Promoting sexual and reproductive health among adolescents: What works?

Adolescence face many pressures and decisions that often occur simultaneously. Research has shown that many health risk behaviors occur in combination with one another, yet it is often unclear which behavior comes first. Substance use increases the probability that an adolescent will initiate sexual activity at an earlier age which may lead to unprotected sexual intercourse, and have multiple partners which might impacts their sexual and reproductive health systems such as by contracting sexually transmitted diseases (STDs) and HIV/AIDS. Therefore, an attempt has been made to study the Indian female late adolescents’ substance use, risky sexual behavior and resulting of impacts on their sexual and reproductive health systems. Uni-variate, bi-variate was used to see the percentage distributions and by different background characteristics and multivariate analysis was applied in order to examine the most important predictors of their substance use and risky sexual behavior. Spearman Rank Correlation Coefficient to see if there were any significant relationships between their risky behaviours and impacting of their sexual and reproductive health systems. Hence it proved to have a strong statistically significant positive correlation between risky behavior and impacting on their sexual & reproductive health systems (rho=0.286,p<.000

Stigma and discrimination against PLHIVs could be social, physical, verbal or institutional and each or a combination of them could worsen the health condition of the affected person. Such people are often given names which are described as derogatory or insults. These observations have generally emerged from social researches on HIV/AIDS which have focused entirely on adult population. This study therefore assessed the knowledge, attitudes and perceptions of children (9-13yrs) towards PLHIVs in Cape Coast Metropolitan area of Ghana. This was a cross-sectional descriptive study conducted in three contrasting study sites (urban, peri-urban and rural). Data collected from the over four hundred and fifty children were both quantitative and qualitative in nature. Majority of the respondents were of the view that HIV/AIDS could be contracted through mosquito bite or witchcraft. Most of the respondents were unwilling to eat or sleep with a PLHIV. They were also neither ready to be taught by a female teacher who is HIV+ or buy fresh vegetables from an infected person. It was recommended that behavioural change communication programmes should also focus on children.

This paper examines the impact of peer led intervention on challenging gender norms among young men. The analysis is based on the operations research (the Horizons program) which covered 1040 young men (18-29 years) from 28 villages from one of the northern states of India. Pre-Post intervention surveys, including measures of attitudes towards gender norms using the Gender Equitable Men (GEM) scale and other key HIV/STI risk outcome were used as evaluation tools. The study demonstrated that there was a significant decrease in supporting inequitable gender norms, there was an increase in condom use with marital and non-marital partners and reported less physical harassment. Majority of men who participated in the study showed considerable improvement in inter-spousal communication on various issues such as STI, HIV prevention and condom use, which clearly highlights the importance of interpersonal communication and reinforcing gender equity and HIV risk reduction messages at the community level.

Providing family life education (FLE) to unmarried adolescent women is a taboo in India. The DLHS-3 collected information on FLE and menstrual practices from urban unmarried women aged 15-24 years. Around half women had high school and above education, two third was Hindus and one-fifth Muslims. Three fourth were aware of FLE four fifth perceived FLE important, half received FLE while three-fifth perceived right ages for FLE as 15-17 years. Eighty percent women think right place for FLE as school/college when they are studying. One-fourth opined that they could get pregnant during very first sexual intercourse. One-fifth had menstruation related problems. They used cloth/locally made sanitary napkins during menstruation. Educated women practised more menstrual hygiene. Three fourth adolescent unmarried women had awareness about FLE, eighty percent thought FLE as important, half had received FLE and three-fifth women opined proper time for FLE as 15-17 years, eighty percent want FLE to be given by school/college when they were still studying.Logistic regression indicated that older, higher educated, other castes and richest women were more of aware of FLE, perceived FLE important and received FLE than their counter parts. The study suggests for a need to create awareness among the adolescent women.