International Guidelines on Sexuality Education (UNESCO)

International Guidelines on Sexuality Education:

An evidence informed approach to effective sex, relationships and HIV/STI education

Conference Ready Version International Guidelines on Sexuality Education:

An evidence informed approach to effective sex, relationships and HIV/STI education

June 2009

Conference Ready Version The designations employed and the presentation of materials throughout this document do not imply the expression of any opinion whatsoever on the part of UNESCO concerning the legal status of any country, territory, city or area or its authorities, or concerning its frontiers and boundaries.

Published by UNESCO

Education Sector Division for the Coordination of UN Priorities in Education Section on HIV and AIDS 7, place de Fontenoy 75352 Paris 07 SP, France Website: www.unesco.org/aids Email: [email protected]

Composed and printed by UNESCO ED-2009/WS/36 (CLD 1983.9)

Conference Ready Version Acknowledgements

These International Guidelines on Sexuality Education Talking about Reproductive and Sexual Health Issues were commissioned by Chris Castle and Ekua (TARSHI); Hans Olsson, The Swedish Association Yankah in the Section on HIV and AIDS, Division for for Sexuality Education; Grace Osakue, Girls’ Power the Coordination of United Nations (UN) Priorities in Initiative (GPI) Edo State, Nigeria; Jo Reinders, World Education at the United Nations Educational, Scienti c Population Fund (WPF); Sara Seims, the William and and Cultural Organization (UNESCO) with support from Flora Hewlett Foundation; Ekua Yankah, UNESCO Laura Laski and Prateek Awasthi in the Adolescent and Youth Cluster of the Reproductive Health Branch at the Written comments and contributions were also gratefully United Nations Population Fund (UNFPA). received from (in alphabetical order):

This document was written by Nanette Ecker, Director Vicky Anning, independent consultant; Prateek Awasthi, of International Education and Training at the Sexuality UNFPA; Andrew Ball, World Health Organization Information and Education Council of the United States (WHO); Tanya Baker, Youth Coalition for Sexual and (SIECUS) and by Douglas Kirby, Senior Scientist at Reproductive Rights; Jeffrey Buchanan, UNESCO; ETR (Education, Training, Research) Associates. Chris Castle, UNESCO; Katie Chau, Youth Coalition Peter Gordon, independent consultant, edited various for Sexual and Reproductive Rights; Judith Cornell, drafts. UNESCO; Anton De Grauwe, UNESCO International Institute for Educational Planning (IIEP); Jan De Lind UNESCO and UNFPA would like to thank the William and Van Wijngaarden, UNESCO; Marta Encinas-Martin, Flora Hewlett Foundation for hosting the global technical UNESCO; Jane Ferguson, WHO; Dakmara Georgescu, consultation that contributed to the development of the UNESCO International Bureau of Education (IBE); guidelines. The organizers would also like to express Anna Maria Hoffmann, United Nations Children’s Fund their gratitude to all of those who participated in the (UNICEF); Roger Ingham, University of Southampton; consultation, which took place from 18-19 February Laura Laski, UNFPA; Changu Mannathoko, UNICEF; 2009 in Menlo Park, USA (in alphabetical order): Rafael Mazin, Pan-American Health Organization (PAHO); Maria Eugenia Miranda, Youth Coalition Prateek Awasthi, UNFPA; Arvin Bhana, Human Sciences for Sexual and Reproductive Rights; Jenny Renju, Research Council South Africa; Chris Castle, UNESCO; Liverpool School of Tropical Medicine & National Dhianaraj Chetty, ActionAid; Esther Corona, Mexican Institute for Medical Research, United Republic of Association for Sex Education and World Association Tanzania; Mark Richmond, UNESCO; Justine Sass, for Sexual Health; Mary Guinn Delaney, UNESCO; UNESCO; Barbara Tournier, UNESCO IIEP; Friedl Van Nanette Ecker, SIECUS; Nike Esiet, Action Health, den Bossche, UNESCO; Diane Widdus, UNICEF; Arne Inc. (AHI); Peter Gordon, independent consultant; Willems, UNESCO; Ekua Yankah, UNESCO. Christopher Graham, Ministry of Education, Jamaica; Nicole Haberland, Population Council/USA; Douglas UNESCO would like to acknowledge Sandrine Bonnet, Kirby, ETR Associates; Sam Kalibala, Population UNESCO IBE; Claire Cazeneuve, UNESCO IBE; Claire Council/Kenya; Wenli Liu, Beijing Normal University; Greslé-Favier, WHO; Magali Moreira, UNESCO IBE and Elliot Marseille, Health Strategies International; Helen Lynne Sergeant, UNESCO IIEP for their contributions Omondi Mondoh, Egerton University; Prabha Nagaraja, to the bibliography of useful resources.

Conference Ready Version iii Acronyms

ASRH Adolescent sexual and reproductive health AIDS Acquired Immune DeI ciency Syndrome ART Anti-retroviral Therapy CEDAW Convention on the Elimination of All Forms of Discrimination against Women CRC Convention on the Rights of the Child EFA Education for All ETR Education, Training and Research FHI Family Health International HFLE Health and Family Life Education HIV Human ImmunodeI ciency Virus HPV Human Papilloma Virus IATT Inter-Agency Task Team IBE International Bureau of Education (UNESCO) ICPD International Conference on Population and Development IIEP International Institute for Educational Planning (UNESCO) IPPF International Planned Parenthood Federation LGBTQ Lesbian, Gay, Bisexual, Transgender, Questioning MDG Millennium Development Goal MoE Ministry of Education MoH Ministry of Health NGO Non-Governmental Organization PEP Post-exposure prophylaxis SIECUS Sexuality Information and Education Council of the United States SRE Sex and relationships education SRH Sexual and reproductive health SRHR Sexual and reproductive health and rights STD Sexually transmitted disease STI Sexually transmitted infection UN United Nations UNAIDS Joint United Nations Programme on HIV/AIDS UNESCO United Nations Educational, ScientiI c and Cultural Organization UNFPA United Nations Population Fund UNICEF United Nations Children’s Fund VCT Voluntary Counselling and Testing WHO World Health Organization

iv Conference Ready Version Table of Contents

Acknowledgements iii

Acronyms iv

Part I: The rationale for sexuality education 1 1. Introduction 2 2. Background 5 3. Building support for sexuality education 8 4. The evidence base for sexuality education 12 5. Characteristics of effective programmes 17

