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Raghavan-gilbert/vw-991 k Social factors shape and interact with biology. k Learn how to act out sexual feelings on the basis of social attitudes, extracted.

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Presentation on theme: "Raghavan-gilbert/vw-991 k Social factors shape and interact with biology. k Learn how to act out sexual feelings on the basis of social attitudes, extracted."— Presentation transcript:

1 raghavan-gilbert/vw-991 k Social factors shape and interact with biology. k Learn how to act out sexual feelings on the basis of social attitudes, extracted from cultural contexts. Sexuality & Adolescent Development

2 raghavan-gilbert/vw-992 Social Influences on Adolescent Sexuality A. Proximal Social Influences n Parents Attitudes initially formed at home and so parental models and Teachings are important. n Peers Later children are influenced by peer groups and the wider social arena.

3 raghavan-gilbert/vw-993 I. Parents p Psychological literature reveals the profound influence that parents have on the lives of their children. Parents are the primary socializers of their children.

4 raghavan-gilbert/vw-994 n 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.

5 raghavan-gilbert/vw-995 ¸ The Religious environment influence sexual attitudes and sexual guilt. ¹ The education level and work experience of the parents may influence attitudes and present opportunities for sexual activity if parents are away.

6 raghavan-gilbert/vw-996 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.

7 raghavan-gilbert/vw-997 ·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.

8 raghavan-gilbert/vw-998 n Erickson places a great emphasis on establishing a sense of identity and a coherent sense of self in adolescent sexual development. n 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.

9 raghavan-gilbert/vw-999 n Non virginity in youth is associated with non-authoritative parenting. n 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.

10 raghavan-gilbert/vw-9910 q 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.

11 raghavan-gilbert/vw-9911 II. Peers (& Friends) q Behaviour of peers have little impact on young children - but importance of peers shifts at adolescence. q Peer influence and positive or negative pressure can be through: peer information peer attitudes peer behaviour

12 raghavan-gilbert/vw-9912 Studies show in Adolescent sexual activity and FP use Peers have 70-73% of influence, Mothers have 33-37% influence Fathers have 15% influence

13 raghavan-gilbert/vw-9913 p 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.

14 raghavan-gilbert/vw-9914 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

15 raghavan-gilbert/vw-9915 1.The Youth Culture (a)Sets of beliefs: fashions, leisure, music influenced by: oprint, media, definitions of female femininity and desirability, definitions of maleness, lyrics, etc. oPerceptions of peers about sexual experiences.

16 raghavan-gilbert/vw-9916 (b)Adult models of sexual behaviour o Parents are not the only role models; other adults in society o How changing adult sexual norms affect the youth is unknown

17 raghavan-gilbert/vw-9917 (c)Media models of sexual behaviour Movies and videos reinforcing roles and messages - y women as passive victims y women as sexual beings y women as play things

18 raghavan-gilbert/vw-9918 2.Social Institutions (a)School whave an important role to play in informing young people and providing a forum for values exploration and clarification about sex w school based sex education policy and implementation w 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

19 raghavan-gilbert/vw-9919 (b) Religion Religiosity is negatively related to premarital sexual behaviour. Sexual conservation is greater among religious youth u consequence of religious values u association of youth with similar values u may be other sources of values

20 raghavan-gilbert/vw-9920 (c)The Law Laws that deal with adolescent sexual expression relate mainly to: Y age of consent laws for sexual intercourse and medical interventions such as FP and abortions Y laws on homosexuality

21 raghavan-gilbert/vw-9921 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)

22 raghavan-gilbert/vw-9922 ¸ Danger - public health approach and medical models (fear related to pregnancy, disease, HIV/AIDS) ¹ Victimization - power of women in sexual encounters is limited and so is responsibility

23 raghavan-gilbert/vw-9923 Rationale for Addressing Adolescent Sexual and Reproductive Health y Number of Adolescents adolescents aged 10-19 constitute approximately 20% of the world population half of all individuals are younger than 25 y 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 y Pregnant adolescents resort to abortion more often than pregnant women of other age groups

24 raghavan-gilbert/vw-9924 X Risk Factors in of Adolescence: Psychosocial Risks w the period during which sexual and reproductive health issues are added to the health concerns of the individual w adolescents not knowledgeable about sexuality and reproduction w abstinence not encouraged w gender equality not promoted w healthy and responsible sexual and reproductive behaviour not discussed w sexual and reproductive risk-taking not discussed

25 raghavan-gilbert/vw-9925 ˜ 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

