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Holiday collage

 

Wishing the best of holidays and a happy new year to all of our readers. Thank you for reading our blog; we look forward to bringing you more information on youth reproductive and sexual health in the New Year.

Until then…happy holidays!

Robyn Dayton is an Associate Technical Officer at FHI where she works on the research utilization portfolio of youth reproductive and sexual health activities.

I had an opportunity recently to travel to Bogotá, Colombia for the UNFPA Global Consultation on Sexuality Education.  The meeting covered a range of topics, from what works in sexuality education to how to advocate for comprehensive sex ed with national governments.  There were attendees from Asia, sub-Saharan Africa, the Arab states, Latin America, Eastern and Western Europe, and the United States.  Everyone shared their successes and stumbling blocks on the path to ensuring that young people all over the world have the information they need to make safe and healthy choices in their reproductive lives and beyond.

A few key ideas really stood out to me.  First, there was an emphasis on gender throughout the conference.  All acknowledged that if gender isn’t addressed explicitly, young men and women are less likely to be able to use the information they learn in sexuality education programs or classes.  But if we help young people recognize and question gender norms – like “real men are aggressive and don’t take no for an answer,” and “women should be passive and not question men’s authority” – they are more capable of engaging their partners in delaying sex or practicing safe sex. 

Another important point frequently raised at the meeting: if you don’t measure it, it doesn’t count.  It can be difficult to determine what young people gain from sexuality education if we only measure behavioral outcomes like delayed sexual initiation.  We need to think more broadly.  Improving students’ ability to think about complicated concepts like gender constructs also builds critical thinking skills, which improves a student’s overall performance.  Thus, measurements of academic performance generally could be used to indicate the success of sexuality education programs. Another factor to consider is how students engage in sex – is it coerced, transactional, forced, consensual?  The context in which young people have sex affects their mental and physical health and is another indicator of the success of sex education.  If we aren’t collecting information on these kinds of indicators, we’re missing the bigger picture.

Which relates to the final point that I took away from the meeting – sexuality education isn’t only about preventing poor health outcomes.  We need to move away from the idea that sexuality education is just another weapon in the fight to curb HIV.  It is that, but it’s so much more.  Sexuality education gives young people tools to think about themselves and their sexuality, to understand and respect their changing bodies and emotions (and those of their peers), and to mature into healthy and satisfied adults.  Our sexuality should not be viewed simply as a risk factor for contracting diseases, and the meeting emphasized that we all have the right to understand and feel comfortable with ourselves as sexual beings and as people generally.

A full meeting report will be made available in January.  So check back because we’ll be posting the link!

We are disappointed by the news that the International Protecting Girls by Preventing Child Marriage act  failed to pass in the U.S. House of Representatives.  On Dec. 1, 2010 the Senate unanimously passed the bill. This news created hope and excitement among advocates and professionals working with youth and in the field of youth reproductive health globally.  Unfortunately, the House of Representatives rejected the bill yesterday by a 241-166 vote.  The Congressional Budget Office estimated that the bill would cost approximately $67 million, which raised concerns among some House members. Some Republican House members were also concerned with implications for family planning and the possibility that the bill might affect pro-life laws. However, the bill (full text available here) contained no mention of abortion or any abortion provisions.

There are more than 60 million child brides worldwide. Over 25,000 girls under the age of seventeen are married daily, resulting in approximately 10 million child marriages each year. Early marriage places girls at a greater risk of many negative health outcomes such as increased likelihood of maternal mortality and becoming infected HIV. Girls are often forced to leave school at a young age as a result of early marriage and are at greater risk for sexual violence. Under the proposed bill, the U.S. government would have developed an integrated, strategic approach to combating child marriage with the goal of eliminating this practice worldwide.

One of the goals of the Interagency Youth Working Group is to synthesize and share information on new research, programs, and best practices related to youth sexual and reproductive health. We promote publications of partner organizations and develop our own.

