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I. PROGRAM RESOURCES
1. Adolescent Forum Issues No. 46 and 47
2. An Increase in Prostitution Among Romanian Minors in Rome
3. Breaking the Silence and Saving Lives: Young People's Sexual and Reproductive Health in the Arab States and Iran
4. Community-Level Influences on Early Sexual Initiation in Nigeria
5. Evaluating the Kenya Girl Guides Association's HIV/AIDS Peer Education Program for Younger Youth: Baseline Results
6. Evaluation of the CIES Adolescent Program
7. Programming for HIV Prevention in South African Schools: A Report on Program Implementation
8. Side by Side: Building and Sustaining a Culture of Youth Participation at Reprolatina
9. Synergising HIV/AIDS and Sexual and Reproductive Health and Rights A Manual for NGOs
10. The Training of Trainers Manual
11. Understanding and Challenging HIV/AIDS Stigma
12. Youth Participation in Development Projects
II. RESEARCH SUMMARIES
1. AIDS mortality and the mobility of children in KwaZulu Natal, South Africa
2. Comparison of knowledge, attitudes, experience, and opinions between teachers and guardians regarding the emergency contraceptive pill in Chiang Mai, Thailand
3. Contradictory sexual norms and expectations for young people in rural Northern Tanzania
4. Gender and relationship differences in condom use among 15-24-year-olds in Angola
5. HIV risk behaviors and the context of sexual coercion in young adults' sexual interactions: results from a diary study in rural South Africa
6. Impact of accessible sexual and reproductive health care on poor and underserved adolescents in Managua, Nicaragua: a quasi-experimental intervention study
7. Influence of religion on adolescent sexual attitudes and behaviour among Nigerian university students: affiliation or commitment?
8. Knowledge of HIV/AIDS among secondary school adolescents in Calabar-Nigeria
9. Pharmacists' knowledge and perceptions of emergency contraceptive pills in Soweto and the Johannesburg central business district, South Africa
10. Prevalence of sexual activity and family-planning use among undergraduates in Southwest Nigeria
11. Reducing the risk of HIV transmission among adolescents in Zambia: psychosocial and behavioral correlates of viewing a risk-reduction media campaign
12. Sexual risk behaviour among young people in Osogbo, Osun state Nigeria
13. Socioeconomic and contextual determinants of reproductive activity among adolescent women in Colombia
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I. PROGRAM RESOURCES
1. Adolescent Forum Issues No. 46 and 47
Adolescent Forum Issue 46 focuses on parental involvement in comprehensive sexuality education, while Adolescent Forum Issue 47 discusses peer education and its role in educating and empowering youth. Both issues include related articles, Web sites, tools, and guides.
Other languages: Spanish
Contact: info@ippfwhr.org
2. An Increase in Prostitution Among Romanian Minors in Rome (2005, PDF, 438 KB)
This qualitative and quantitative study of unaccompanied Romanian children in Rome, Italy indicates a rise in the trafficking of these children for sex. Neither country has been able to effectively coordinate intervention activities; recommendations suggest combined efforts will be most successful in protecting children.
Contact: daniela.ercolani@tdh.ch
3. Breaking the Silence and Saving Lives: Young People's Sexual and Reproductive Health in the Arab States and Iran (2005, PDF, 1.73 MB)
This comprehensive review examines young people's sexual and reproductive health issues in the Arab States and Iran, with a specific focus on gender. It reviews issues including marriage, maternal mortality, unintended pregnancy and abortion, STIs, HIV, and violence against women. It also identifies risk and protective factors, examines social factors influencing youth, and includes program and policy recommendations.
Contact: bshepard@hsph.harvard.edu
4. Community-Level Influences on Early Sexual Initiation in Nigeria (2006, PDF, 215 KB)
Researchers from the MEASURE project used national survey data to determine that community factors do have an influence on early initiation of sexual activity. Young people living in communities with supportive attitudes toward reproductive health and HIV/AIDS, including contraception, are more likely to delay sexual activity.