Part II: Topics and learning objectives 25 1. Age range 26 2. Components of learning 27 3. Points of entry 27 4. Structure 28 5. Presentation 29 6. Overview of key concepts and topics 29 Tables of learning objectives 30

Endnotes 57

Part III: Appendices 59 I. Glossary on sex and sexuality terms 60 II. International conventions outlining the entitlement to sexuality education 63 III. Interview schedule and methodology 65 IV. Criteria for selection of evaluation studies and review methods 57 V. People contacted and key informant details 68 VI. Bibliography of useful resources 70 VII. List of participants from the UNESCO/UNFPA global technical consultation on sexuality education 77 VIII. Reference material for the International Guidelines 79

Conference Ready Version v Part 1: The rationale for sexuality education

Conference Ready Version 2 Part 1 1.1 Conference Ready Version people withage-appropriate, culturallyrelevant and Effective sexualityeducationcanprovide young HIV. particularly thosewithdisabilitiesandliving Some youngpeopleare more vulnerable thanothers, entitlement of It istherefore essentialtorecognise theneedand period oftimefrom sexualdebutuntilmarriage. age. Theyare alsomarryinglater, thereby extendingthe are becomingsexuallymature andactiveatanearlier very timewhenitismostneeded.Globally, youngpeople matters byadults,includingparents andteachers, atthe silence, anddisapproval ofopendiscussion of sexual gender. Thisisoftenexacerbatedbyembarrassment, con Many youngpeopleapproach adulthoodfaced with and sexuallytransmittedinfections(STIs),includingHIV. coercion, abuseandexploitation,unintendedpregnancy sexual lives.Thisleavesthempotentiallyvulnerableto Few youngpeoplereceive adequatepreparation fortheir 1. • • • • This documentisbaseduponthefollowing assumptions: icting andconfusingmessagesaboutsexuality discussion withinthecontext ofsexuality education. do notoccur, orthattheyshouldbeexcluded from unacceptable. This doesnotmeanthatthesebehaviours as acceptableanddesirable whileothersare considered across andwithincultures. Certainbehaviours are seen sexualThe rulesthatgovern behaviour differwidely Diversity isafundamentalcharacteristic ofsexuality. gender. Sexuality cannotbeunderstoodwithoutreference to political andcultural dimensions. physical, psychological, spiritual, social, economic, Sexuality isafundamentalaspectofhumanlife: ithas Introduction Whatissexuality education and whyisitimportant? all youngpeopletosexualityeducation. Access prevention andisalsocriticaltoachievingUniversal Effective sexualityeducationisacriticalpartofHIV lives. be abletomakeinformeddecisionsabouttheirsexual and values,topractisetheskillstheywillneed opportunities foryoungpeopletoexplore theirattitudes scienti properly designedandimplementedprogrammes pregnancy, andcoercive orabusivesexualactivity, eliminate theriskofHIVandotherSTIs,unintended support. Whilethere are noprogrammes thatcan curriculum) withinwhichtodoso. as offering anappropriate structure (i.e.theformal education before theybecomesexuallyactive,aswell reach largenumbersofyoungpeoplewithsexuality School settingsprovide animportantopportunityto increase theuse ofprotection againstpregnancy • reduce thenumberofsexual partners;and • reduce thefrequency ofunprotected sexual • delaythedebutofsexualintercourse; • characteristics canhelpto: Research showsthatprogrammes sharingcertainkey increase communicationwithparents orother • improve perceptions aboutpeergroup norms; and • • increase clarifyandsolidifypositivevalues attitudes; skills; • • increase knowledge; • reduce misinformation; can: Studies show(seesection4)thateffective programmes reduce someoftheserisks. and STIsduringsexualintercourse. activity; trusted adults. callyaccurateinformation.Itincludesstructured 1 targetsforprevention, treatment, care and

