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Sex has regularly proven to be a polarising issue for the UN Member States, and the 2016 High-Level Meeting on Ending AIDS on June 8–10 was no exception. The Political Declaration adopted at the meeting addresses the sexual health needs of young people (15–24 years), including adolescents (11–19 years). 2000 new HIV infections occur among young people every day. HIV is the leading cause of death among adolescents in Africa, and the second-highest cause of death worldwide in this age group. …
Human Immunodeficiency Virus (HIV) and Sexually Transmitted Infections (STIs) among youths represent an important public health challenge in developing countries. The incidence of HIV peaked in the 1990’s and saw a decline from 2005. What was done to prompt the decline? To answer this question selecting studies between 1990 and 2005 was appropriate to assess whether the drop in HIV incidence in developing countries was as a result of education interventions. …
Adolescents in sub-Saharan Africa are highly vulnerable to HIV, other sexually transmitted infections (STIs) and unintended pregnancies. Evidence for the effectiveness of individual behaviour change interventions in reducing incidence of HIV and other biological outcomes is limited, and the need to address the social conditions in which young people become sexually active is clear. Adolescents' peers are a key aspect of this social environment and could have important influences on sexual behaviour. There has not yet been a systematic review on the topic in sub-Saharan Africa. …
Comprehensive sexuality education (CSE) – including learning about relationships, gender and gender-based violence (GBV), sex, sexuality, and sexual and reproductive health and rights (SRHR) – can empower young people to make informed, autonomous decisions regarding their current and future relationships. CSE may also influence a positive shift in social norms which underpin violence against women and girls (VAWG), such as harmful notions of masculinity, and rigid gender roles and stereotypes – both in schools and the wider community. …
Most interventions designed to prevent HIV/STI/pregnancy risk behaviours in young people have multiple components based on psychosocial theories (e.g. social cognitive theory) dictating sets of mediating variables to influence to achieve desired changes in behaviours. Mediation analysis is a method for investigating the extent to which a variable X (e.g. intervention indicator) influences an outcome variable Y (e.g. unprotected sex) by first influencing an intermediate variable M (e.g. …
Comprehending praxis is a critical step in developing interventions that can have a real-world impact on people's lives. In this paper, we reflect on the lessons learned in the development of a curriculum for young people living in informal settlements in eThekwini, who are exposed to numerous vulnerabilities, including HIV-related risks associated with precarious urban livelihoods. Behavioural interventions have not led to commensurate reductions in HIV incidence, and the impact of these approaches remains regulated by numerous contextual conditions affecting those participating. …
Youth centers, peer education, and one-off public meetings have generally been ineffective in facilitating young people's access to sexual and reproductive health (SRH) services, changing their behaviors, or influencing social norms around adolescent SRH. Approaches that have been found to be effective when well implemented, such as comprehensive sexuality education and youth-friendly services, have tended to flounder as they have considerable implementation requirements that are seldom met. …
This guide provides introductory information for schools about relationship education programmes. Relationship education supports the vision of The New Zealand Curriculum (NZC) so that young people will be confident, connected and lifelong learners. There is evidence that young people who take part in effective relationship education are more likely to make healthy choices and avoid problems in adolescence, including violence.
Numerous definitions of sexual health have been developed over the past few years. Perhaps the best known and most widely accepted of them is the World Health Organization’s (WHO) working definition, which reads as follows: ". . . a state of physical, emotional, mental and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity. …
Globally, adolescents aged 12–15 years are making sexual and reproductive decisions of profound significance for their future, often based on misguided, inadequate or dangerously wrong information. Very few countries provide evidential and comprehensive education about puberty, sexuality, and reproductive health and safety to children and young adolescents at school, when it is most effective and beneficial. UNESCO has produced a culturally applicable framework for such education, with the primary aim of reducing sexual risk behaviour and sexually transmitted infections including HIV/AIDS. …
Education about sex, relationships and HIV and AIDS in African contexts is riddled with socio-cultural complexity. In this paper the authors argue that in extreme contexts education can lead change further by developing young people as significant actors in their own lives and in the lives of the community by bringing about change in attitudes in the community, as well as practices in schools. …
Policy-makers who are making decisions on sexuality education programs face important economic questions: what are the costs of developing sexuality education programs; and what are the costs of implementing and scaling them up? This study responds to these questions by assessing the costs of six school-based sexuality education programs (Nigeria, Kenya, Indonesia, India, Estonia and the Netherlands). Cost analyses were carried out in schools that were fully implementing a SE program, as this best reflects the resources needed to run an effective program. …
Evidence-based health promotion programmes, including HIV/AIDS prevention and sexuality education programmes, are often transferred to other cultures, priority groups and implementation settings. Challenges in this process include the identification of retaining core elements that relate to the programme’s effectiveness while making changes that enhances acceptance in the new context and for the new priority group. This paper describes the use of a systematic approach to programme adaptation using a case study as an example. …
The ability of specific behaviour-change interventions to reduce HIV infection in young people remains questionable. Since January 1999, an adolescent sexual and reproductive health (SRH) intervention has been implemented in ten randomly chosen intervention communities in rural Tanzania, within a community randomised trial (see below; NCT00248469). The intervention consisted of teacher-led, peer-assisted in-school education, youth-friendly health services, community activities, and youth condom promotion and distribution. …
In an effort to reduce unintended pregnancy and sexually transmitted disease (STD) in adolescents, both abstinence and comprehensive sex and STD/HIV education programs have been proffered. Based on specified criteria, the author searched for and reviewed 56 studies that assessed the impact of such curricula (8 that evaluated 9 abstinence programs and 48 that evaluated comprehensive programs) on adolescents’ sexual behavior. Study results indicated that most abstinence programs did not delay initiation of sex and only 3 of 9 had any significant positive effects on any sexual behavior. …
