Sexual and reproductive health

The sexual and reproductive health problems confronting youth today are varied and complex. Known and documented, they include risky sexual behavior, unwanted pregnancies, and sexually transmitted infections (STI), HIV among them. Furthermore, young people must overcome cultural barriers resulting from oppressive, discriminatory policies and laws that limit the reproductive options of women, for example, and must also contend with the lack of physical infrastructure that would provide safe and healthy spaces for its development. However, some progress has been made.

A fundamental change in the new concept of health and disease from a gender and civil rights perspective has been the concept of sexual and reproductive health, introduced at the International Conference on Population and Development (UNPOPIN 1994), endorsed by the IV World Conference on Women (Beijing 1995), the World Conference on Human Rights, the Declaration of the World Association for Sexual Health Declaration on Sexuality, and the Valencia Declaration on Sexual Rights established at the XIII World Congress of Sexology (Spain, 1997), and reviewed and approved by the General Assembly of the World Association for Sexology (WAS), on 26 August 1999, at the XIV World Congress of Sexology, Hong Kong, Peoples Republic of China. This gave people, especially women, rights in the domain of sexuality and reproduction, which implies access to power and resources to make decisions about their own lives and bodies through self determination, based on the ethical principle of autonomy.

However, many youth programs have not yet adopted these broad concepts of sexual health and development, and little is known about the healthy sexuality of young people in their cultural environment. We need to learn more about the values, identity, and attitudes of both sexes. Sexual and reproductive health indicators for adolescents focus primarily on reproductive health outcomes, ignoring indicators of sexual health and development-- for example, knowledge and appreciation of the body itself, the development of important relationships, and the ability to negotiate.

In recent years, the Pan American Health Organization (PAHO) has taken important steps toward the inclusion of sexual and reproductive health in the Region's national adolescent health programs, proposing a new conceptual framework that addresses the sexuality of young people from a human development perspective, integrating sexual health into the broader framework of health and development. This approach recognizes sexual health as an objective of human development and that its status is related both to cultural and familial factors and the social, political, and economic environment in which adolescents live. The approach defends a positive development and recognizes youth as an opportunity for the Region. It has been designed to reach different levels of influence-such as policymakers and national program planners-to encourage them to make disease prevention and health protection policies and services for youth part of their health programs.