ADOLESCENT REPRODUCTIVE HEALTH

Youth in Danger

Youth at Risk

Will there be time to act? Students attending a Family Life Education Workshop in Western Samoa

HIV has created a pandemic from which the Pacific islands cannot be insulated. Apart from the reported cases of HIV and AIDS, 234 and 645 cases respectively as of mid-1995, the prevalence of sexually transmitted diseases (STDs) provides further e vidence that unprotected sex and risky sexual behaviour might fuel the nascent HIV epidemic. This scare has raised awareness of the vulnerability of young people. Almost all Pacific island populations have median ages of less than 25; about half have me dian ages of below 20.

Time to Act, the United Nations study of the Pacific response to HIV and AIDS published in 1996, captures some of the problems and risky behaviours of youth in the island countries. Economic pressures facing many Pacific countries are particul arly hard on the school leaver. Pacific schooling has not equipped students with the range of skills needed by modern industries. School drop-outs find themselves unwilling to return to village subsistence living and unable to get a job in the urban areas. Governments, over the past decade, have not been able to create sufficient jobs to cater to the rising numbers of school-leavers every year and the existing pool of the unemployed and underemployed. Economic hardship has been known to lead some young people to sell sex for money to pay for their schooling or for the good life.

Unprotected sex puts youth at great risk of contracting STDs and HIV/AIDs. The relatively high rates of STDs among Pacific youth gives indication that many young people are becoming sexually active earlier and engaging in unprotected sex, some wit h several partners. One study of ninth graders in one Pacific country found that 37 per cent of the boys and 17 per cent of the girls reported having experienced sexual intercourse, with several partners in a large number of cases. Another source noted that two-thirds of gonorrhea cases each year in Fiji involve people between 15 and 24 years old.

SPC poster

The incidence of teenage pregnancy is clearly an indication of rising adolescent sexual activity. In some countries, there are undoubtedly pressures on girls especially to marry and have children in their teens, but there are clearly rising rates of adolescent sexual activity and pregnancies outside of marriage. Teen pregnancy rates range from 3 percent to 20 percent or more to mothers below 19 years of age. In Vanuatu and Solomon Islands, the rates are 12 and 9 percent respectively of women aged 16-19. Marshall Islands has the highest rate of 20 percent pregnancies below the age of 20.

Alienation resulting from limited unemployment opportunities, conflict with traditional culture, pessimism about future prospects, and frustration with low esteem and social status might be cause and effect in a pattern of young people's behaviour s from aimless loafing, to alcoholism and substance abuse, anti-social and criminal activities, and risky sexual behaviour.

Included elsewhere in this bulletin are three essays by Pacific writers which reached the semi-finalist stage of an international essay-writing contest sponsored by UNFPA on the theme "Promoting Responsible Reproductive Health Behaviour : The Yout h Perspective". All of them suggest that youth are in ignorance about sexuality and reproductive health.

Disturbingly, in a baseline survey in Fiji, Marshall Islands and Western Samoa, undertaken on behalf of the South Pacific Commission, Carol Jenkins of the Papua New Guinea Institute of Medical Research found that, among the sample population of 13 -25 year olds, basic knowledge of the main modes by which HIV is transmitted is deficient. Knowledge of the consequences of untreated STDs is very low. The level of knowledge about safe sexual practices is fairly poor.

In another survey of urban youth in Apia, W. Samoa, 26 percent of males and 29 percent of females aged 15-19 were unable to identify the cause of AIDS. The level of education is important: 45 percent of the sample population with only primary s chooling showed ignorance about what causes AIDS.

"There is a clear need to reconceptualize population education to focus on the emerging concerns of youth", Allan Kondo writes (see page 9). Sexuality education is needed in schools. There is no discussion about sexual development and reproducti ve health in most homes. School principals contend that parents oppose the teaching of sex education in the curriculum. Between parental coyness and educational conservatism, the teenage population bears the onsequences of ignorance.

Yet sexuality education in schools, straight talk about safe sex, and availability of information about responsible reproductive health may not be enough. Sometimes, young people want to know about contraception; some may want access to condoms to practise safe sex. Family planning programmes have operated for nearly 30 years in the Pacific. Yet access to information and contraceptives is difficult for young people. Cult urally acceptable solutions must be found. It is time to act.