can informed by practitioner experience and expert opinion. informed bypractitionerexperience andexpertopinion. studies, the education isdrawnprimarily from publishedresearch While sectionfourontheevidence baseofsexuality conventional standards ofpublishedresearch studies. example, about‘promising approaches’; aswellthe education: practitionerexperienceandexpertopinion,for Different kindsofevidenceexist inrelation tosexuality include behaviourallyde range oftopicsandconceptsthatmayornot best availableevidenceandencompassesabroad education combinesarights-basedapproach withthe behaviour. Inthese conceptual emphasiswouldbeonreducing sexualrisk safer behaviour. Forpublichealthprofessionals, the right, aswellbeinga is valuedbothasaworthwhileoutcomeinitsown activity inwhichincreasing knowledge(e.g.about HIV) For educationalists,sexualityeducationisabroader objective andtotheoverallintendedgoalfocus. differ intherelative importancetheyattachtoeach designers, researchers andpractitionerssometimes When itcomestosexualityeducation,programme their personal,socialandsexuallives. people accesstotheknowledgeandskillstheyneedin to respond tothechallengeofgivingchildren andyoung social leadershipfrom educationandhealthauthorities level, the and well-beingofchildren andyoungpeople.At another parents, contributingtowards ensuringtheprotection classroom havearesponsibility toactintheplaceof institutions. Initssimplestinterpretation, teachers inthe duty ofcare ofeducationandhealthauthorities and be life-threatening, sexualityeducationispart ofthe In acontextwhere ignoranceandmisinformationcan topromote andsustainrisk-reducing behaviour. • todeveloporstrengthen skills;and • toexplainandclarifyfeelings,valuesattitudes; • toincrease knowledgeandunderstanding; • mutually reinforcing objectives: Sexuality educationprogrammes usuallyhaveseveral social relationships inaworldaffected byHIVandAIDS. values tomakeresponsible choicesabouttheirsexualand young peopleare equippedwiththeknowledge,skillsand The primarygoalofsexualityeducationisthatchildren and 1.2 Whatarethegoals International Guidelines of sexuality education? International Guidelines International Guidelines ned outcomes. ned rst steptowards adopting callforpoliticaland are also deliberately are alsodeliberately , sexuality The sexuality education. set ofage-speci materials. Itdoesthisprimarilybyrecommending a school-based sexualityeducationprogrammes and authorities inthedevelopmentandimplementationof primarily toassisteducation,healthandotherrelevant These 1.3 Provide guidance onhowtodevelopresponsive, • • Build teacher preparedness andenhance Provide guidancetoeducation authoritiesonhow • Provide aclear understandingofwhatsexuality • Promote anunderstandingoftheneedforsexuality • process. Theyare intendedto: and HIV/STIswithinastructured teaching/learning to children andyoungpeopleaboutsex,relationships offering guidedaccesstoinformationandknowledge The mayaffectturn, sexualbehaviour. and skillsthatare amenabletochangeand which, in designed, thataddress factorssuchasbeliefs, values is placedontheneedforprogrammes thatare logically out ofschool,may delivery andevaluationofsexualityeducation,in and teachers.However, anyoneinvolvedinthedesign, staff, includingcurriculumdevelopers,schoolprincipals relevance foreducationministersandtheirprofessional Conference Ready Version education materialsandprogrammes. culturally-relevant andage-appropriate sexuality sexuality education;and institutional capacitytoprovide goodquality sexuality education; to buildsupportatcommunityandschoollevelfor what thepossibleoutcomesare; education comprises,whatitisintendedtodo,and affectingconcerns children andyoungpeople; salient sexualandreproductive healthissuesand education programmes byraisingawareness of International Guidelines International Guidelines Whatarethepurposeand International Guidelines International Guidelines intended audienceofthe c standardobjectivesfor learning nd thisdocumentuseful.Emphasis are aframeworkfor willhaveimmediate have beendeveloped ?

3 Part 1 4 Part 1 Conference Ready Version existing programmes. of newprogrammes orthereview andscalingupof those involvedinpolicy, advocacy andthedevelopment Thus, the practical resource material. described inPartI,togetherwithotherrelevant and detailed background informationontheevidencebase objectives. Thethird sectionprovides thereader with towards theachievementofteachingandlearning of whatisbeingtaughtandtoassessprogress a setofbenchmarkswithwhichtomonitorthecontent objectives forfourdistinctagegroups. Theyestablish of keyconceptsandtopics,togetherwithlearning International Guidelines of effective programmes. Thesecondpartofthe sexuality educationandpresents thekeycharacteristics of theavailableevidenceinrelation totheimpact of is andwhyitimportant.Itsetsoutaclearoverview parts. The The 1.4 HIV andAIDSatthenationallevel. it isanessentialpartofacomprehensive response to part ofagoodcurriculumand,itcouldalsobeargued, In abroader context,sexualityeducationisan essential acceptance. can bemadeinorder toincrease localrelevance and on thebasisofwhichregional andcountryadaptations Guidelines across awiderangeofsettings.The the diverserealities andneedsofyoungpeople’s lives and evidence-based.Theyare intendedtoaddress comprehensive, scienti sensitive, respectful ofsexualandgenderdiversity, to sexualityeducationthatare rights-based,culturally The can befoundinAppendixVI. that already exist.Alistofrecommended resources resources, curriculaandmaterialsfortrainingteachers The ‘howto’issuesare dealtwithinclassroom strategies tointroduce orstrengthen sexualityeducation. on the‘why’and‘what’issuesthatrequire attentionin This documentisnotacurriculum.Instead,itfocuses International Guidelines International Guidelines Howarethe International Guidelines are thusintendedtobeaglobaltemplate, Guidelines rst partexplainswhatsexuality education cally accurate,age-appropriate presents aglobaltemplate are baseduponapproaches structured? are dividedintothree International provide aplatformfor International within these objectives means exhaustive,thetopicsandlearning both in-schoolandoutofschool.Thus,whilebyno curricula across arangeofsettingsandaudiences, in somecasesrigorously evaluated,sexualityeducation The review yieldedadiversesampleofwidelyused, and Curricula from 12countries wide rangeofresources. databases, websitesandlistserves by keyinformantsandthrough searches ofrelevant existing curricula,guidelinesandstandards as identi was informedbyaspeciallycommissionedreview of The developmentofthe review. were identi times impactinguponbehaviour. Thesecharacteristics clarifying valuesandattitudes,increasing skillsandat found tobeeffective intermsofincreasing knowledge, education programmes were outlinedthathavebeen characteristics ofexistingandevaluatedsexuality other developedcountries.Furthermore, common countries, 47from theUnitedStatesand11from around theworld;29studieswere from developing behaviour. Thereview considered 87studiesfrom literature ontheimpactofsexualityeducationsexual a speciallycommissionedsystematicreview ofthe The developmentofthe 1.5 from educational andbehaviourchangetheory, they the as relying onprofessional guidance from expertsin inclusion withinpositivelyevaluatedcurricula,aswell Guidelines objectivesinthese The topicsandlearning objectives. the topicsandlearning Guidelines provide theoverallorganizingframeworkfor and theUnitedStateswere consulted.TheSIECUS which drawsonexperiencefrom India,Jamaica,Nigeria organization(NGO), non-governmental international Education CounciloftheUnitedStates(SIECUS),an Education, In addition,the identify commontopicsandrelatedobjectives. learning eld. Thus,whilethe Howwerethe havebeenselectedonthebasisoftheir developedbytheSexualityInformationand Guidelines ed andveri International Guidelines Guidelines forComprehensiveSexuality topics andlearningobjectives International Guidelines rationale 3 ed through independent were examinedinorder to developed? International International wasinformedby 2 are drawnfrom a (seeAppendixV). International draw ed

