Evidence for Effective Sex Ed

Where did you first learn about sex? From a parent? From a teacher in school? From friends? On the internet? Was the information you learned accurate?

I think most of us would agree that the best time to learn about sex is before you start having it, but millions of adolescents and young people – especially those in low-resource environments – don’t have access to quality, comprehensive sexual and reproductive health information and services. Many of them are pressured into sex before they are ready, putting them at risk of sexually transmitted infections and unplanned pregnancy.

To help prevent this, public health experts recommend offering comprehensive sexuality education (sex ed) in schools. But people have a lot of questions.

At what age should children start learning about sex?

What do they need to know and when?

Does teaching kids about sex encourage them to start having sex earlier than they might otherwise?

Fortunately, there is evidence about what effective sex ed programs look like, and we can now answer many of these questions.

Back in 2009, the United Nations released its first guidance document on comprehensive sex ed. The purpose of this guide was to help government officials to develop and implement effective school-based programs by providing them with the best available evidence about what young people should know about their sexual and reproductive health and rights.

Recently, a revised and updated version of the International Technical Guidance on Sexuality Education was released. The new addition is more inclusive than the original, covering a wide variety of concepts and topics from relationships, gender, social norms, and values, to sexual behavior and reproductive health. The information is broken down by age groups, starting with age 5 and continuing to late teens.

The authors of this document reviewed the best available research and compiled some key findings on effective, comprehensive sex ed programs. We encourage you to read the whole thing for yourself, but if you’re short on time, here are some highlights (see p. 29-30):

  1. Sex ed “does not increase sexual activity, sexual risk-taking behavior or STI/HIV infection rates.
  2. Sex ed “has positive effects” on young people. It increases knowledge about sexual and reproductive health, sexuality, and risk of pregnancy and sexually transmitted infections (including HIV).
  3. Abstinence-only sex ed is ineffective at reducing or delaying sexual activity among students.
  4. Programs that encourage students to reflect on, question, and challenge social and cultural norms related to gender, and to adopt more equitable attitudes about gender, are more effective than those that don’t.
  5. Sex ed is most effective when community-based services are available and tailored to youth, such as condom distribution, training health providers to offer youth-friendly services, and involving parents and teachers.

Although not all policymakers find this evidence convincing, one small African country is leading the charge for comprehensive sex ed. The Government of Burundi, concerned about high rates of teenage pregnancy and the spread of HIV and other sexually transmitted infections, is taking steps to improve access to sexual and reproductive health information and services for in-school and out-of-school young people.

They partnered with CARE, Cordaid, Rutgers, and UNFPA, and received funding from the Embassy of the Kingdom of the Netherlands in Burundi to implement the Menyumenyeshe program (translation: “be informed and inform others”), designed to provide comprehensive sex ed, to make sexual and reproductive health services more accessible and friendly to youth, and to promote supportive attitudes toward youth accessing these services in their communities.

Adolescents and youth represent about one-third of the population of Burundi, and their education and health status will impact their country and communities for years – and decades – to come.

Comprehensive sex ed programs help to equip young people with the knowledge and skills to make responsible choices in their lives, but too often the needs of youth are neglected by those with the power to implement these programs. Fortunately, young people around the world are speaking up, advocating for themselves, and claiming their rights to comprehensive sexual and reproductive health information and services. Adults would do well to support them in these efforts. Youth, after all, are not just the future; they are the present.

Cervical Cancer: a Threat to Women in Developing Countries

More than half a million women develop cancer of the cervix every year. It is the fourth most frequent cancer type worldwide and the global mortality rate remains high at 52%.

Of the estimated 270 000 deaths each year, more than 85% occur in less developed regions. This makes cervical cancer one of the greatest threats to women’s lives in these countries.

The high toll of cervical cancer in developing countries is due to the fact that the majority of cases are detected in late stages as a result of lack of access to health care and resources. Patients often report for treatment at a very advanced stage when their pain and symptoms have become extreme.

In most instances, cervical cancer can be prevented, and yet it is still killing millions of women worldwide. There is sufficient scientific evidence to conclude that screening for cervical cancer would result in significant reductions in incidence, mortality and morbidity.

Screening tests can help prevent cervical cancer or to find it early. The first is the Pap test (or Pap smear), which detects precancerous or cancerous cells. The Pap test is one of the most reliable and effective cancer screening tests available. In many countries, it is recommended to women between the ages of 21 and 65 years old, and can be done in a doctor’s office or clinic.

Another screening test is the HPV test, which looks for the virus (Human Papilloma Virus) that can cause cell changes leading to cervical cancer. HPV infection is the most common sexually transmitted infection among sexually active women. At least 12 types of HPV have been linked to cervical cancer.

Most sexually active people have been exposed to HPV at some point in their lives. All sexually active women are at risk of contracting it, therefore, it is highly recommended that all women visit a medical professional to discuss cervical cancer screening. Screening aims to prevent the development of cancer by identifying high-grade, pre-cancerous cervical lesions. When screening detects pre-cancerous lesions, these can be treated easily.

Screening can also detect cancer at an early stage when treatment has a much higher rate of success. Because pre-cancerous lesions take many years to develop, the World Health Organization recommends screening for women aged between 30 and 49 at least once in her lifetime and ideally more frequently.

