Sex Education in a Fractured World: Towards a Social-Ecological Approach
McKee, Neill, The Brown Journal of World Affairs
TODAY, IN OUR GLOBALIZED WORLD, we have the largest-ever generation of young people.1 Over 86 percent of them live in developing countries, where this period of life has only recently begun to be recognized as significant.2 In most developing countries, the transition from childhood to adulthood traditionally occurs abruptly through initiation rites and adult work for both sexes, as well as early marriages and pregnancies for girls. These rapid changes often bring with them great risks to young peoples health. Many methods have been attempted to end such practices, perhaps the most effective being enrolling and keeping girls in school. However, such changes have also brought about a breakdown in traditional systems of initiation into adulthood and sex education. Typically, young people are now left to their own devices to deal with their physical and psychological development and sexual awakening. At the same time, young people are exposed to images of sexual freedom dirough the global reach of mass media. And yet, faced with these changes, sex education programs in most countries remain woefully inadequate or nonexistent.
Young people have also been hit hardest by the HIV/AIDS pandemic. The World Health Organization (WHO) estimates that more than two million young people are newly infected with HIV each year, two-thirds of them female.1 Furthermore, at least 6.6 million young people today are displaced by armed conflicts that have separated them from their families and communities. In such situations, girls are at increased risk of suffering gender-based violence, including rape and transactional sex, which can result in unsafe abortions and sexually transmitted infections (STIs) such as HIV/AIDS.3
By the age of 17, over 50 percent of young people worldwide become sexually active.4 Edward Scholl and William Finger estimated that 15 million births (about 11 percent of total annual births) take place globally among young women ages 15 to 19, both married and unmarried.5 The global HIV/AIDS epidemic has brought with it the realization that a dual fight is needed against HIV infection and teenage pregnancy. There is a massive effort backed by substantial resources to educate young people on HIV/AIDS around the world and in countries where young people are very aware of the dangers of the disease. However, in countries like India, youth often lack specific knowledge of the modes of transmission, especially sexual transmission, due to the lack of in-depth HIV/AIDS and sex education.6
Experience has shown that sex education programs that have brought results in disparate societies and cultural contexts deploy community-based, holistic tactics to drive beneficial social change rather than resorting to ineffective abstinence-only sex education.
CONDOMS, CONTRACEPTIVES, AND CONTROVERSY
In spite of the raging dual epidemics of teenage pregnancy and HIV infections, the majority of young people around the world have poor access or no access to condoms and other contraceptives. In Asia, 32 percent of all unsafe abortions occur among females 15 to 24 years of age.7 In 2004, nationally representative household surveys of 12- to 19year-olds in Burkina Faso, Ghana, Malawi, and Uganda showed that only about one in two sexually-experienced adolescents has ever used a modern contraceptive method (usually a male condom), and a large proportion of sexually-experienced adolescents do not know how or where to obtain contraceptive methods due to embarrassment, fear, and financial costs.8
The U.S. government traditionally supplied condoms and other contraceptives through its many reproductive health and HIV/AIDS prevention programs. However, under President George W. Bush's Emergency Plan for AIDS Relief (PEPFAR), which was launched in 2003, nearly 60 percent of all HIV sexual transmission prevention funding has gone to promoting abstinence and being faithful, the A and B of the "ABC approach." The C, for condom, is largely devoted to high-risk groups such as sex workers and their clients. …