Are you using our publications?  We’d love to hear from you!  These publications are intended for an international audience, and we want to know who is using them and where in the world they’re being used. Are you conducting trainings with the Training Guide for HIV Counseling and Testing for Youth? Planning a new program with Evidence-based Guidelines for Youth Peer Education? Please take a picture of our publications being used and send the photo to us with a short explanation of the work you’re doing. We might feature you in our blog!

Send photos and feedback about our publications to: youthwg@fhi.org

Allison Prickett, MPH and Kathy Lancaster, MPH,  are Global Health Research Fellows at FHI.

In many HIV prevention programs, we ask young people to change the behaviors that put them at risk. And yet, if we fail to address the larger societal factors that drive their risky behavior, we do youth a great disservice.

One new study aims to reduce HIV transmission in young South African women by influencing the structural barriers to education and the negative gender norms that place young women at risk.

Working in coordination with the HIV Prevention Trials Network (HPTN), Dr. Audrey Pettifor, an assistant professor of epidemiology at University of North Carolina at Chapel Hill, recently developed the HPTN study 068: “Effects of cash transfer and community mobilization for the prevention of HIV in young South African women.” The name of the study in the local language is “Swa Koteka,” which means “Yes, We Can!”

This Phase III, randomized, controlled factorial design study is being conducted in a rural area in Mpumalanga Province, South Africa.  The study includes two components: (1) providing young women and their households with monthly cash transfer payments, conditional on the young woman attending school, and (2) conducting a community mobilization intervention that focuses on changing negative gender norms and HIV risk behaviors in young men ages 18 to 35—the age of most of the young women’s partners.

The study will involve about 2,900 young women and last for four years. Researchers will determine whether young women who receive cash transfers conditional on school attendance have a lower incidence of HIV infection and a lower incidence of herpes simplex virus type 2 than women who do not receive the monthly cash transfers.  Other factors to be compared among the two study groups are incidence of unprotected sex, number of sex partners, age of their male partners, age at coital debut, incidence of self-reported pregnancy, and school attendance.

Read more about the study here.

On Wednesday, December 1, the United States Senate unanimously passed the International Protecting Girls by Preventing Child Marriage Act. The bill requires the U.S. government to develop an integrated, strategic approach to combating child marriage with the goal of eliminating this practice worldwide. The bill identifies early marriage as a human rights violation, and calls on the White House to create an action plan to combat early marriage, report on the practice as a human rights violation in the State Department Human Rights Report, and integrate prevention programs into existing U.S. development efforts.

It is estimated that more than 25,000 girls under the age of 18 are married daily. At this rate, approximately 10 million girls each year, a striking 100 million within the next decade, will become child brides. To date, more than 60 million girls under the age of seventeen have been married worldwide. Globally, one in three girls is married before she is 18 and one in seven girls is married before she is 15. In some countries, as many as half of the girls are married before they turn 18.

When girls marry at a young age, they often leave their homes, stop attending school, and lose contact with family and friends. For most, marriage marks the beginning of their sexual life. Child brides face a higher risk of contracting HIV because they often marry an older man with more sexual experience. Girls ages 15–19 are two to six times more likely to contract HIV than boys of the same age in sub-Saharan Africa.

Many girls give birth during their first year of marriage, when their bodies are not fully matured. As a result, pregnancy is the leading cause of death worldwide for women ages 15 to 19; girls younger than 15 are five times more likely to die in childbirth than women in their 20s. Adolescents enduring a difficult labor also are at risk of obstetric fistula, a condition in which a hole develops between either the rectum or bladder and the vagina. The consequences of obstetric fistula are devastating: the baby usually dies, and women suffer from constant leakage of urine or feces or both, which results in great stigma, isolation, and abuse.

Take a look at this slide essay about child brides.

You can show your support for the bill by logging your comments here.

For more information on early marriage, please visit our program area page. Also, the IYWG will soon publish a four-page brief that discusses five promising approaches for delaying marriage. Keep an eye on our Web site!

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This blog is brought to you by the Interagency Youth Working Group (IYWG) with financial assistance from the U.S. Agency for International Development and the U.S. President's Emergency Plan for AIDS Relief. The content is managed by FHI, which functions as the secretariat for the IYWG.
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