Adolescents are having sex – oftentimes uninformed and consequently, unprotected. Helping young people to make informed, positive and safe choices about healthy relationships, responsible sexual activity, and their reproductive health ultimately requires their exposure to developmentally appropriate, evidence-based sexual health education.
In an age dominated by technology, adolescents are most at risk to the dangers posed by unrestricted access to information, in particular hyper-sexualised content online. They increasingly engage in relationships via technology, forwarding sexually explicit text and picture messages at a baffling speed and frequency in their communications via the internet and social media. Recent trends in the Caribbean indicate the popularity of cellphone pornography among adolescents, with device cameras used to take and distribute sexual images of themselves or others.
Locally and regionally, our soca and dancehall music depends largely or wholly on sexual innuendo and metaphor. Popular song lyrics glorify sexual violence, blurring the lines of appropriateness and consent, while pornographic photos and videos surface to make the rounds on social media, exposing users to explicit material both online and off.
Two out of three shows on American television include sexual content, and longitudinal studies suggest that exposure to sexual content on TV and other media in early adolescence is linked to double the instance of sexual intercourse between minors.
Rates of teenage pregnancy
In TT, statistics from the Global School-based Health Survey (GSHS) and the University of the West Indies indicate a significant rate of unprotected sex and pregnancy among adolescents and young women, respectively. World Bank data puts TT’s adolescent fertility rate (births per 1,000 women ages 15-19) at 29 in 2018, while the Ministry of Education reports 2,500 pregnancies among school-aged girls each year, with higher numbers being recorded in government schools.
Despite Health and Family Life Education (HFLE) being taught in primary and secondary institutions, its full implementation has been neglected due to the absence of specific HFLE teaching positions and trained teachers designated to address sex and reproductive health education as a component of its syllabus.
Former county medical officer Dr Akenath Misir stated that in previous initiatives, nurses were trained in school health, but lamented that the programme was piecemeal in terms of execution – school visits should have been coordinated and students able to benefit from the expertise of health practitioners.
Sex education in the Caribbean, around the world
Barbados has taken strides to meet the health needs of its adolescents. According to the World Health Organization, engaging in risky sexual practices starts from an early age in Barbados, leading to unintended pregnancy and sexually transmitted infections.
The country has embarked on a multi-sectoral approach to provide adolescent services through numerous policy and strategy developments, including comprehensive sexuality education in schools and community-based settings supported by effective, evidence-based interventions to prevent and respond to harmful practices such as transactional sex, intergenerational sex, and abuse.
In Nigeria, school-based sexual health promotion has been effective in reducing at-risk sexual behaviours of adolescents. Other studies across North and South America reveal that sexual health interventions have a positive impact on adolescents’ sexual health-related knowledge, attitudes towards HIV and methods of protection.
Generally, European countries tend to have the lowest rate of teen pregnancies, with experts pointing to the generally progressive approach to sexual education in countries such as Italy, Germany, Switzerland, Sweden, France, the Netherlands, Denmark, and Belgium.
Comprehensive sex education
It is obvious, therefore, that comprehensive sex education should form part of a broad and balanced curriculum. It should not only include basic information about the body and its physiological changes during adolescence, but also information about conception, contraception and sexually transmitted diseases. The conceptual approach to sex and reproductive health education exclusively within the bounds of physiological facts and human biology is woefully inadequate, lending itself to a scientific sexuality discourse that assimilates issues of sexuality to sexual hygiene.
In terms of specific content, an emerging model for sexual health education is the rights-based approach, which engages an extensive, comprehensive sexual education programme with a focus on human rights, gender equality, access to healthcare services, and critical thinking – all proven to influence healthy sexual behaviour among adolescents.
Sex and reproductive health education must be accessible, inclusive, and developmentally and culturally appropriate for all students. Implemented properly, informed adolescents will more likely build resilience and resist exposure to possible coercion, exploitation and abuse, making them less vulnerable to sexually transmitted infections and unintended pregnancies.
Sabrina Mowlah-Baksh, general manager of the Coalition Against Domestic Violence (CADV), acknowledges the imperative need for age-appropriate content on the topic to be integrated into the school curriculum. Sensitising students to the dynamics of interpersonal relationships will lead them to make informed choices and develop life skills to address psychological, social and health concerns, increase awareness of abusive or predatory behaviours, and empower them to report cases of sexual abuse. The Pan American Health Organization asserts that adolescents in the Caribbean are at high risk of sexual violence, especially if education has not provided them with skills to resist sexual pressure and be assertive.
On the campaign trail
For the 2020 general election season, CAISO and the Alliance for Justice and Diversity have identified comprehensive sexuality education among its 13 policy actions, to be implemented as mandatory curriculum with modules for parents/families and school system personnel. Sexuality education encapsulates teaching about human sexuality, including intimate relationships, human sexual anatomy, sexual reproduction, sexually transmitted infections, sexual activity, sexual orientation, gender identity, abstinence, contraception, and reproductive rights and responsibilities. Treatment of these topics would require a shift from criticism and opposition involving the arguments that sex education corrupts impressionable young minds and is antithetical to traditional cultural values, as well as a departure from the ideological premise of sexual restraint as a national virtue.
A strategic and coordinated approach to the implementation of sexual and reproductive health education in schools includes family and community involvement. The onus to educate young people on such issues does not solely lie on parents/guardians and healthcare professionals, but requires a joint effort between schools and communities to provide sexual and reproductive health education that is medically accurate, developmentally and age-appropriate, and which encapsulates disease prevention and risk reduction for students to be equipped with the skills and resources to make informed and responsible decisions.
* Darcelle Doodnath is an educator specialising in modern foreign language pedagogy. She holds a postgraduate diploma in education from the University of the West Indies, a diploma in methodologies of teaching Spanish as a second language from Universidad de Chile and an undergraduate degree in Hispanic language and linguistics from Brown University.