What is sex education?

What is sex education?



Sex education, which is sometimes called sexuality education or sex and relationships education, is the process of acquiring information and forming attitudes and beliefs about sex, sexual identity, relationships and intimacy. Sex education is also about developing young people's skills so that they make informed choices about their behaviour, and feel confident and competent about acting on these choices. It is widely accepted that young people have a right to sex education. This is because it is a means by which they are helped to protect themselves against abuse, exploitation, unintended pregnancies, sexually transmitted diseases and HIV and AIDS. It is also argued that providing sex education helps to meet young people’s rights to information about matters that affect them, their right to have their needs met and to help them enjoy their sexuality and the relationships that they form.

What are the aims of sex education?

Sex education aims to reduce the risks of potentially negative outcomes from sexual behaviour, such as unwanted or unplanned pregnancies and infection with sexually transmitted diseases including HIV. It also aims to contribute to young people’s positive experience of their sexuality by enhancing the quality of their relationships and their ability to make informed decisions over their lifetime. Sex education that works, by which we mean that it is effective, is sex education that contributes to both these aims thus helping young people to be safe and enjoy their sexuality.


What skills should sex education develop?
If sex education is going to be effective it needs to include opportunities for young people to develop skills, as it can be hard for them to act on the basis of only having information.6 7 8


The skills young people develop as part of sex education are linked to more general life-skills. Being able to communicate, listen, negotiate with others, ask for and identify sources of help and advice, are useful life-skills which can be applied to sexual relationships. Effective sex education develops young people's skills in negotiation, decision-making, assertion and listening. Other important skills include being able to recognise pressures from other people and to resist them, dealing with and challenging prejudice and being able to seek help from adults - including parents, carers and professionals - through the family, community and health and welfare services.

Sex education that works also helps equip young people with the skills to be able to differentiate between accurate and inaccurate information, and to discuss a range of moral and social issues and perspectives on sex and sexuality, including different cultural attitudes and sensitive issues like sexuality, abortion and contraception.

Who should provide sex education?
 
Sex education can take place in a variety of settings, both in and out of school. In these different contexts, different people have the opportunity and responsibility to provide sex education for young people.


Parents/carers


At home, young people can easily have one-to-one discussions with parents or carers which focus on specific issues, questions or concerns. They can have a dialogue about their attitudes and views. Sex education at home also tends to take place over a long time, and involve lots of short interactions between parents and children. There may be times when young people seem reluctant to talk, but it is important not to interpret any diffidence as meaning that there is nothing left to talk about. As young people get older advantage can be taken of opportunities provided by things seen on television for example, as an opportunity to initiate conversation. It is also important not to defer dealing with a question or issue for too long as it can suggest that you are unwilling to talk about it. There is evidence that positive parent-child communication about sexual matters can lead to greater condom use among young men and a lower rate of teenage conception among young women.26


Teachers

In school the interaction between the teacher and young people takes a different form and is often provided in organised blocks of lessons. It is not as well suited to advising the individual as it is to providing information from an impartial point of view. The most effective sex education acknowledges the different contributions each setting can make. School programmes which involve parents, notifying them what is being taught and when, can support the initiation of dialogue at home. Parents and schools both need to engage with young people about the messages that they get from the media, and give them opportunities for discussion.

Young people

In some countries, the involvement of young people themselves in developing and providing sex education has increased as a means of ensuring the relevance and accessibility of provision. Consultation with young people at the point when programmes are designed, helps ensure that they are relevant and the involvement of young people in delivering programmes may reinforce messages as they model attitudes and behaviour to their peers

How can HIV transmission be prevented?

Hiv can be transmitted in three main ways:

 

 

• Sexual transmission
• Transmission through blood  
• Mother-to-child transmission

 

For each route of transmission there are things that an individual can do to reduce or eliminate risk. There are also interventions that have been proven to work at the community, local and national level.1

 

 

 

Wherever there is HIV, all three routes of transmission will take place. However the number of infections resulting from each route will vary greatly between countries and population groups. The share of resources allocated to each area should reflect the nature of the local epidemic - for example, if most infections occur among men who have sex with men then this group should be a primary target for prevention efforts.

 

 "Knowing your epidemic in a particular region or country is the first, essential step in identifying, selecting and funding the most appropriate and effective HIV prevention measures for that country or region." - UNAIDS guidelines for HIV prevention 2

 

HIV prevention should be comprehensive, making use of all approaches known to be effective rather than just implementing one or a few select actions in isolation. Successful HIV prevention programmes not only give information, but also build skills and provide access to essential commodities such as condoms or sterile injecting equipment. It should be remembered that many people don’t fit into only one “risk category”. For example, injecting drug users need access to condoms and safer sex counselling as well as support to reduce the risk of transmission through blood.

 

What are the obstacles?

 

Despite the evidence that they do not encourage drug use, some authorities still refuse to support needle exchanges and other programmes to help injecting drug users. Restrictions on pharmacies selling syringes without prescriptions, and on possession of drug paraphernalia, can also hamper HIV prevention programmes by making it harder for drug users to avoid sharing equipment.Many resource-poor countries lack facilities for rigorously screening blood supplies.31 In addition a lot of countries have difficulty recruiting enough donors, and so have to resort to importing blood or paying their citizens to donate, which is not the best way to ensure safety. In much of the world the safety of medical procedures in general is compromised by lack of resources, and this may put both patients and staff at greater risk of HIV infection. Find out more about preventing HIV transmission through blood.

Mother-to-child transmission

What works?


HIV can be transmitted from a mother to her baby during pregnancy, labour and delivery, and later through breastfeeding. The first step towards reducing the number of babies infected in this way is to prevent HIV infection in women, and to prevent unwanted pregnancies.



There are a number of things that can be done to help a pregnant woman with HIV to avoid passing her infection to her child. A course of antiretroviral drugs given to her during pregnancy and labour as well as to her newborn baby can greatly reduce the chances of the child becoming infected. Although the most effective treatment involves a combination of drugs taken over a long period, even a single dose of treatment can cut the transmission rate by half.32



A caesarean section is an operation to deliver a baby through its mother’s abdominal wall, which reduces the baby’s exposure to its mother’s body fluids. This procedure lowers the risk of HIV transmission, but is likely to be recommended only if the mother has a high level of HIV in her blood, and if the benefit to her baby outweighs the risk of the intervention.33 34



Weighing risks against benefits is also critical when selecting the best feeding option. The World Health Organisation advises mothers with HIV not to breastfeed whenever the use of replacements is acceptable, feasible, affordable, sustainable and safe. However, if safe water is not available then the risk of life-threatening conditions from replacement feeding may be greater than the risk from breastfeeding. An HIV positive mother should be counselled on the risks and benefits of different infant feeding options and should be helped to select the most suitable option for her situation.35

What are the obstacles?

In much of the world a lack of drugs and medical facilities limits what can be done to prevent mother-to-child transmission of HIV. Antiretroviral drugs are not widely available in many resource-poor countries, caesarean section is often impractical, and many women lack the resources needed to avoid breastfeeding their babies.
HIV-related stigma is another obstacle to preventing mother-to-child transmission. Some women are afraid to attend clinics that distribute antiretroviral drugs, or to feed their babies formula, in case by doing so they reveal their HIV status.
Find out more about preventing mother-to-child transmission (PMTCT) and why PMTCT programmes are failing to reach most women in need.