Contact: measure@unc.edu
5. Evaluating the Kenya Girl Guides Association's HIV/AIDS Peer Education Program for Younger Youth: Baseline Results (2005, PDF, 397 KB)
This research update presents the baseline data from an evaluation of a peer education program in Kenya; the preliminary data suggests that youth need additional information about HIV, resisting peer pressure, and the negative impact of alcohol and drugs.
Contact: horizons@pcdc.org
6. Evaluation of the CIES Adolescent Program (2005, PDF, 1.42 MB)
This resource evaluates the Centro de Investigacin, Educacin y Servicios/Salud Reproductiva (CIES) adolescent sexual and reproductive health program in Bolivia which targets adolescents with IEC materials, collaborates with the Ministries of Health and Education (as well as local governments), and works to engage the support of influential adults such as parents, teachers, and health care workers.
Other languages: Spanish (PDF, KB)
Contact: listen@rti.org
7. Programming for HIV Prevention in South African Schools: A Report on Program Implementation (2005, PDF, 229 KB)
This evaluation of a school-based HIV/AIDS program in South Africa found that life skills training had a positive impact on students' knowledge of HIV/AIDS, attitudes toward abstinence, and intention to use condoms. The report includes teachers' experiences and recommendations for program planning.
Contact: horizons@pcdc.org
8. Side by Side: Building and Sustaining a Culture of Youth Participation at Reprolatina (2006, PDF, 1 MB)
This case study documents the successful youth-adult partnerships at Reprolatina, an organization promoting sexual and reproductive health in southern Brazil.
Other languages: French (PDF, 209 KB)
Spanish (PDF, 262 KB)
Portuguese (PDF, 137 KB)
Contact: communications@iwhc.org
9. Synergising HIV/AIDS and Sexual and Reproductive Health and Rights A Manual for NGOs (2005, PDF, 6.19 MB)
This manual focuses on increasing the capacity of NGOs working on HIV and integrating sexual and reproductive health and rights into existing work. The manual provides overviews of reproductive health areas, ideas for points of entry, and further resources. Topics covered include rights-based approaches, adolescent reproductive health, orphans and vulnerable children, and emergency situations.
Contact: aidsnet@aidsnet.dk
10. The Training of Trainers Manual (2006)
The Training of Trainers Manual is a curriculum tool to prepare master-level peer education trainers. The manual uses participatory techniques based on a variety of theoretical frameworks, to ensure that future trainers are skilled and confident in their abilities to train peer educators and serve as informed resources for their peers. YouthNet collaborated with the United Nations Population Fund and the Y-PEER program in developing this manual.
Contact: youthnetpubs@fhi.org
11. Understanding and Challenging HIV/AIDS Stigma (2005, PDF, 1.79 MB)
This booklet is a tool for discussing stigma associated with HIV/AIDS in South Africa. Examples and text are appropriate for youth and offer ideas for community involvement. Topics covered include a discussion of the meaning of stigma, causes of stigma, how stigma impacts HIV/AIDS work, and how to address stigma.
Contact: c.campbell@lse.ac.uk
12. Youth Participation in Development Projects (2006, PDF, 128 KB)
This brief profiles four programs working in youth participation around the globe. Included are a discussion of youth participation in rapid appraisals in Uganda, a Palestinian youth empowerment program, a Jordanian education reform project, and participatory learning and action in Ethiopia, Namibia, and Tanzania.
Contact: mbeauvy@edc.org
II. RESEARCH SUMMARIES
1. AIDS mortality and the mobility of children in KwaZulu Natal, South Africa. Ford K, Hosegood V. Demography 2005;42(4).
Researchers examined the effect of parental death on the mobility of 39,163 children aged 017 in rural KwaZulu Natal, South Africa, in 2000 and 2001. Parental mortality from all causes prior to and during follow-up increased the risk of a child moving by nearly two times after control was established for the age, gender, and household characteristics of each child. However, in the follow-up period, child mobility following maternal deaths from AIDS was lower than child mobility following maternal deaths from other causes. Younger children, boys, and children whose mothers or fathers were resident members of the children's households were also less likely to move.
