Sexuality & Adolescent

Development

Social factors shape and interact

with biology.

Learn how to act out sexual feelings

on the basis of social attitudes,
extracted from cultural contexts.

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 Social Influences on Adolescent
Sexuality

A. Proximal Social Influences

Parents
Attitudes initially formed at home and so
parental models and Teachings are
important.
Peers
Later children are influenced by peer
groups and the wider social arena.
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 I. Parents

Psychological literature reveals the

profound influence that parents have
on the lives of their children.
Parents are the primary socializers
of their children.

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 Parents influence Adolescent
Sexual Behaviour through four
different avenues:

Parental attitudes towards adolescent

behaviour influence adolescent
attitudes.

Marital and child rearing behaviour of

parents provide and support role models
for young people.

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 The Religious environment influence
sexual attitudes and sexual guilt.

The education level and work

experience of the parents may
influence attitudes and present
opportunities for sexual activity if
parents are away.
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 Theories on Adolescent
Sexual Development

Psychosexual Theorists such as FREUD,

BLOS attach great significance to the
impact of sexual drives on the
psychological functioning of the person.

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 Psychosocial Theorists like Erikson,
Marcia, Adams, take the position that
anatomy is destiny but takes into
account social context and their
cultural factors that mediate sexual
conflict.

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 Erickson places a great emphasis on establishing
a sense of identity and a coherent sense of self
in adolescent sexual development.

Difficulty in parent-adolescent particularly

parent-daughter conversation regarding
Sexuality seems to have a negative effect in
delaying sexual activity. i.e. Greater the
difficulty, the earlier the initiation of sexual
activity.
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 Non virginity in youth is associated with
non-authoritative parenting.

Girls from single parent-families repeat

this cycle. It is unclear whether this is
related to role modeling or lack of
parental supervision or to parental
absence.

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 Parents also influence via socialization of the
child to coping strategies in their personal life.
Learned Restraint was a factor in adolescent
sexual expression for boys. This was the
ability by parents to delay gratification, inhibit
aggression, exercise impulse control, display
consideration of others and to act responsibly.

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 II. Peers (& Friends)

Behaviour of peers have little impact on

young children - but importance of peers
shifts at adolescence.

Peer influence and positive or negative

pressure can be through:
peer information
peer attitudes
peer behaviour
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 Studies show in Adolescent sexual
activity and FP use

Peers have 70-73% of influence,

Mothers have 33-37% influence
Fathers have 15% influence

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 Theory of reasoned action:

Perceived attitudes and values of

significant others have important
effect on shaping intention.

Young women more than men were

influenced by attitudes of their
peers about pre-marital sex,
contraception and safer sex
practices.
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B. Distant Social Influences

1. The Youth Culture

(a) Sets of beliefs
(b) Adult models of sexual behaviour
(c) Media models of sexual behaviour

2. Social Institutions
(a) School
(b) Religion
(c) The Law

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1. The Youth Culture

(a) Sets of beliefs: fashions, leisure,

music influenced by:

print, media, definitions of female femininity

and desirability, definitions of maleness, lyrics,
etc.
Perceptions of peers about sexual experiences.

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(b) Adult models of sexual behaviour

Parents are not the only role models;

other adults in society
How changing adult sexual norms
affect the youth is unknown

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(c) Media models of sexual behaviour

Movies and videos reinforcing roles and

messages -
women as passive victims
women as sexual beings
women as play things

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2. Social Institutions
(a) School

have an important role to play in informing young

people and providing a forum for values
exploration and clarification about sex

school based sex education policy and

implementation

whether sex education per se without supportive

services translates to behaviour change is less clear
prefer to turn to peers for info
do not trust teachers knowledge or discretion
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 (b) Religion

Religiosity is negatively related to

premarital sexual behaviour. Sexual
conservation is greater among
religious youth
consequence of religious values
association of youth with similar values

may be other sources of values

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(c) The Law

Laws that deal with adolescent sexual

expression relate mainly to:

age of consent laws for sexual intercourse

and medical interventions such as FP and
abortions

laws on homosexuality

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Arguments about adolescent sexuality
revolve around 4 central themes:

Morality and responsibility (parents

and religions, especially related to
sexuality education)

Desire - media representation

(responsibility vs. gratification)

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 Danger - public health approach and
medical models (fear related to
pregnancy, disease, HIV/AIDS)

Victimization - power of women in

sexual encounters is limited and so
is responsibility

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Rationale for Addressing Adolescent
Sexual and Reproductive Health

Number of Adolescents
adolescents aged 10-19 constitute approximately 20% of the
world population
half of all individuals are younger than 25
The fertility level for this age group is decreasing but
decreasing more slowly than for other age groups
resulting in an increasing proportion of births being to
adolescent mothers
Pregnant adolescents resort to abortion more often
than pregnant women of other age groups

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 Risk Factors in of Adolescence:
Psychosocial Risks

the period during which sexual and reproductive

health issues are added to the health concerns of the
individual
adolescents not knowledgeable about sexuality and
reproduction
abstinence not encouraged
gender equality not promoted
healthy and responsible sexual and reproductive
behaviour not discussed
sexual and reproductive risk-taking not discussed

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 Early Pregnancy Risks

neo-natal mortality levels are higher

infant mortality are higher
an increase in the age of marriage
a fall in the age of menarche
no decrease in sexual activity
a greater risk of adolescent girls becoming pregnant
outside of marriage
social stigma prevent pregnant adolescent girls from
obtaining early prenatal care

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 Abortion Risks

lack of information on contraception

the cost of health services
lack of confidentiality
limited access to safe services
delay in realising or admitting to the pregnancy

