More Than Condoms: Towards Effective
Sexual Health Promotion for Youth
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WOMANLY TIMES ARCHIVES More Than Condoms: Towards Effective Sexual Health Promotion for Youth |
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This article originally appeared in WOMANLY TIMES, the Women's Health Clinic newsletter, Summer/Fall 2000 issue. by deb kozak
Adolescence is an intensely formative time in human development; played out against the physical changes of puberty, young people are developing emotionally, socially, spiritually and sexually. It's natural for adolescents to engage in experimental behavior that helps them figure out who they are and forms the values that will guide them in adulthood. They face the challenge of forming a positive sexual identity and protecting their sexual and reproductive health in a culture that bombards them with complicated and contradictory messages about sex and sexuality. Traditional values and societal ideas about different sexual roles for women and men compete with messages about immediate gratification and sexual freedom; we encourage young people to be whole in a culture that divides them into body parts; we tell them to protect themselves in a world filled with images of unsafe, often violent, sexual behaviour. It's a time of making choices that may have implications for the rest of their lives. Our challenge is to help them navigate this rocky terrain towards developing healthy sexual identities and maintaining sexual and reproductive health. Empowerment strategies used with youth tend to focus on building life skills, and often neglect to incorporate sexual health information. Sexual health education has focused on reducing rates of unintended pregnancy and sexually transmitted infections by providing information and condoms without considering the climate in which teens are making sexual health decisions. To be truly effective, we need a comprehensive approach that takes both into account. We need programs that address the real-life and very human needs of young people. To most effectively prevent and reduce high-risk sexual behavior, our strategies must encourage youth to develop personal motivation to protect their sexual and reproductive health as well as provide the practical tools for how to do so. We must be responsive to the diversity of values and beliefs across cultural, socioeconomic and ethnic groups. We must be aware of the tensions teens feel between cultural values and reality-based struggles for personal identity social and sexual growth. Our challenge is to help youth to develop feelings of self-worth within the realities of their family, social and cultural environments and their experience of poverty, racism, sexism, homophobia, violence, abuse and discrimination against youth. Our work in sexual health promotion and risk prevention must include working to change the social conditions that act as barriers to making healthy sexual decisions. We must help adolescents develop a critical awareness of how larger social circumstances influence their personal circumstances and options for decision-making. Discussing social and cultural values helps to deconstruct societal expectations and engendered roles and rules for women and men, and helps them formulate healthy sexual guidelines based on principles of fairness, equality, non-violence and respect for themselves and others. Traditionally, public health intervention has focused on issues that adult service providers perceive teens need. The implication of this approach has been that young people were asked to adopt behaviors that they didn't see as relevant to their real lives. The best way to learn about the circumstances in which young people are making their sexual decisions is to talk to them and to listen to them. By teaching young people to think critically about their environments, we help them understand the ways in which their thoughts, feelings and actions are shaped by culture and society. We need to encourage young people to tell us their stories so that we understand the choices they make within the context of their real lives. The most important work we can do is to help young people develop and maintain a healthy core identity that includes self-respect, self-awareness and a sense of personal boundaries. When we focus on strengths and assets, we help young people identify, develop and rely on their own assets and increase their abilities to respond to the challenges in ways that protect their sexual health. By building on strengths and assets, we motivate young people to work toward a future. We can help young people learn the differences between thinking, feeling and acting, between immediate gratification and long-term goals, and help them discover the values that will guide them in adulthood. Ideally, young people should participate in designing health promotion/harm reduction programs and activities. They are the experts of their own lives: they have an insider view of the strategies appropriate and relevant to their life circumstances. Giving teens a role in the design, implementation and evaluation of activities helps them take ownership of their sexual health. The most effective sexual health programs acknowledge the complexity of the lives of young people and try to meet the needs that youth identify for themselves. When we listen to youth, we learn how their actions are influences by the basic human need for identity, intimacy and social acceptance and how this impacts in their ability to negotiate safer sex practices with their partners. The challenge to us is to help teens learn how to meet their needs within their relationships without compromising their sexual health. Young people benefit from opportunities to learn practical information and to develop attitudes and skills that will enable and empower them to make informed decisions, to communicate with their partners, peers, parents and give them the ability to identify and access resources which will help them maintain health. Activity based learning like role playing and modeling gives teens opportunities to try new behaviors; to hear themselves say "no" and to develop problem-solving skills. It's a process of empowerment; they learn that they are capable of making decisions for themselves and that they can change risk-taking behaviors. It also gives them an opportunity to learn skills needed to negotiate/refuse unwanted or high-risk sexual behavior. It allows opportunity to review their sexual health options and to learn more about ways to protect themselves. By building a healthy core identity, we give teens an opportunity to develop the motivation and means to avoid sexual risk behaviors. We can help them increase their relationship skills: the interpersonal, communication and assertiveness skills that help them negotiate healthy behaviors in each of their relationships and for each sexual encounter. As self-esteem increases, so does motivation to develop skills to protect themselves. Sexual health promotion and risk prevention programs should involve adults who are knowledgeable about the issues and who are committed to supporting young people in developing a positive sexual identity. It's important that, along with professional expertise, these adults bring a positive, non-judgmental attitude and a genuine respect for teens. They must be willing to work collaboratively with young people and demonstrate flexibility, commitment, interest and a willingness to be a role model. Successful youth development requires building community partnerships. All members of our communities - families, peers, academic and spiritual leaders, business, government and community organizations - have a stake in fostering the capabilities of young people. By identifying and linking the resources and service providers available in the community, we can facilitate partnerships, identify strengths and gaps in services for youth, and ensure community involvement and commitment to the sexual and reproductive health of young people. We need to work together to convey coordinated, realistic, healthy messages and to give youth access to a variety of services. Adolescence is a challenging time, for young people and the adults in their lives. We can ease the transition to adulthood when we help them build on their natural capacities, and assist them in cultivating their talents and increasing their feelings of self-worth. When we promote and celebrate the basic human right to sexual and reproductive health, we are teaching skills to last a lifetime. It's apparent that we must foster motivation as well as provide information; it's simply not enough to give young people condoms and tell them to use them, we must help them identify reasons to do so. Sexual and Reproductive Health: The Cost of Inaction Health Canada, in consultation with key stakeholders, has developed The Framework for Sexual and Reproductive Health. While this strategic planning tool provides an overview of key issues concerning sexuality and reproduction, there has been no promotion to inform the public of its existence, nor does it identify an action plan or funding strategy to follow up on the problem it identifies. The Planned Parenthood Federation of Canada encourages Health Canada to take a leadership role in developing a National Policy, strategy and plan of action to work with provincial and territorial governments to address the problems of:
The Solution The Planned Parenthood Federation of Canada strongly encourages Health Canada to develop a national strategy on sexual and reproductive health and a plan of action that includes proactive intervention, defined time lines and adequate funding, specific policies and programs to address priority areas and gather statistics and provide increased funding and to facilitate partnerships that will address the sexual and reproductive health needs of Canadians, especially those of young people. Concerned citizens and stakeholders are urged to contact the Minister of Health: To obtain a copy of A Report from Consultations on a Framework for Sexual and Reproductive Health, call Health Canada at (613) 954-5995. For more information contact: |
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