Motherhood in Childhood

has learned a number of lessons about comprehensive
sexuality education. One is that
even in the face of the HIV/AIDS pandemic,
governments have been slow to implement
comprehensive sexuality education, and even
slower to reach the most vulnerable young
people (Haberland and Rogow, 2013).
A second lesson is that comprehensive sexuality
education can be effective beyond the
prevention of high-risk behaviours. Research
shows that programmes that tend to have the
greatest impact on adolescent pregnancy and
sexually transmitted infections are those that
emphasize critical thinking about gender and
power in relationships (Haberland and Rogow,
2013). These findings offer promise for a new
generation of programmes that can have a
concrete, positive impact on the well-being
of young people.
New research shows that comprehensive sexuality
education programmes are more likely to
have an impact on reducing adolescent pregnancy
and sexually transmitted infections when
they address gender and power issues. Studies
from both developing and developed countries
confirm that young people who believe in gender
equality have better sexual health outcomes
than their peers. In contrast, those young
people who hold less egalitarian attitudes
tend to have worse sexual health outcomes
(International Sexuality and HIV Curriculum
Working Group, 2011).
Gender equality and human rights are key to
preventing the spread of HIV and to enabling
young people to grow up to enjoy good health.
For example, young people who, compared to
their peers, adopt egalitarian attitudes about
gender roles are more likely to delay sexual
debut, use condoms, and practice contraception;
they also have lower rates of sexually
transmitted infections and unintended pregnancy
and are less likely to be in relationships
characterized by violence. Another study found
that a targeted programme to increase girls’
understanding of the risks of intergenerational
sex reduced pregnancy by 28 per cent (Dupas,
2011).
Most comprehensive sexuality education
is delivered through school-based curricula.
However, not all adolescents attend school and
not all remain in school until they initiate sex.
Married girls between the ages of 10 and 14
and who are not in school thus have virtually
no access to sexuality education. It is therefore
important to make additional efforts to meet
the needs of adolescents who are out of school.
Curriculum- and group-based sexuality and
HIV education programmes can reach those
who are not in school if they are implemented
by providers of health and other services for
youth, community centres, or other local
institutions accessible to adolescents (Kirby
et al., 2006).
According to UNESCO (2013), 57 million
children of primary school age and 69 million
children of lower-secondary school age do not
attend school. Most of them live in developing
countries, and slightly more than half
are girls. Two approaches with potential for
reaching large numbers of out-of-school adolescents—although
not necessarily as stand-alone
programmes for preventing pregnancy—involve
the use of the mass media and interactive radio
instruction.
Recent reviews of mass media campaigns that
promoted adolescent sexual health, mostly in
developing countries, found that they commonly
increased knowledge, and the majority
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