The World Health Organization (WHO) defines adolescents as the age group 10–19 a definition used throughout this volume. The meaning of adolescence as a cultural construct has been understood in many different ways throughout the world however. In general terms it is considered a time of transition from childhood to adulthood during which young people experience changes following puberty but do not immediately assume the roles privileges and responsibilities of adulthood. The nature of adolescence varies tremendously by age sex marital status class region and cultural context. As a group however adolescents have sexual and reproductive health needs that differ from those of adults in important ways and which remain poorly understood or served in much of the world. (excerpt)

Towards adulthood: exploring the sexual and reproductive health of adolescents in South Asia. Joint HRP, ISRRF and IRR conference " Adolescent Reproductive Health: Evidence and Programme Implications for South Asia", Mumbai. India, November 2000.

Although there is increasing evidence of risky consensual sex among young people in developing countries non-consensual sexual experiences among them have rarely been studied and few interventions have been designed to protect them from the risks of such experiences. However what is available suggests that coercion and unwantedness may play a considerable role in the sexual relations of young people — girls and young women but also boys and young men. The implications of non-consensual sexual experiences for young people’s rights their health and development and the risks they pose in the transition to adulthood are enormous. This review collates what is known about non-consensual sexual experiences of young people — those aged 10–24 — in developing countries synthesises from this a profile of the magnitude and correlates of sexual coercion and draws lessons for the implementation of appropriate programmes. Notwithstanding significant methodological limitations the few available studies provide several common insights and have suggested that although definitions study populations and study designs may differ making comparison difficult nonconsensual sex is indeed experienced by disturbing proportions of young people in all settings from which data were drawn. Non-consensual sex is experienced largely by girls and women but also by boys and men. While studied largely among the unmarried there is evidence that it is commonplace among married couples as well. It occurs largely among individuals who are acquainted with each other. It covers a continuum of behaviours ranging from unwanted verbal advances to unwanted touch to assault and forced sex as well as sex in exchange for money gifts food or protection. The consequences of sexual coercion are formidable: they are short and long-term; and have physical psychological and social effects. Sexual health manifestations range from unintended pregnancy abortion and infection to risk-taking behaviours including early onset of consensual sex multiple partner relations and non-use of condoms. Psychological outcomes range from symptoms of anxiety and depression to suicide attempts. School performance can also be affected. A number of obstacles inhibit adolescents from protecting themselves from non-consensual sexual relations and from taking action against a perpetrator or to withdraw from a coercive relationship. Gender double standards and expectations of women and men in the sexual arena dominate these obstacles. Communication and negotiation on sexual matters moreover tend to be difficult and are often replaced by actions that include force and violence to resolve differences. The lack of a supportive environment and trusted adults and peers to consult on sexual health matters may also enhance young people’s (and particularly young women’s) vulnerability to coercive sexual relations. And finally perceptions of institutional indifference — at the community school crime and health sector levels — can inhibit help-seeking both among victims as well as others who may wish to seek counselling on how to confront a potentially threatening situation. We conclude with a discussion of programmatic and research priorities. (authors)

/pdf/non-consensual-sexual-experiences-of-young-people-a-review-ht5vozw1v2.pdf

Non-consensual sexual experiences of young people: a review of the evidence from developing countries.

Approximately one-third of the world's population is between 10-24 years of age, and four out of five young people live in developing countries, a figure which is expected to increase to 87% by the year 2020 (Friedman, 1993; Ainsworth and Over, 1997). In many countries the majority of young people are sexually experienced by the age of 20 and premarital sex is common among 15-19 year-olds. For example in recent surveys it was found that 73% of young men and 28% of young women in this age group in Rio de Janeiro reported having had premarital sex, compared with 59% and 12% respectively in Quito, and 31% and 47% respectively in Ghana (Population Council, 1996)

http://www.pwhce.ca/hivaids/scenario2/Gender_and_the_HIV_Epidemic.pdf

Adolescent sexuality, gender, and the HIV epidemic.

Results from an ethnographic study carried out in a community within the Durban area concerning the meanings and symbolic representations given to sexual activities and to HIV/AIDS are presented in this article. The interpretation of the field-work material draws on the literatures of the genderification of HIV/AIDS and on studies of the symbols used to signify AIDS. The Zulu interpretation of AIDS is shown to be intimately bound up with the overall socio-cultural construction of femininity, in which women are seem as both the sources and disseminators of the disease.

Demonising women in the era of AIDS: On the relationship between cultural constructions of both HIV/AIDS and femininity

In Asia, the lesbian and gay rights movements are clearly dominated by activists, who tend to think in terms of a binary opposition (homo- vs hetero-) and clear-cut categories. Based on "Western patterns," the approach is practical, the arguments based on minority rights. "Coming out" is often perceived as a "white model" bringing more problems than real freedom. On the contrary, "Asian values" put the emphasis on family and social harmony, often in contradiction to what is pictured as "lesbian and gay rights." Homophobia follows very subtle ways in Asian countries. Asian gays have to negotiate their freedom, lifestyle and identities in an atmosphere of heterosexism, and not the endemic violent homophobia prevalent in many western countries. In Asia, one's identity relates to one's position in the group and sexuality plays a relatively insignificant role in its cultural construction. That Asian gays often marry and have children shows the elasticity their sexual identity encompasses. Fluidity of sexuality does not really match the Western approach in terms of essentialist categories that have a right to exist. Most Asian societies can be thought of as "tolerant" as long as homosexuality remains invisible. Procreative sexuality can be seen as a social duty, and heterosexual marriage is often not considered incompatible with a "homosexual life." The development of the Internet has even facilitated the encounters while allowing secrecy. Unfortunately, the traditional figures of transgender and transvestites have often been separated from the gay liberation movement.

Sexuality and human rights: an Asian perspective.

This report presents findings from the most comprehensive qualitative and quantitative study to date of Sri Lankan youth sexuality. The study included the assessment of attitudes beliefs and knowledge of unmarried youth about sexuality AIDS/STDs and risk and protective behavior. The study described the behaviors of youth that would help explain sexual risk and romantic relationships. Data were used to design a pilot intervention which was evaluated. Findings were disseminated. Data were obtained from key informant interviews observations of youth "hang out" settings semistructured interviews with 156 university students and out-of-school youth aged 17-28 years self-administered questionnaires among 303 community youth and 312 university students and a pre-post test of the peer education intervention. The authors found that young people were willing to talk openly with same sex interviewers and to respond in anonymous self-administered questionnaires. There was a wide diversity of sexual behaviors including nonpenetrative sex. Culture strongly determined sexual behavior. Risky behavior occurred among a subset of young males. The risks included unprotected sex with young and older males married women and commercial sex workers while using alcohol and drugs and after watching pornography. Condoms were rarely used and viewed as inappropriate for sex with love. There were significant differences in levels of knowledge communication skills and the nature and extent of risk behaviors and preferred risk reduction behaviors. The peer education model was effective especially for women without vocabulary knowledge or peer networks. Women and men were least able to agree on the risk reduction in negotiation and nonpenetrative sex. There was more agreement on condom use or abstinence. This pilot study should be modified based on findings and the problem of male recruitment and retention.

Youth and sexual risk in Sri Lanka.

Translating state data into local programs: targeted research for intervention planning (TRIP)

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Youth and sexual risk in Sri Lanka.

Translating state data into local programs: targeted research for intervention planning (TRIP)