to thiseffort. these communities considertobesensitive.Itishopedthat people inareas ofthecurriculumwhichparents and rights ofparents andtherightsofchildren andyoung and schoolmanagersare calledupontobalance the an averageschoolsettingthisisimportant;teachers force normativeinstrument.Evenfor ofaninternational and non-bindingincharacterdonothavethe noted thatthe level.Atthesametime,itshouldbe at international highest qualitysafeguards, acceptabilityandownership recognised andlegitimateprotocol whichensures the engagement ofotherUNAIDSCosponsors.Thisisa contracting andconsultingwithleadingexpertsinthe In termsofprocess, theywere developedby International Guidelines people willbesensitivetothelegalstandingofthese education andotherinstitutionsproviding foryoung withsettingpolicyin Decision-makers concerned this document. UNICEF, UNFPA andWHOhavealsoprovided inputfor group ofyoungpeopleandcolleaguesfrom UNESCO, The UnitedNationsPopulationFund(UNFPA) advisory February 2009 through aglobaltechnicalconsultationmeetingheldin with recognised experts(seelistinAppendixV),and were furtherdevelopedthrough keyinformantinterviews These available evidence. the world,andwillcontinuetobebasedonbest and willincorporatefeedbackfrom theirusersaround versions ofthe are solidlyembeddedinpracticalexperience.Future eld ofsexualityeducationandwiththesupport International Guidelines International Guidelines

International Guidelines with expertsfrom 13different countries. International Guidelines in the international community.in theinternational constructivelycontribute on sexualityeducation willbeproduced are voluntary

future. and childbearingasexpected possibilitiesinthenear mobility, andthebeginningof adult life,withmarriage For girls,pubertymaysignal anendtoschoolingand increased freedom, mobilityand socialopportunities. and girls.Forboys,pubertycanbeagatewayto of socialaswellphysicalchangeforbothboys 2002), inmanycultures pubertyrepresents atime According totheWorld Health Organization (WHO, discomfort. because ofculturalnorms,theirownignoranceor to engageindiscussionofsexualmatterswithchildren and sexuality. Furthermore, parents are oftenreluctant orevencon with alternative teachers, mediaandpeers).Theseoftenpresent them sources ofinformationandvalues(e.g.from parents, communities, youngpeopleare exposedto several includes valuesrelated togenderandsexuality. Inmany to thenextformsacriticalpartofsocialisation;it The transmissionofculturalvaluesfrom onegeneration within speci the developmentofone’s genderidentityanditunfolds and culturaldimensions.Itisalsoinextricablylinkedto comprises physical,psychological,emotional,social The sexualdevelopmentofapersonisprocess that HIV andAIDS). (reducing mortality)andMDG6(combating maternal especially MDG3(achievinggenderparity),5 achieving theMillenniumDevelopmentGoals(MDGs), education inschools,isthusakeystrategytowards reproductive health,includingtheprovision ofsexuality and reducible. Promoting youngpeople’s sexualand resources andyetsuchburdens are preventable families andcommunitiesuponscarce government unintended pregnancy allplacesubstantialburdens on sense: HIVinfection,otherSTIs,(unsafe)abortionand health ofyoungpeoplemakessocialandeconomic young people.Ensuringthesexualandreproductive important contributorstotheburden ofdiseaseamong Sexual andreproductive ill-healthare amongthemost 2. 2.1 Conference Ready Version Background Young people’s sexual and reproductive health c socio-economicandculturalcontexts. icting valuesaboutgender