2. Comparison of knowledge, attitudes, experience, and opinions between teachers and guardians regarding the emergency contraceptive pill in Chiang Mai, Thailand. Sripichyakan K, Tangmunkongvorakul A. Nurs Health Sci 2006;8(1).
Teachers and guardians (parents or authorized persons) are expected to collaborate in educating female students about emergency contraceptive pills (ECPs), but it is unknown whether they share similar perspectives on ECPs. This study aimed to compare their knowledge, attitudes, experience, and opinions regarding ECPs. Researchers distributed questionnaires to 720 female teachers and guardians of eight randomly selected high schools and vocational schools in Chiang Mai, Thailand. Responses indicate significantly more teachers knew of ECPs than guardians; however, more guardians reported some accurate information regarding ECPs than did teachers. More teachers than guardians believed that the use of ECPs was not immoral. Both teachers and guardians had a similar experience level with ECP use and similar views on teaching female adolescents about ECPs. The teachers and guardians had differing opinions on what the teaching barriers were.
3. Contradictory sexual norms and expectations for young people in rural Northern Tanzania. Wight D, Plummer ML, Mshana G, et al. Soc Sci Med 2006;62(4).
Through participant observation data, the authors of this article outlined the main features of sexual culture in rural northern Tanzania, highlighting both permissive and restrictive norms and expectations for young people. It also illustrates how sexual beliefs are socially constructed and subject to social change. For example, it is believed that school pupils all remain abstinent, females maintain sexual respectability, and discussions of sex are taboo. However, these norms are incompatible with several widely held, contrasting expectations: that sexual activity is inevitable unless prevented, sex is a female resource to be exploited, restrictions on sexual activity are relaxed at festivals, and masculine esteem is boosted through sexual experience. Differential commitment to these norms and expectations reflects conflicts between generations and genders. Young people appear to manage the contradictions in these norms by concealing their sexual relationships. This almost certainly contributes to their short duration and the high levels of partner change, since relationships are not reinforced through social recognition and there is little scope to develop intimacy through non-sexual contacts.
4. Gender and relationship differences in condom use among 15-24-year-olds in Angola. Prata N, Vahidnia F, Fraser A. Int Fam Plan Perspect 2005;31(4).
In order to identify determinants of condom use among Angolan adolescents and young adults, researchers examined data from 1,995 sexually experienced youth aged 15-24 who participated in a 2001 knowledge, attitudes, and practices survey in Luanda, Angola. Higher levels of education and believing that condoms do not diminish sexual pleasure were both associated with consistent condom use for both males and females. Consistent condom use was negatively associated with being married or in a cohabiting relationship. Females who equated condom use with lack of trust were less likely to use condoms consistently, and males who believed that condoms were safe and those who had multiple partners were more likely to be consistent users. Urban residence, higher education, being in school, and not equating condom use with lack of trust were important predictors of use at last intercourse in regular and casual relationships, whereas access to condoms was the most important factor in spousal relationships.
5. HIV risk behaviors and the context of sexual coercion in young adults' sexual interactions: results from a diary study in rural South Africa. Hoffman S, O'Sullivan LF, Harrison A, et al. Sex Transm Dis 2006;33(1).
Researchers involved with this study sought to gain insight into the specific gender dynamics in the intimate relationships of rural South African young adults that contribute to risk for HIV infection. Fifty secondary school students kept daily reports in a diary over three weeks, detailing 466 sexual interactions. The results show that inconsistent condom use was more likely in relationships in which the male partner had ever used threat or force to engage in sex during this period. Alcohol use was associated with sexual coercion, as was when a man's desire to engage in sex was perceived as greater than the woman's.
