This article was based on a review of publications focused on the reproductive health of adolescents, including studies in peer-reviewed journals (eg, on evaluation of clinical or sex education programmes), reviews analysing sets of such studies, and monographs, mainly from globally-focused health and development organisations such as the Joint United Nations Programme on HIV/AIDS, WHO, Family Health International, the United Nations Population Fund, The Guttmacher Institute, the UN
SeriesGlobal perspectives on the sexual and reproductive health of adolescents: patterns, prevention, and potential
Section snippets
Sexual behaviours and use of contraceptives
The timing of first sexual intercourse and the context in which it occurs both have health implications. In some parts of the world, for instance in North Africa and parts of Asia, most sexual activity reported even 10–15 years ago takes place within the context of marriage.13 With the gap between age at first sexual intercourse and age at marriage widening in many developing countries, more people are sexually active before marriage than in the past.14 A study from 2000 with data from 14
Birth and abortion rates
National health statistics typically include rates of birth (as opposed to pregnancy rates) for 15–19-year-olds (table 2).6, 38, 39, 40, 41 In the developing world, birth registration rates differ widely; thus, data from some developing countries in table 2 represent a best estimate.
In sub-Saharan Africa, the average birth rate (for most recent year available) per 1000 girls aged 15–19 years is 143, varying from 37 in Mauritius to 229 in Guinea.6, 39 This rate is high compared with the
STIs including HIV/AIDS
WHO has estimated that 340 million new cases of curable STIs—syphilis, gonorrhoea, chlamydia, and trichomoniasis—occur every year. The largest number of new infections occurred in south and southeast Asia, followed by sub-Saharan Africa, Latin America, and the Caribbean. Data from epidemiological surveys show that within countries and between countries in the same region, the prevalence and incidence of STIs can vary widely, between urban and rural populations and even similar population
Strategies for prevention and health promotion
Despite the vastly differing patterns of sexual health behaviours and outcomes and the great diversity in the life situations that determine adolescents' reproductive health pathways, common elements comprise prevention and health promotion worldwide.54, 55 As noted by Wellings and colleagues9 in the recent Lancet series on sexual and reproductive health, “…no general approach to sexual-health promotion will work everywhere, and no single-component intervention will work anywhere”. We present
Worldwide outlooks for improving adolescents' sexual and reproductive health
The goals of the 1994 International Conference on Population and Development in Cairo recognised reproductive rights as among fundamental human rights and put universal access to safe, affordable, and effective reproductive health care on the international agenda for the two following decades.86 Sexual and reproductive rights refers to the rights of individuals, who are free of coercion, to the highest attainable standard of sexual health, and a satisfying and safe sexual life, and to be able
The next steps
Although there are signs of progress, continued worldwide investment is needed to prevent early pregnancy, STIs, and the spread of HIV in adolescents. Evidence provides consistent direction as to the next steps towards these goals.
All strategies designed for adolescents must be tailored to the unique developmental needs of young people and to the contexts and cultures in which they live. Health providers, teachers, and programme leaders all need specific knowledge and skills to assess and
Search strategy and selection criteria
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