Development of Contextually-relevant Sexuality Education: Lessons from a Comprehensive Review of Adolescent Sexuality Education Across Cultures

Abstract

As reported by the World Health Organization in 2017, there are 2 million+ young people living with HIV worldwide. The World Health Organization also reported that a third of all new HIV infections around the world are estimated to occur among youths (aged 15–25). and teen pregnancy rates are on the rise in many places. These worrying trends suggest that existing sexuality education programs and interventions may be inadequate and/or ineffective. Although the 1994 International Conference on Population and Development’s (ICPD) Programme of Action highlighted the roles of Governments to offer sex education to young people to promote teenage reproductive health, yet inconsistency exists in the related initiatives in the global context. The present article aims to provide a comprehensive literature review of the existing sexuality programs in selected places in both English-speaking (i.e., the United States of America, the United Kingdom) and Chinese-speaking contexts (i.e., Hong Kong, Mainland China, and Taiwan). Based on the review, observations and implications for sexuality education policy and practice, as well as recommendations for future research for youths are outlined.

Can sexual health interventions make community-based health systems more responsive to adolescents? A realist informed study in rural Zambia

“…The research team in the RISE trial expected that interventions that target the SRHR of adolescents in the CBHS would significantly be affected by contextual factors, such as the local policies, socio-cultural norms, existing structures in the CBHS and prevailing conditions at the health facility. This was in line with other studies that have highlighted the importance of the context on how adolescents adopt or not SRHR interventions [36,37]. Depending on contextual conditions and how the actors adopt the intervention, the refined programme theory will probably lie within the broad range of possibilities highlighted by the two 'extreme' programme theories.…”

“…Although some respondents in our study seemed to suggest a linear relationship between the mechanisms, with one leading into another, the development of the individual and collective mechanisms are more likely to be affected by individual demographics, interpersonal relationships and structural factors, such as political and socio-economic structures [35,40]. For example, sociocultural norms have been shown to negatively affect the type of SRHR information given and consequently adoption of SRHR interventions, especially if they include promoting discussions related to sexual matters between parents and unmarried adolescents [36]. In addition, they tend to go beyond promotion of abstinence to promote condom and contraceptive use, which are generally considered culturally a taboo [41,42].…”

Factors influencing sexual and reproductive health among adolescents in Lao PDR

“…For this reason, the life-skills curriculum and comprehensive sexuality education (CSE) need to be further integrated into the national core curriculum in Lao PDR. CSE focuses on gender equality, participation, consent, and empowerment, which are all vital for establishing equal opportunities, positive gender attitudes, and autonomy [14,41,42].…”

“…Nevertheless, teachers' own cultural norms and values might make them hesitant to teach CSE effectively, or, as expressed by several key informants, they might think that teaching adolescents CSE is inappropriate [41]. The latter finding suggests that although the poor current teaching quality was largely recognised, not everyone was ready or open to changing the situation.…”

Pre-Service Teachers attitudes and knowledge concerning Sexual Health Education in the field of Special Education

“…Several recent studies indicate the importance of training programs for teachers intending to deliver Sexual Health Education (SHE) in mainstream schools (Arrington et al, 2018;Leung et al, 2019;McKay & Barrett, 1999) and in the field of Special Education (Owens, 2014;Thorpe & Oakes, 2019;Treacy et al, 2018). The lack of insufficient preparation of teachers for delivering SHE in Special Education (SE) has been reported as one of the obstacles preventing effective SHE for young people with special needs (Attwood, Henault, & Dubin, 2014;Goldman & Coleman, 2013;Klein & Breck, 2010;May & Kundert, 1996;Wilkenfeld & Ballan, 2011;Travers et al, 2014).…”