget that God has given us many faiths, many races, but only one world in which we live together. J Saks

Approaches to sexuality education (SE) - 1 Positive and negative examples

Approaches to sexuality education (SE) - 2 List 3 most important issues for young people SE should address What strategies/activities are best to address these issues?

Schools of thoughts on SE Right based approach Developmental approach Behavioural change/communication approach

Cont. Schools of thoughts; SE Behavioural change/communication approach – YP as recipients Right based approach - YP as actors Developmental approach - invest in YP’s assets and protective factors as they develop; life skills

Basic components in many SE programs Rights Gender Participation

Design a SE program ! Aim: Discuss and gain awareness of the most important factors in designing and evaluating a SE program in different settings

Group work: Planning SE Each group (1,2,3,4..) plans SE activities for different population groups Start by agreeing on a ‘setting’. Give a brief description of main characteristics of importance for SE programming Use the given questions to guide you in designing the SE program Present the plan in mixed groups (a,b,c,d,e..)

What shapes YPs’ sexual behaviour ? Social and cultural forces shape YPs sexual behaviour Can help explain why information and condoms alone are often not enough Review of research to help inform policymakers and guide research Marston C, King E. Lancet 2006;368:

This 7 factors shapes YPs sexual behaviour: 1. YP assess potential sex partners as ‘clean’ or ‘unclean’ 2. Sex partners influence general behaviour 3. Condoms are stigmatising and associated with lack of trust 4. Gender stereotypes are crucial in determining social expectations and in turn behaviour PTO

more factors… 5. There are penalties and rewards for sex from society 6. Reputations and social displays of sexual activity or inactivity are important 7. Social expectations hamper communication about sex

DID YOUR SEXUAL EDUCATION PROGRAMS ADDRESS THESE FACTORS? Thank you for participating today! Pia