5 Part 1 6 Part 1 Conference Ready Version behaviour in ourunderstandingofhumansexualityandsexual The pastfourdecadeshaveseendramaticchanges education. carefully inrelation totheevidencebaseforsexuality and programmatic interventionsneedtobeassessed one ofarangechoicesavailabletoyoungpeople safer sexualandsocialrelationships. Abstinenceisonly and respect thatare prerequisites forhealthierand reinforcement ofvaluessuchasreciprocity, equality sexuality educationprioritisestheacquisitionand/or people choosetobesexuallyactive,comprehensive of expressing affection andlove.Whetherornotyoung it canbeasource ofpleasure andcomfortaway ‘Being sexual’isanimportantpartofmanypeople’s lives: 61 percent Saharan Africa,thisproportion risestoapproximately of thetotalnumberpeoplelivingwithHIV, butinsub- 15 to24years.Globally, womenconstitute50percent cent ofallnewinfectionsoccurringamongthoseaged concentrated amongyoungpeople,withroughly 45per live insub-SaharanAfrica.NewHIVinfectionsare people globallyare livingwithHIV, two-thirds ofwhom HIV/AIDS (UNAIDS,2008),more thantenmillion young According totheJointUnitedNationsProgramme on acquire abetterunderstandingofgenderand sexuality. which islargelysexuallytransmitted–weneededto rapidly understoodthat,inorder toaddress HIV– role inbringingaboutthischange,becauseitwas Source: Fisher, J. andMcTaggart J. needs, evenindevelopedcountries’ educationsystems. shows thescaleofchallenge inmeetingyoung people’s reviewing SREprovision yieldedimportantdata. The dataalso Involving astructure like the Youth Parliamentintheprocessof • • • SRE%20 Chapter 3, Section14.www.teachernet.gov.uk/_doc/13030/ Relationships Education(SRE)in Schools only average. Otherkey or withafurther33percentdescribingitas ‘poor’ poor’ ‘very Relationships Education(SRE)theyhadreceived aseither says that40percentofyoungpeopledescribedtheSex and on questionnaire responses fromover 20,000youngpeople, A report publishedin2007by theUK Youth Parliament, based Box 1. Involving Young People their local sexual health service wastheir localsexuallocated. healthservice Just over halfofrespondents hadnotbeentold where how touseacondom; 16-17 year oldfemalesreported nothaving beentaught 55 percentofthe12-15year oldsand57percentofthe taught anythingaboutrelationships; 43 percentofrespondents reported nothaving been I nal.pdf orhttp://ukyouthparliament.org.uk/sre 4 . TheglobalHIVepidemichasplayeda 5 . I ndings from the survey were that:ndings fromthesurvey

Review ofSex and , Issues2008, about HIVanditsprevention 15 to24hadaccurateandcomprehensive knowledge 40 percentofmalesand38femalesaged Survey datafrom sixty-fourcountriesindicate thatonly cite condomsasaneffective strategyforHIVprevention. protect againstHIV, only55percentofyoungwomen than 70percentofyoungmenknowthatcondomscan avoid exposure toHIV. WhileUNAIDSreports thatmore still lackaccurate,completeinformationonhowto men. According toUNAIDS(2006),manyyoung people countries, withwomengenerallylesswellinformedthan Knowledge aboutHIVtransmissionremains low inmany status totheirpartners. not haveHIV. Manydidnotknowhow todisclosetheir cent were inrelationships withasexualpartnerwhodid disclosed theirstatustosexualpartners;39per cent ofthoselivingwithHIVreported thattheyhadnot discouraged from becomingsexuallyactive.Sixtyper and reproductive healthservicesandare actively with HIVare oftendiscriminatedagainstbysexual experience inUganda However, theseneedsare oftenunmet.Forexample, issues relating todisclosure, stigmaanddiscrimination. living positivelywithHIV; sexualityandrelationships; and reproductive health,including:opportunitiestodiscuss have particularneedsinrelation totheirsexualand psychosocial support.Young peoplelivingwithHIV anti-retroviral andrelated therapy(ART) medicaland longer, thankstoimproved accesstotreatment with In manycountries,youngpeoplewithHIVare living maternal mortality thanolderwomen. maternal are toteenagemothers,whoexperiencehigherratesof which willbeunsafe.Ten percentofbirthsworldwide aged 15to19yearsseekabortions,themajorityof aged between10and24,upto4.4milliongirls new casesofcurableSTIsoccuramongyoungpeople Federation (IPPF, 2006),eachyearatleast111million STIs. AccordingPlannedParenthood totheInternational Globally, youngpeoplecontinuetohavehighratesof in 95percentofyoungpeopleby2010’(UN,2001). global goalof‘ensuringcomprehensive HIVknowledge less that15percent.This indicated thecoverageofHIVprevention inschools was receive anyschool-basedHIVeducation.Furthermore, that atleasthalfofstudentsaround theworld didnot v of ve fteen countriesreporting toUNAIDSin2006 6 reveals thatyoungpeopleliving gure fallswellshortofthe 7 . UNAIDS(2007)reported sustainable social backgrounds inwaysthatare replicable and reaching largenumbersofyoungpeoplefrom diverse in school.Thus,schoolsprovide apracticalmeansof most countries,youngpeoplebetweentheagesof responsible choicesinoursocialandsexuallives.In with theappropriate skillsandknowledgetomake to adulthoodrequires beinginformedandequipped their adultroles andresponsibilities role toplayinpreparing children andyoungpeoplefor In thelargercontext,educationsectorhasacritical 2.2 that governments guarantee the rights of young people guaranteetherightsof youngpeople that governments organizations,requirebodies andotherinternational human rightsstandards, asarticulatedbyUNgoverning for Reproductive Rights(2008)arguesthatinternational conventions (seeAppendixII).Forexample,theCenter as arightandarguethatthisissupportedbyspeci now promote sexualandreproductive healtheducation health information(Biddlecom,2007).Someorganizations Young peoplewantandneedsexualreproductive 2.3 contribute tomakingschoolshealthyforchildren point toacore setofcost-effective activitiesthatcan UNESCO, WHO,theUNICEFandWorld Bank and trustedsource ofinformation.Evidencefrom and thebroader community. important issuesbetweenyoungpeople,trustedadults have thepotentialtopromote communication about other services(forexample,healthservices).Thus,they link children, parents, familiesandcommunitieswith also socialsupportcentres, trustedinstitutions thatcan reproductive health.Inmanycommunities,schoolsare an opportunitytoprovide educationaboutsexual and school, makingthesettingevenmore important as Moreover, inmanycountries,youngpeoplehave their ve andthirteenspendrelatively largeamountsoftime rst sexualexperienceswhiletheyare stillattending Young people’s needs Theroleofschools sexuality education and entitlementto 9 . Teachers are likelytobethemost skilled 8 . Thetransition 10 . c age appropriate andrelevant. right balancebetweentheneedtoknowandwhatis process andgrowth, oflearning itiscrucialtostrikethe any teacherorparent inguidingandsupportingthe orientation. Giventhecomplexityoftaskfacing or stigmaanddiscriminationbecauseoftheirsexual is intheformofabusiverelationships, exposure toHIV their well-beingexistsinarangeofcontexts,whetherit a difference totheirlifechances.Thethreat tolifeand information andskillsonsexualityeducationthatmakes children andyoungpeoplehaveaspeci education isinterpreted from thestandpointthat In these secondary schools. and discriminationavailabletotheminprimary scienti making comprehensive sexualityeducationthatis to health,life,educationandnon-discrimination,by imperatives shouldtakepriority overpersonalopinion. that goodscienti Decision-makers withadutyofcare havetorecognise policy-makers andothersmaypersonallydisapprove. sexual lives:thisincludesthoseaspectsofwhich importance ofaddressing the These poverty, disabilityandsocio-economicfactors. attention tootheraspectsofvulnerability, particularly For manydevelopingcountries,thisdiscussionwillrequire into considerationinsexualityeducationprogrammes. needs ofthosewhomaybemostvulnerablemusttaken Furthermore, incountrieswithlowHIVprevalence, the relationships isnotasolution. delivering sexualityeducation.Overlookingsame-sex issues forthosewithresponsibility fordesigning and of theirownsex.Theseare sensitiveandchallenging now orinthefuture, willbesexuallyactivewithmembers money, foodorshelter)coercion. Somestudents, this isthrough choice,necessity(e.g.inexchange for people before theybecomesexuallyactive, whether The challengeforsexualityeducationistoreach young 2.4 Conference Ready Version cally accurate,objectiveandfree from prejudice Addressing sensitive International Guidelines International Guidelines issues c evidenceandpublichealth reality theneedforsexuality emphasisethe ofyoungpeople’s c needfor