6. Impact of accessible sexual and reproductive health care on poor and underserved adolescents in Managua, Nicaragua: a quasi-experimental intervention study. Meuwissen LE, Gorter AC, Knottnerus AJ. J Adolesc Health 2006;38(1).
Researchers performed a quasi-experimental intervention study, through which adolescents received 28,711 vouchers that gave free access to sexual and reproductive health care (SRHC) in 20 health centers. Self-administered questionnaires were completed by 3,009 female adolescents, ages 12 to 20 years old (904 voucher receivers, and 2,105 nonreceivers), to measure their use of SRHC clinics and knowledge and use of contraceptives and condoms. Voucher receivers reported a significantly higher use of SRHC compared with nonreceivers (34 percent versus 19 percent). Voucher receivers answered significantly more questions correctly that were related to knowledge of contraceptives and sexually transmitted infections than nonreceivers. Sexually active voucher receivers who were in school showed a significantly higher use of modern contraceptives than nonreceivers (48 percent versus 33 percent); in neighborhoods, condom use during last sexual contact was significantly greater among voucher receivers than nonreceivers.
7. Influence of religion on adolescent sexual attitudes and behaviour among Nigerian university students: affiliation or commitment? Odimegwu C. Afr J Reprod Health 2005;9(2).
In order to examine the role of religion in adolescent sexual attitudes and behavior in Nigeria, researchers collected data from 1,870 students (but because of restrictions, only the information from 1,153 campus-based adolescents aged 10-24 years was analyzed.) Findings indicate a strong relationship between religious beliefs and adolescent sexual attitudes and behavior, although religious commitment is more important than religious affiliation in affecting adolescent sexual attitudes and behaviors.
8. Knowledge of HIV/AIDS among secondary school adolescents in Calabar-Nigeria. Oyo-Ita AE, Ikpeme BM, Etokidem AJ, et al. Ann Afr Med 2005;4(1).
An observational study using structured questionnaires among secondary school students indicated 181 (31 percent) of the adolescents did not know the etiological agents of HIV/AIDS. A majority (n=522, or 90 percent), knew HIV/AIDS was transmitted through sexual intercourse. Only 78 (13 percent) respondents knew that HIV carriers might look normal; while 519 (90 percent) did not know the features of AIDS. Knowledge of ways to prevent the spread of HIV varied: 281 (48 percent) knew abstinence prevented transmission; 15 (3 percent) identified keeping one sexual partner as a prevention method; condom use was noted by 101 (17 percent); and screening blood before transfusion was mentioned by 31 (5 percent). Mass media was the main source of information on HIV/AIDS for these adolescents. One hundred ninety-one (33 percent) of them believed HIV/AIDS cannot be prevented; 228 (39 percent) felt HIV/AIDS is common among the uneducated; 127 (22 percent) thought it is not common in Nigeria; and 143 (25 percent) believed it is not common among youth.
9. Pharmacists' knowledge and perceptions of emergency contraceptive pills in Soweto and the Johannesburg central business district, South Africa. Blanchard K, Harrison T, Sello M. Int Fam Plan Perspect 2005;31(4).
In-person interviews were conducted with 34 pharmacists practicing in Soweto and the Johannesburg central business district, from February through April 2003, to assess pharmacists' knowledge of emergency contraceptive pills (ECPs). The pharmacists provided data on their knowledge of ECPs and their attitudes toward providing the medication to women in specific situations. Nearly all pharmacists sold at least one of the two types of dedicated ECPs available in South Africa. Although most had accurate knowledge about the method's dosing schedule, side effects and mechanism of action, more than half erroneously believed that repeated use posed health risks. A large majority of pharmacists believed the pills should be available to rape victims, to single or married women, and to women who had never given birth, but almost half did not think the pills should be given to women younger than 18, and one-fourth said they would not give them to women with a late menstrual period. About one-third to one-half of pharmacists supported advance provision of the medication under certain circumstances. Most were willing to display promotional materials on emergency contraceptives in their pharmacies.
