Tuesday, June 30, 2009

Too young, too curious

Adolescence is a period marked by confusion, as adolescents try to make sense of the changes in their physical appearance, as well as to establish their own identity. It is a crucial stage where being curious is not enough; that curiosity has to be satisfi ed, and the consequences can often be dire. One of the pressing concerns facing adolescents is the rise of unwanted pregnancy and incidences of sexually transmitted infections (STI) among this particular age group.

Sexual initiation among adolescents is occurring at a younger age; the typical age for boys is 13 and 14 for girls. More alarming, most of fi rst time sex were either
unplanned or non-consensual. The 2002 Young Adult Fertility and Sexuality Study (YAFS) conducted in the Philippines showed that 57 percent of fi rst time sex fell in
the unplanned or non-consensual category. For unplanned - and therefore unsafe - sex, the risk of unwanted pregnancy and/or getting STI becomes higher.

The 2001 ESCAP Population Data Sheet showed that adolescent fertility rate in the
Asia-Pacific region stands at 36 births per 1,000 females 15 to 19 years old. South and Southwest Asia registered the highest rate of 57 births per 1,000; while North and Central Asia registered the lowest with 37 births per 1,000.

Teenage pregnancy – with its attendant risks and the prospect of abortion – is now becoming a global health threat. A report from the World Health Organization’s
Western Pacifi c Region Office showed that in developing countries, pregnant women below 18 years old are two to five times more likely to die than pregnant women 18
to 25 years old. Young mothers are not the only ones at risk; morbidity and mortality risks are higher among infants born to young mothers.

Adolescents are also prone to STIs. In a presentation, Dr. Suman Mehta, Global HIV and AIDS Coordinator of UNFPA, reported that nearly a third of people living with
HIV and AIDS are young people, and that half of new cases involved the young. Moreover, an estimated 111 million new cases of STI infection among the youth are
reported every year. In China, STI prevalence among 15 to 19 years old is at 79.45 percent. The WHO, has in fact, stated that “the current epidemiology of STI and HIV suggest that they are diseases of young people.”

Non-consensual sex

Non-consensual sex presents a particular challenge, since studies have shown that women whose fi rst sex was coerced are more likely to experience subsequent coercive sex. In addition, they are more likely to be sexually active. Non-consensual sex has far reaching effects, affecting a woman psychologically and mentally. Studies in India and Ethiopia showed that sexually-abused teenagers often drop out of school or suffer from poor academic performance. The women are also more likely to be depressed and to commit suicide. Even young boys fall prey to non-consensual sex, either with an older male acquaintance or relative, or an older and more sexually experienced female.

Breaking the taboo

Different social institutions have been actively speaking on the need to protect the youth from sexual proclivity, but the reality is that there is a growing and unmet need for reproductive health services and information among the youth. Ideally,
information should come from the parents, but in the Asia-Pacific context, sex remains to be a taboo issue. Often, parents and guardians are ill-equipped to give appropriate counseling to their wards, and the youth are forced to obtain the information from unreliable sources.

Despite their limited knowledge and their reluctance to discuss sex and sexuality with their children, parents can still infl uence their children to be more circumspect. A literature review conducted by the WHO and the Johns Hopkins Bloomberg School of Public Health and other institutes showed that adolescents who grew up in a loving and caring household, and who have parents whom they look up to as role models, are less likely to engage in premarital sex.

Admittedly, providing services and information is just a part of the solution. Looking at the bigger picture, a more holistic intervention is required to ensure that the youth are protected. Non-consensual sex, for instance, often has socio-economic, political, and even cultural determinants. Poverty forces young boys and girls to prostitution, which makes them all the more vulnerable. Forced or arranged marriage – often done as payment for a debt - also makes a young girl vulnerable to coercive sex.

Gender issue is also a dominant factor, since women are often the victims of coercive sex. There is a widespread belief that young women should preserve their virginity until they are married, while young boys are expected to be sexually active and to have multiple female sex partners. The issue of teenage sex and adolescent reproductive health will always be a fodder for debate, but families and other key social institutions can no longer afford to turn a blind eye on the issue.

The article is published in Health Alert Asia Pacific newsletter (Issue 15) by HAIN. For copies of the newsletter, please write to hain@hain.org