7 Part 1 8 Part 1 Conference Ready Version Table 1. Commonconcernsabouttheprovision ofsexualityeducation thataresome typicalexamplesofconcerns expressed aboutintroducing orpromoting sexualityeducation). to address, orelsethere isnoclearguidanceaboutwhattoteachandhowit(see Table 1,whichprovides to doso.Teachers’ personalorprofessional valuescouldalsobeincon need toprovide sexualityeducation,orelseare reluctant toprovide itbecausetheylackthecon that manypeople,includingeducationministrystaff, schoolprincipalsandteachers,maynotbeconvincedofthe resulting from misunderstandingsaboutthenature, purposeandeffects ofsexualityeducation.Evidencesuggests the worldthisisstillnotavailable.There are manyreasons forthis,including‘perceived’ or‘anticipated’resistance Despite theclearandpressing needforeffective school-basedsexualityeducation,inmost countriesthroughout 3. taught inschools. sexuality educationbeing Parents willobjectto about sexuality. educate ouryoung people and theextendedfamilyto It istherole ofparents religion. against ourculture or Sexuality educationis Response children oftheir ‘innocence’. Sexuality educationdeprives early sex. Sexuality educationleadsto Concerns not foryoung children. good foryoung people, but Sexuality educationmay be promote values. Sexuality educationshould or civicseducation). subjects (biology, lifeskills already covered inother Sexuality educationis do so. lacking inskillorafraid to but are uncomfortable, teach sexualityeducation Teachers may bewillingto Buildingsupportforsexuality education quali andresponsible choicesinformed intheirsocialandsexual lives.Furthermore, teachers remain thebest institutions functionwell, youngpeopleare abletodevelopthevalues, skillsandknowledge tomake aboutsex,an appropriateenvironmentforyoungpeopletolearn relationships andHIV/STIs. When these Schools andeducationinstitutionswhere children andyoungpeoplespendalarge partoftheirlivesare sexuality education. environmentandthetoolsmaterialsforgoodquality is toprovide asafeandsupportivelearning to sexuality andrelationships. Government’s role, throughministriesofeducation, schools andteachers, role ofparents andthefamilyasasource ofinformation, supportandcare inshapingahealthy approach down insomeplaces, oftenwithnothingleftintheirplace. Sexuality educationrecognises theprimary Traditional mechanisms forpreparing youngpeopleforsexual lifeandrelationships maybebreaking girls andyoungwomen. same time, respect forculture andvalues hastobebalancedwiththeneedsofyoungpeople, especially religious leaders, sexuality educationtakes. mustbeinvolvedinthedevelopmentofwhatform At the and buildingsupportamongthecustodiansofculture inagivencommunity. Keystakeholders, including Guidelines are builtupontheprincipleofbeingculturallyThe International relevant aswellengaging andanemphasisonvalues. correct information peers, themediaorothersources. Goodqualitysexuality educationbalancesthisthroughtheprovision of children andyoungpeoplewilloftenreceive con at anearlyage, issomethingtowhich allchildren andyoungpeopleare entitled.Intheabsence ofthis, thatisscienti Getting therightinformation sexuality educationleadstolaterandmore responsible sexual behaviour. Research fromaroundtheworld clearlyindicatesthat, rather thanleadingtoearlysexual initiation, learning conceptssuch assafetyandcon learning understanding principlesofhumanreproduction, exploring familyandinterpersonalrelationships and an earlyage. Sexuality educationlaysthefoundations–e.g. correct namesforpartsofthebody, learning their sexuality andtherefore needthe skillstounderstandtheirbodies, relationships andfeelingsfrom sexual relationships. Children are aware ofandrecognise theserelationships longbefore theyacton objectives.Sexuality educationencompassesarange of learning ofrelationships,grouping notonly Guidelines are builtupontheprincipleofage-appropriatenessreThese International are inextricably linked to universally accepted human rights. are inextricably linked touniversallyacceptedhumanrights. Guidelinesonsexuality education supportarights-basedapproachThese International inwhich values base inadynamic andrapidly changing presents anopportunity to evaluate andstrengthen thecurriculum, teaching practice andtheevidence sexuality education. Whilst recognising thevalue ofthese efforts, Guidelines usingtheseInternational Ministries, schools andteachers inmanycountries are already responding tothechallenge ofimproving professional developmentandsupport. thesubjectincurriculum,education throughaddedemphasisonformalising aswell stronger ofsexuality educationintheclassroom. delivery Teachers shouldbeencouraged tospecialiseinsexuality sexuality education.Clearsectoral andschool policiesandcurriculahelptosupportteachers inthe Well-trained, supported andmotivated ofgoodquality teachers are anessentialpartofthedelivery age anddevelopmentofachild. I ed and the most trusted providers of information andsupportformostchildrened andthemosttrustedproviders ofinformation andyoungpeople. I I eld. eld. cally accurate, non-judgemental, age-appropriateandcomplete, I dence. These can thenbebuiltupongradually, inlinewiththe J icting andsometimesdamagingmessagesfromtheir ict withtheissuestheyare beingasked dence andskills J ected inthe 3.1 understood. the voicesofyoungpeopleare rarely heard and many cases,especiallyaround suchsensitiveissues, considered asoneofthestrategiestobuildsupport.In especially betweenyoungpeopleandadults,couldbe Facilitating dialoguebetweendifferent stakeholders, are outofschool. content willbeequallyrelevant tothosechildren who focus speci out ofschool.Whilethese is importantforallchildren andyoungpeople,in they re youth-friendly, gender-sensitive, rights-based,andthat and designofprogrammes toensure thattheseare Young peopleneedtobeinvolvedinthedevelopment • Donors. Training institutionsforhealthprofessions; and • Media(localandnational); • NGOs,particularlythoseworkingonsexualand • Lesbian,gay, bisexualandtransgendergroups; • Localcommunitiesandtheirrepresentatives; • • Researchers; Religiousleadersand/orfaith-basedorganizations; • • Parent-teacher Teachers’ tradeunions; associations; • Educationprofessionals andinstitutionsincluding • ministries, includinghealthandothers Government • Policy-makersandpoliticians; • Young peopleandorganizationsthatworkwith • with keystakeholders,including,forexample: sexuality educationthrough consultationandadvocacy a criticalrole inbuildingconsensusontheneedfor insurmountable. Ministriesofeducationhavetoplay Should oppositionoccur, itisbynomeans Opposition tosexualityeducationisnotinevitable. reproductive healthwithyoungpeople; teachers, headteachersandtraininginstitutions; withtheneedsofyoungpeople; concerned them (includingyouthparliaments); Key stakeholders ect thereality oftheirlives.Sexualityeducation cally upontheschoolsetting,muchof International Guidelines

