Sexual health human rights and the law

32 | Sexual health, human rights and the law
interventions that are complemented by sexual
negotiation skills can increase condom use in the
short term (316). The duration and intensity of
programmes as well as the use of trained facilitators
are also important for success (311). In particular, a
rights-promoting approach to sexuality education
requires the participation and contribution of young
people, particularly adolescents (1).
Within the broader community, well designed sexuality
information and education programmes can have
a positive effect on sexual health. For example, the
community intervention Stepping Stones, in South
Africa, uses participatory learning approaches to build
knowledge and communication skills and to stimulate
critical reflection with regard to gender roles, sexual
health, HIV/AIDS and gender violence within the
broader community context. The intervention showed
sustained reduction in the incidence of herpes simplex
virus type 2 in men and women, and in the incidence of
male violence against women, although no impact on
HIV in women was found (317–319).
4.3 Legal restrictions on sexuality
information and education
Laws can create an enabling environment for the
promotion and protection of health, including
sexual health, but they can also pose barriers
to people accessing sexuality information and
education. Because sexuality is considered to be a
sensitive topic in many societies, sexuality-related
information and education have often – historically
and still today – been considered “obscene”, been
censored, and in some instances provision of such
information has been or still is criminalized. Laws
that impose such restrictions are likely to contribute
to people being exposed to risks – sometimes lifethreatening,
such as STIs including HIV, unwanted
pregnancies and unsafe abortion – that they might
otherwise have been able to avoid (59, 74).
A diverse array of national laws provide the
framework for governing what is permissible in
speech, publications, performance, research and
other forms of expression, and what must be
censored, all with implications for sexual health.
These laws include criminal codes, intellectual
property law, and administrative laws. Limitations
elaborated in criminal law often use terms such as
“obscene”, “indecent”, “offensive”, “pornographic”,
“prurient” or “against public morals” to indicate
material that cannot be published, distributed,
purchased or viewed/read. Frequently, such laws
do not define what is covered by those terms, such
that their interpretation is subjective and thus the
application of the law may not be supportive of
people’s need for comprehensive sexual health
information and education (320).
4.4 Human rights standards and legal
protections
The freedom to seek, receive and impart information
and ideas of all kinds, regardless of frontiers, either
orally, in writing or in print, in the form of art, or
through any other media, is a fundamental human
right that cannot be arbitrarily restricted (89, 321–
323). Human rights standards clearly articulate that
states must proactively put in the public domain
information of public interest, including information
related to sexual health, and make every effort to
ensure easy, prompt, effective and practical access
to such information (29, 40, 324). This includes the
fact that people must have guaranteed access to
sexuality education, including information about
contraceptives, that enables them to decide freely
and responsibly the number and spacing of their
children, as well as access to specific educational
information to help ensure the health and wellbeing
of families (37, 40, 110, 325, 326). States must
also take legislative and other measures to combat
harmful practices, such as female genital mutilation
(FGM) and early/child marriage, including the
creation of public awareness in all sectors of society
regarding harmful practices (37).
A growing number of governments around the world
are confirming their commitment to providing sexuality
information and education as a priority essential to
achieving national goals for development, health and
education. In 2006, African health ministers adopted
a plan of action for realizing sexual and reproductive
health and rights, with provision of sexuality education
within and out of school as a key strategy (327). Two
years later, health and education ministers from across