There are preventive vaccines which have been used for decades in developed countries to protect against the most high-risk HPV groups. HPV vaccine efficiency in preventing cervical dysplasia and cancer has been recommended globally on population-based studies. Vaccination is recommended for all girls aged 9-13.

A global prevention strategy, starting with vaccination programmes and backed up by proper screening on a regular basis, would do a huge amount to fight the cancer that takes a heavy toll on women’s health and lives around the world.

Potato Salad or Global Public Health: Invest in Something that Matters

I sat with Derek Fetzer, Co-Founder and Team Leader of Caring Crowd in a quaint café in the Johnson & Johnson headquarters during their Global Citizen Summit. He told me about the significance of this new crowdfunding platform and the various ways young leaders in the health sector can become involved.

After explaining the purpose of Caring Crowd, he pointed out that Johnson & Johnson is genuinely invested as a sponsor and truly values the needs and wellbeing of those they serve. During his thirty second shark-tank-style pitch, he – the multimillion dollar investor – explained to me why I should donate to a Caring Crowd project. Among some of those reasons were:

  • We are sponsored by Johnson & Johnson
  • Health workers are passionate about their involvement
  • The sole focus is global public health
  •  All projects are registered 501 © 3

The projects on the Caring Crowd platform highlight the power of people working together to ensure the wellbeing of others. In his interview he talked about the easy process for individuals to apply as well as the role of a digital presence and accountability. He shared his thoughts on the typical idea of infectious diseases as interconnected but also mentioned the limited attention to health and well being as a point of interconnectivity. A couple of years ago, a Kickstarter project for making potato salad raised over $50,000 – just imagine what we could achieve, if people would be as willing and eager to invest in public health as they were in a side dish. Consider this:

In some parts of the world it only takes $100 to treat tuberculosis for 6 months.

Derek Fetzer finds a never-ending wealth of inspiration from the patients and people benefiting from the Caring Crowd platform. An inspirational platform and an inspiring leader.

Girls’ Globe was sponsored by Johnson & Johnson to provide coverage during the Global Citizen 2016 Festival and to share the stories of the Young Leaders who are participating in the activities in New York. 

Featured image: Russell Watkins/Department for International Development

10-Year-Old Girls are the Future of the World

According to the latest State of World Population by the United Nations Population Fund (UNFPA), girls at the decisive age of 10 are the future of the world. At this age, girls are moving away from the world of childhood towards the world of adolescence and adulthood. In this season of life, it’s essential that girls be presented with opportunities, encouraged to dream big, given tools to pursue those dreams, and have access to education and health care.

For many girls around the world, this phase of life is when they begin to face the reality of limited choices in life compared to boys and when they become more vulnerable to discrimination and gender violence. This reality needs to be changed, not only for the good of these girls, but also for the good of their societies and the world as a whole.

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Here are 4 reasons why investing in 10-year-old girls is good for the world:

1) Access to education is not only a human right, but it’s essential to helping girls achieve their full potential. The more years girls spend in school, the more opportunities they will have to get better jobs and earn higher wages. Several organizations and leaders, such as Michelle Obama, have recognized the positive and long-lasting impacts of providing girls a good education, not just for girls’ own lives, but for their families, communities, and even for the economy of their countries.

 2) Access to sexual and reproductive health allows girls to receive crucial information about their health and sexuality, as well as providing them with important health tools such as vaccinations for HPV. Investing in sexual education for girls is essential as many young women simply lack information about contraceptives, STIs and pregnancy. Information about these very important topics can empower girls to make conscious choices about their lives and bodies. HIV/AIDS is the leading cause of death among 10-19 year old girls, so investing on their health around this age means saving lives and preventing more infections in young girls. 

3) No child marriage means that girls can stay in school longer and pursue their life dreams and goals. It means that they can live healthier lives, be less likely to be infected with an STI, and can be free to be kids. It also means that they will have the choice to start their own families when and if they choose to. Child marriage is a human rights violation, therefore eradicating it means opening many doors of possibilities to girls which they wouldn’t have as child brides.

 4) Investing in young girls’ self-esteem helps to keep them encouraged to pursue sports, math, science, politics, or whatever they desire to pursue. The popular “Like a Girl” commercials by Always, have brought to attention how girls’ self-esteem tends to plummet significantly around puberty. Suicide has been found to be “the second-leading cause of death among adolescent girls”, which shows just how serious the issue of a girl’s self-esteem really is. Girls with high self-esteem will be more likely to pursue politics, to start a business, and to overcome the challenges they will inevitably face.

Investing in 10-year-old girls means investing in the 17 Sustainable Development Goals, which include good health and well-being, quality education, and gender equality. In 2030, when these goals are hoped to be achieved, today’s 10-year-old girls will be in their mid-20s. The lives they’ll live then and what impact they’ll be able have in society depends on the opportunities they are given today. The main reason why investing in girls is so important is quite simple: when girls thrive, so does the rest of the world.

For more information, check out the UNFPA State of World Population 2016, and consider ways of investing in girls, such as donating to organizations like UNFPA and Girls’ Globe, and sharing information about the importance of investing in girls on social media.

Featured Image by: Jessica Lea/Department for International Development
Additional Image by: UNFPA/Matthias Mugisha