To help adolescents in developing countries protect themselves from HIV and unintended pregnancy, policymakers in the United States and abroad must acknowledge the role that sexuality plays in the lives of young people, according to the policy recommendations drawn from a major new Guttmacher Institute study in Sub-Saharan Africa. In addition to an overall strengthening of education and health systems, a key focus of national government efforts should be on providing high-quality, age-appropriate sex education. To be most effective, sex education in schools should reach adolescents before they begin to have sex. Because not all adolescents stay in school, sex education should begin in early primary grades.

"One major challenge developing countries face is that the United States undermines efforts to provide better sex education and other needed services by restricting how U.S. foreign aid can be used," according to Heather Boonstra, author of the issue brief "Learning from Adolescents to Prevent HIV and Unintended Pregnancy." Recipients of U.S. HIV funds may provide teens aged 15 and older with information about condoms, but cannot use these funds to "promote or provide" condoms in most situations. Teens younger than 15 cannot receive any information about condoms in school.

"The reality is that by the age of 18, most adolescents have begun to have sex, but they often lack basic information they need to understand—and avoid—the risks they face," says Ann Biddlecom, lead researcher of the study. "Even when they are aware of how to protect themselves, adolescents often do not seek the help they need because of fear or embarrassment. The young people we talked to yearn for honest information, but they are often let down by policymakers and others who make teen sexual activity a taboo. This is ultimately self-defeating."

Strong evidence shows that hard-line abstinence-only-until-marriage education does not work here in the United States. "Rather than exporting failed policies, the United States should follow the example of western European governments that support developing countries in promoting a positive attitude toward the sexual health of young people," says Boonstra. "Levels of adolescent pregnancy and childbearing are much lower in western Europe than in the United States, which suggests the effectiveness of this approach."

About the study

Boonstra’s policy analysis summarizes key findings of a multiyear, multicountry study on the scope of young people’s sexual and reproductive health needs in Sub-Saharan Africa. Guttmacher staff worked with 10 organizations (nine based in Africa) to gather evidence from more than 20,000 adolescents in four countries—Burkina Faso, Ghana, Malawi and Uganda. Researchers obtained information from national surveys of 12–19-year-olds, focus group discussions with 14–19-year-olds, in-depth interviews with 12–19-year-olds and in-depth interviews with key adults in adolescents’ lives. The full study report will be available in December 2007.

Click here for "Learning from Adolescents to Prevent HIV and Unintended Pregnancy."