and contraception. duration andconcurrency, aswelluseofcondoms number ofsexualpartners,agedifferences, coercion, sexual initiation,partnershipdynamicsincludingthe sex andgender-speci Ideally, thiswillincludebothquantitativeandqualitative, factors associatedwithHIV/STIriskandvulnerability. be mostvulnerable,togetherwithstudiesonspeci ofyoungpeople,includingthosethoughtto patterns other STIsandteenagepregnancy, sexualbehaviour assessments. ThisshouldincludelocaldataonHIV, evidence from thelocal/nationalsituationandneeds education canbedevelopedonthebasisof A clearrationalefortheintroduction ofsexuality 3.2 Conference Ready Version Leading thecalltoaction Box 2. LatinAmerica: minsterdeclaration_es.pdf http://data.unaids.org/pub/BaseDocument/2008/20080801_ minsterdeclaration_en.pdf http://data.unaids.org/pub/BaseDocument/2008/20080801_ Ministerial.asp Resources/FeatureStories/archive/2008/20080731_Leaders_ See also: http://www.unaids.org/en/KnowledgeCentre/ • • Main features oftheMinisterialDeclaration: schools intheregion. andsecondary it acore area ofinstructionatbothprimary strengthening comprehensive sexuality educationandtomake education throughouttheregion. The declaration advocatesfor a mandatefornationalschool-based sexuality andHIV together inMexico Citytosignahistoricdeclaration af ministers fromacrossLatin America andtheCaribbeancame and educationgoals.In August 2008, healthandeducation priority essentialtoachieving nationaldevelopment, health con aroundtheworldA growingnumberofgovernments are I theircommitmenttosexuality educationasa rming identities. aspects; respects diversityofsexual orientations and ethical, biological, emotional, social, cultural andgender Comprehensive sexuality educationentailshumanrights, care ofsexual health, includingHIVprevention; comprehensive sexuality educationandpromotion Implement and/orstrengthen multisectoral strategies of Developingthecasefor sexuality education c dataregarding theageof I rming rming c