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STD Risks

most susceptible to STDs due to

physiological and social factors
5% of all adolescents contract an STD
half of those infected with HIV are
younger than 25
less developed physiological barriers
towards infection
young womens low decision-making power

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 Contraceptive Use
level of contraceptive use is often very
low among adolescents
due to insufficient or incorrect
information
to limited access to contraception
because of location, cost or social and
cultural barriers
to the low social status and decision-
making power
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 The Sexual and Reproductive Rights of
Adolescents

Economic Benefits
the cost of contraceptive use is significantly lower
than the cost of medical care related to unwanted
pregnancies and treatment of STDs
is a cost-saving strategy
educational options limited
economic opportunities curtailed

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 Meeting Adolescents Needs

The primary goal of ASRH programming and policy is

to enable adolescents to enjoy their sexual and
reproductive rights
provide adolescents with knowledge and services
sexual and reproductive health care for all
adolescents
create an enabling environment to reinforce
preventive interventions and services

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 Preventive Interventions

to promote responsible and healthy reproductive

and sexual behaviour, including voluntary abstinence
to provide services and counselling
to educate and counsel in the areas of gender
relations on equality
to reduce violence against adolescents
to promote responsible sexual behaviour
to promote responsible family planning practice
to promote family life and reproductive and sexual
health, including STD prevention

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 IEC

IEC initiated before adolescents have

engaged in sexual activity give adolescents the
skills
to postpone the onset of sexual activity and
to engage in safer sexual practices once
sexual activity begins

For sexually active adolescents, IEC and services

raise the level of contraceptive use
increase condom use
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 Sexual and Reproductive Health
Care

access to services for treatment and

care
treatment of complications of self-
induced or clandestine abortions
pre-and post-natal care
counselling and contraceptive service
provision

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 Service Provision

the provision of adolescent-friendly

preventive services is a key element
in enabling adolescents to engage in healthy
responsible sexual practices
special hours
special centres,
peer distribution of condoms

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 Enabling Environment

Gender
enhance gender equity and equality
eliminate discriminatory practices, laws
and policies against women and girls
introduce appropriate laws for legal age of
consent and minimum age of marriage
promote a focus on mens role by inclusion
promote concept of shared responsibility

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 Significant Adults

IEC and advocacy initiatives should address

parents, teachers and local leaders

religious leaders
national level policy-makers

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 Research

Research is important to understand

adolescent sexual and reproductive health
problems and the underlying socio-cultural,
economic and other development factors

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 Limitations of
Evaluation in ARH Studies

Self report techniques (problematic areas

in research):
verification of validity
gap behaviour between knowledge and
behaviour

Conscious and unconscious distinction of

respondents (pressure, privacy, confidence
and anonymity issues)
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 Unreliable measures (test - retest the
reliability)

Memory (recall)
Inadequate definition of the construct
under consideration e.g. in utilization of FP
knowing the methods is as important as
knowing where to receive services

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 Using qualitative methodologies
may produce richer data
(thought harder to interpret)

Triangulation is important

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 Inappropriately worded questions (no
formal terminology, no ambiguities, no
double negatives)

Differences across survey

presentation mode: mail out, surveys,
self-administered, etc.

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 Types of Studies:

Surveys and correlation studies (describe

and compare group)
Experiments to establish causality
Case materials - ethnographic studies
through participant or non-participant
observer techniques:
individuals
groups
Generalizability is extremely limited
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 Networking

Involvement of all stakeholders

networking at all levels

Involving Adolescents in programming

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 Advocacy

National Capacity-Building in Advocacy

Innovative approaches in Advocacy
Advocacy against Sexual Violence
Advocacy for Adolescent Sexual and
Reproductive Rights
Advocacy to Establish an Enabling
Environment
Advocacy to Promote Gender Equality and
Equity

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 Information, Education and
Communication

Needs Assessment and IEC Content

Peer Education and Peer counsellors
Parent Education
Gender Training
Innovative approaches
Involvement of Professionals
National Curriculum
Strategies for Implementation
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 Training

Health Care Providers

Teachers

Strategies for Training

Institutionalisation of Training

Sustainability of Training

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Lessons Learned by Youth for Youth

Execution by youths at the national level was a

successful approach;
Youths preferred topics which affected them
directly such as human sexuality, STDs,
including AIDS, and contraception over
general issues such as population;
Its difficult to decide at the global level what
will happen at the national level;

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Lessons Learned by Youth for Youth (CONTD)

Networking is easier at the peripheral level;

The involvement of stakeholders in project
design triggers positive attitudes and deep
commitment to the project;
Governmental institutions and NGOs can
successfully be involved in the same project;
It is important to build trust among youths
and their organisations;
Youth learn better from other youth.

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the Youth Perspective

[Youth] tell us they want information on

reproductive health and sexuality education,
preferably from their parents. They want this
information early and in a form appropriate to their
psychological and physical development. They want
accurate information so they can empower
themselves to make choices and take responsibility
for those choices.

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the Youth Perspective (contd)

They also say they want to have at their disposal -

and this does not mean they will automatically use
those services - family planning information and
supplies that will allow them to avoid early and
unwanted pregnancy, and abortion, and to protect
themselves from sexually transmitted diseases,
including HIV/AIDS.

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 Challenges for the Future

Advocacy
Research
Evaluation
Indicators
Upscaling of programmes
Gender awareness
Segmentation of Target Group
Management
Sustainability
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Key References: Adolescent Sexuality

1. S. Moore & D. Rosenthal, 1993 Sexuality in Adolescence.

Routledge London & N.Y.

2. UNFPA Technical Report No. 43 1998 The Sexual &

Reproductive Health of Adolescents: A Review of UNFPA
Assistance

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