Let’s talk about sex to save lives

Let’s talk about sex to save lives


Ariela Zibiah

Monday, February 22, 2016

A REPORT on sexual and reproductive health of young people in Asia and the Pacific released last month affirms that a significant proportion of young people, 15 to 24-year-olds, are sexually-active, and premarital sex is more common in the Pacific.

The report which was collaboratively produced by the UNFPA, UNESCO and WHO provides analysis based on several variables but among other factors, the report states young people in urban setting are more likely to have earlier sexual debut than their rural counterparts and those who leave schools are more likely to commence rather than those who are still in school.

The report affirms how adolescents across the countries discussed in the report remain discriminated against by gate keepers of essential services particularly the health services and/or those who are supposed to ensure timely and correct sexual and reproductive health and reproductive rights information.

Adolescence in limbo

Adolescence is a minefield of emotions that will require a lot more open discussion around sexual and reproductive health and reproductive rights issues. It is a critical time of self-defining processes when influencers of world views crowd thought-processes, and in this day and age, parents, guardians and or teachers compete with the rush of the information highway.

Adolescence has historically referred to those between 10-19 and youth between 15 to 24-year-olds. It is a time of transition from childhood to adulthood. For the United Nations Population Fund, UNFPA, this is also a time when good sexual and reproductive health and reproductive rights fundamentals must be established.

It is not only a basic human right to ensure our young people are able to achieve the highest attainable sexual and reproductive health standards, but investing in it will eventuate in inclusive national progress.

The report found an increasing number of young people are initiating sexual debut before marriage. A clash between the diverse factors which inform young people’s world views and the sociocultural realities of their communities are inevitably becoming barriers to good sexual and reproductive health.

The region is home to numerous communities where faith-based ideals give power to moral policing without serious consideration or acknowledgment to what is actually driving attitudes, decision-making processes and behaviour of young people in relation to sexual and reproductive health and reproductive rights. The religiosity is compounded by gender dynamics that not surprisingly tilts the burden of poor sexual and reproductive health and reproductive rights to girls and women.

It should be no surprise therefore that in the region we are part of, one in seven girls in the region would have given birth by the age 18 in the context of high unmet need of contraceptives (failure to access vital reproductive health service to ensure a lived reproductive right to decide for herself if she wants to have children, how many and at what intervals), in terms of child marriages (a despicable cultural practice with irreparable damage to girls with a rippling effect which impacts national indicators of development) and also in relation to the lack of access to critical information (age-appropriate comprehensive sexuality education delays sexual debut as opposed to popular belief that it encourages sexual debut).

Norms as barriers

Entrenched sociocultural practices and attitudes to issues around sexual and reproductive health and reproductive rights are the reason why less than half of the 15 to 24-year-olds are reporting not using a condom at the last high-risk sexual encounter.

Taboos which disallows frank discussions around reproductive health and rights is an example of sociocultural barrier to a safer space for our young people. A faith-based consideration should allow the discussion of sexual and reproductive health as a gift for pro-creation and a symbol of love between two people, as Reverend Jeremaia Waqainabete, superintendent minister of the Wesley Division of the Fiji Methodist Church, describes it.

The report emphasises how gender norms have a “profound influence” on young people’s sexual and reproductive health. Most countries indicate a more relaxed attitudes to young men having premarital sex then young women but both sexes are permissive of male premarital sex rather than female premarital sex.

High-risk behaviour which includes multiple sex partners, intergenerational sex and/or sex under the influence of alcohol will increase the likelihood of sexually-transmitted infection including HIV.

The report states: “Young men are more likely to report multiple sexual partners particularly in the Pacific where up to half of young men who have ever had sex reports two or more partners in the last 12 months.”

The relationship between alcohol or substance use and risky sexual behaviour is well-documented. For countries with national data, young men reported much higher rates of sex while drunk than young women “most significantly in the Pacific”.

The Pacific is also well-represented in binge drinking data in the report (entitled Sexual and reproductive health of young people in Asia and the Pacific: A review of issues, policies and programmes) with the highest rate reported in Fiji (21 per cent), PNG (18 per cent) and Solomon Islands (16 per cent). In all countries, risky alcohol use is more common among males than females, with binge drinking rates two-three times higher among adolescent boys.

It is evident that high-risk behaviour has successfully lodged itself into our collective psyche as “normal”. Depriving one of critical sexual and reproductive health information and services like the provision of contraceptives from nurse posts based on socioculturally-influenced reasoning is “normal”.

Serious consideration of these norms which are becoming barriers to both life-saving information and services is urgent for a population that is fundamentally unhealthy cannot be a resilient and productive population.

Family support

and gender equality

The report affirms that families can be important protective influences on our youths. Studies in Indonesia, Thailand and Philippines ascertained a relationship between delayed sexual debut and a close relationship with parents.

Family support will be particularly important for girls. Studies in India, Vietnam, Cambodia and the Philippines suggested a connectedness between adolescent girls and their parents, particularly their mothers, and a family environment that supported gender equality corresponded with delayed first sex among girls.

The Pacific is part of a region that is home to 60 per cent of 1.8 billion people aged 10 to 24-year-olds in the world today.

We may not be a landlocked area but there is significant interaction by air and sea. If the lack of forthrightness in issues related to sexual and reproductive health and the rather high levels of sexually-transmitted infections is anything to go by, then an underlying albeit inconspicuous consequence awaits.

The inability to accept the fact that our children are being exposed to issues around sexual and reproductive health and reproductive rights at a much earlier age will continue to throw back data as reported in the report like 10 per cent of males and 20 per cent of females in the age group of 15-24, report having a sexually-transmitted infection or its symptoms in a period of 12 months.

It is a sociocultural and economic imperative to shed ourselves of the façade of taboo. The consequences of inaction is unfathomable and a deadly legacy to leave behind as a people.

* This is the first article in a series of four.

* Ariela Zibiah is the communication analyst at the UNFPA Pacific subregional office.

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