10. Prevalence of sexual activity and family-planning use among undergraduates in Southwest Nigeria. Orji EO, Adegbenro CA, Olalekan AW. Eur J Contracept Reprod Health Care 2005;10(4).
A cross-sectional survey of 283 students assessed the prevalence of sexual activity and family planning use among undergraduates in a private tertiary institution in Nigeria. Of 283 students, 245 (87 percent) were sexually active in the last month. Out of these 245, 219 (89 percent) reported currently using a family planning method. In the study population, the percentages of awareness, ever use, and current users were 89 percent, 77 percent, and 75 percent, respectively. The most commonly known, ever used, and currently used contraceptive is the condom, followed by (in descending order) the calendar method, oral contraception, coitus interruptus, injectable contraception, emergency contraception, the intrauterine device, and the diaphragm. Unmarried students and male gender show statistical significance with condom use. The reasons for preferring their current contraceptive method, among 219 current users, include safety, cost, ready availability, and partner's preference, among others. Most of the non-users gave no reason for the failure to use a contraceptive, but others felt that contraceptives are dangerous, while a minority was not aware of any method.
11. Reducing the risk of HIV transmission among adolescents in Zambia: psychosocial and behavioral correlates of viewing a risk-reduction media campaign. Underwood C, Hachonda H, Serlemitsos E, Bharath-Kumar U. J Adolesc Health 2006;38(1).
Researchers evaluated phase I of a theoretically informed media campaign designed by youth in Zambia to encourage their peers to adopt risk-reduction practices to protect themselves from sexually transmitted infections and HIV. The Helping Each other Act Responsibly Together (HEART) campaign conveys information for young people ages 13 to 19 years about sexually transmitted infections and HIV/AIDS transmission and prevention, and promotes abstinence, a return to abstinence, or consistent condom use as viable risk-reduction practices. Separate sample baseline and follow-up designs were used to evaluate phase I of the HEART campaign among adolescents aged 13 to 19 years. The 1999 baseline survey had a sample of 368 male and 533 female adolescents; the 2000 follow-up survey comprised 496 male and 660 female adolescents. When controlling for age, sex, educational attainment, and urban or rural residence, logistic regression analyses demonstrated that, compared with nonviewers, campaign viewers were 1.61 times more likely to report primary or secondary abstinence and 2.38 times more likely to have ever used a condom. The odds ratio of condom use during last sex was 2.1 for respondents who recalled at least three television spot advertisements compared with other respondents.
12. Sexual risk behaviour among young people in Osogbo, Osun state, Nigeria. Mabayoje VO, Akinwusi PO, Fadiora SO, et al. Trop Doct 2005;35(4).
Questionnaires distributed to 628 young people living in Osogbo, Nigeria, revealed that the mean age of first sexual encounter was 17.4 years for men and 16.5 years for women. Men tended to have multiple sexual partners more often than women (74 percent and 25 percent, respectively), and there was also a highly significant relationship between sexually transmitted infection and multiple sexual partners among singles.
13. Socioeconomic and contextual determinants of reproductive activity among adolescent women in Colombia (Factores socioeconmicos y contextuales que determinan la actividad reproductiva de las adolescentes en Colombia). Florez CE. Rev Panam Salud Publica 2005;18(6).
This longitudinal study combined quantitative and qualitative research methods, using information generated by a survey of adolescents conducted in 2003, to contribute to a better understanding of the problems of pregnancy among adolescent women in two large, culturally different cities in Colombia. The survey included 550 adolescents in Bogot and 550 adolescents in Cali from various socioeconomic strata. The patterns of sexual activity, union (defined as married or unmarried relationships), and maternity differ considerably among socioeconomic stratas in both of the cities. Adolescent women in the low stratum begin having sexual relations, forming unions, and becoming mothers earlier in life and with greater frequency than do adolescent women in the medium or high stratum. The main determinant of the reproductive behavior of adolescent women appears to be their socioeconomic status and their educational background (the average number of years of formal education of family members over the age of 15).