26 raghavan-gilbert/vw-9926 Z Abortion Risks w lack of information on contraception w the cost of health services w lack of confidentiality w limited access to safe services w delay in realising or admitting to the pregnancy

27 raghavan-gilbert/vw-9927 o most susceptible to STDs due to physiological and social factors o 5% of all adolescents contract an STD o half of those infected with HIV are younger than 25 o less developed physiological barriers towards infection o young womens low decision-making power STD Risks

28 raghavan-gilbert/vw-9928 j Contraceptive Use level of contraceptive use is often very low among adolescents w due to insufficient or incorrect information w to limited access to contraception because of location, cost or social and cultural barriers w to the low social status and decision- making power

29 raghavan-gilbert/vw-9929 z 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 His a cost-saving strategy Heducational options limited Heconomic opportunities curtailed

30 raghavan-gilbert/vw-9930 q Meeting Adolescents Needs The primary goal of ASRH programming and policy is to enable adolescents to enjoy their sexual and reproductive rights w provide adolescents with knowledge and services w sexual and reproductive health care for all adolescents w create an enabling environment to reinforce preventive interventions and services

31 raghavan-gilbert/vw-9931 _ Preventive Interventions w to promote responsible and healthy reproductive and sexual behaviour, including voluntary abstinence w to provide services and counselling w to educate and counsel in the areas of gender relations on equality w to reduce violence against adolescents w to promote responsible sexual behaviour w to promote responsible family planning practice w to promote family life and reproductive and sexual health, including STD prevention

32 raghavan-gilbert/vw-9932 ] 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

33 raghavan-gilbert/vw-9933 qSexual and Reproductive Health Care yaccess to services for treatment and care y treatment of complications of self- induced or clandestine abortions y pre-and post-natal care y counselling and contraceptive service provision

34 raghavan-gilbert/vw-9934 z Service Provision the provision of adolescent-friendly preventive services is a key element in enabling adolescents to engage in healthy responsible sexual practices o special hours o special centres, o peer distribution of condoms

35 raghavan-gilbert/vw-9935 n Enabling Environment y 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

36 raghavan-gilbert/vw-9936 Z Significant Adults IEC and advocacy initiatives should address parents, teachers and local leaders religious leaders national level policy-makers

37 raghavan-gilbert/vw-9937 Research r Research is important to understand adolescent sexual and reproductive health problems and the underlying socio-cultural, economic and other development factors

38 raghavan-gilbert/vw-9938 Limitations of Evaluation in ARH Studies n Self report techniques (problematic areas in research): –verification of validity –gap behaviour between knowledge and behaviour n Conscious and unconscious distinction of respondents (pressure, privacy, confidence and anonymity issues)

39 raghavan-gilbert/vw-9939 m Unreliable measures (test - retest the reliability) m Memory (recall) m 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

40 raghavan-gilbert/vw-9940 i Using qualitative methodologies may produce richer data (thought harder to interpret) i Triangulation is important

41 raghavan-gilbert/vw-9941 n Inappropriately worded questions (no formal terminology, no ambiguities, no double negatives) n Differences across survey presentation mode: mail out, surveys, self-administered, etc.

42 raghavan-gilbert/vw-9942 n 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 n Generalizability is extremely limited

43 raghavan-gilbert/vw-9943 Networking Involvement of all stakeholders networking at all levels Involving Adolescents in programming

44 raghavan-gilbert/vw-9944 b 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

45 raghavan-gilbert/vw-9945 p 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

46 raghavan-gilbert/vw-9946 i Training u Health Care Providers u Teachers u Strategies for Training u Institutionalisation of Training u Sustainability of Training

47 raghavan-gilbert/vw-9947 Lessons Learned by Youth for Youth w Execution by youths at the national level was a successful approach; w Youths preferred topics which affected them directly such as human sexuality, STDs, including AIDS, and contraception over general issues such as population; w Its difficult to decide at the global level what will happen at the national level;

48 raghavan-gilbert/vw-9948 Lessons Learned by Youth for Youth (CONTD) w Networking is easier at the peripheral level; w The involvement of stakeholders in project design triggers positive attitudes and deep commitment to the project; w Governmental institutions and NGOs can successfully be involved in the same project; w It is important to build trust among youths and their organisations; w Youth learn better from other youth.

49 raghavan-gilbert/vw-9949 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.

50 raghavan-gilbert/vw-9950 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.

51 raghavan-gilbert/vw-9951 X Challenges for the Future J Advocacy J Research J Evaluation J Indicators J Upscaling of programmes J Gender awareness J Segmentation of Target Group J Management J Sustainability

52 raghavan-gilbert/vw-9952 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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