9 Part 1 10 Part 1 Conference Ready Version methods. and trainingintheuseofactive,participatorylearning sexuality educationwillusuallyalsoneeddesensitisation desensitisation. Teachers responsible forthedeliveryof health. Thisshouldincludevaluesclari and traininginsexualitysexualreproductive should beprovided, asappropriate, withorientation and across, alllevels.Participantsinsuchdiscussions school-based sexualityeducationneedtooccurat, discussions aboutbuildingsupportandcapacityfor minimise oppositiontoimproving sexualityeducation, In order toensure continuityandconsistencyto in general(amongststudentsandteachers). school personnel(includingteachers)anddiscrimination and prohibit sexualharassmentandabuse among and AIDS.Theseshouldclearlypromote con the nationalstrategicplanandpolicyframeworkonHIV explicitly linkedtoeducationsectorplans,aswell national policyonsexualityeducationshouldbe and evaluation.Atthepolicylevel,awell-developed classroom deliverytogetherwithplansformonitoring policies, anddevelopacomprehensive workplanfor sensitisation andadvocacy, review draftmaterialsand council andcommitteememberscanparticipatein development andeducation.Individuallycollectively, reproductive health,rights,education,gender, youth national expertsandpractitionersinsexual committee membershaveincludedyoungpeople, of sexualityeducationprogrammes. Counciland and toassistinthedevelopmentimplementation relevant policies,togeneratesupportforprogrammes, by ministriesofeducationtoinformthedevelopment and/or Task Force Committeeshave beenestablished In somecountries,NationalAdvisoryCouncils 3.3 Planning for implementation cto and cation dentiality Supporting pregnanttocontinuewiththeir learners • Procedures forresponding toparental concerns; • • Parental Curriculum deliverybytrainedteachers; involvement; • commitment to: education willclarifyandstrengthen theschool’s absence ofpre-existing guidance,apolicyonsexuality discrimination andgenderinequality. However, inthe AIDS payspeci example, mostschool-basedpoliciesonHIVand de It ispossiblethatsomeoftheseissuesmaybewell Protect andsupportteachersresponsible for • Setstandards ofappropriate behaviour;and • Setstandards oncon • Anticipateandaddress sensitivitiesconcerning • Provide aninstitutionalframeworkfortheimple- • framework will: homophobia) hasanumberofadvantages.Apolicy (including sexualharassment)andbullying sexual andreproductive health,genderdiscrimination forexample, wide policiesorguidelinesconcerning, the frameworkofaclearsetrelevant school- Secondly, implementingsexualityeducationwithin programmatic interventionsandthosethatfalter. teachers canmakethedifference betweensuccessful con andgrowth.learning Inaclimateofuncertaintyor experience sexualityeducationthrough discovery, to taketheleadinhowchildren andyoungpeople a classroom, instructionalleadershiprequires teachers the needsofyoungpeople.From theperspectiveof which toimplementsexualityeducationandaddress and supporting,aswellcreating therightclimatein management isexpectedtotaketheleadinmotivating (1) leadership,and(2)policyguidance.Firstly, school this regard, twolinkedfactorswillmakeadifference: education istobedelivered iscruciallyimportant.In The overallschoolcontextwithinwhichsexuality 3.4 ned through pre-existing schoolpolicies.For education; and community. protect orincrease theirstatuswithintheschool delivery ofsexualityeducationand,ifappropriate, grammes; the implementationofsexualityeducationpro- mentation ofsexualityeducationprogrammes; ict, thecapacitytoleadamongstmanagersand Atschoollevel c attentiontoissuesofcon dentiality; dentiality, their skills in participatory and active learning. their skillsinparticipatoryandactivelearning. to buildtheircomfortandcon service andrefresher trainingforclassroom teachers, pre-service trainingatteachercolleges, andin- curriculum. Furthermore, itshouldincludeplanning for on theplaceofprogramme withinthe broader (including materials),andneedstoreach agreement adequate developmentandprovision ofresources Implementation planningneedstotakeintoconsideration delivering aparticularsubjectorsetofsubjects. preference, orwhetheritshouldberequired ofallteachers and whetherthisshouldbedonebyaptitudeorpersonal teachers toimplementsexualityeducationprogrammes, Decisions willalsoneedtobemadeabouthowselect Promoting accessandlinkstolocalsexual • Actioninthecaseofinfringementpolicy, for • Makingtheschoolahealth-promoting environment • teaching/learning process. teaching/learning each otherinimplementing a guidedandstructured possible scenario,teachersand parents worktosupport people are likelytobelimited.However, inthebest the chancesofpersonalgrowth forchildren andyoung children through learn sexualityeducationprogrammes, curriculum contentorunwillingtoengageinwhattheir themselves are anxiousabouttheappropriateness of delivering goodqualitysexualityeducation.Ifparents their fearstorest andsupportingtheschool’s efforts in and honestlyaboutsexualitywiththeirchildren, putting equip themwithskillstocommunicatemore openly them tothecontentoftheirchildren’s and that learning through theprovision ofparallelprogrammes thatorient being ofstudents.Parentalcanbeaddressed concerns schools andparents withpromoting thesafetyandwell- important toemphasisethesharedof primaryconcern be soughtfrom theoutsetandregularly reinforced. Itis education. Thecooperationandsupportofparents should (sometimes misplaced)abouttheeffects of sexuality Many parents mayhavestrong viewsandconcerns 3.5 reproductive healthandotherservices. bullying; and stigma anddiscrimination,sexualharassmentor example, inthecaseofbreach ofcon for girlsandboys,othermeasures); (through provision ofclean,private,separatetoilets Parental involvement dence, andtodevelop dentiality, protect themfrom violence,exploitationandabuse. together withaccesstocommunityserviceshelp relevant informationandskillstoprotect themselves, disabled, orphaned,orlivingwithHIV. Theyneed vulnerable. Theseincludethosewhoare displaced, groups ofchildren andyoungpeopleare particularly important intermsofchildprotection, sincesome link betweentheschoolandcommunityisparticularly abuse, gender-based violenceanddomesticcrisis services forsexualandreproductive health,substance provide necessarylinkstootherresources, suchas Schools canbecometrustedcommunitycentres that 3.6 Conference Ready Version Schoolsascommunity resources 11 . This

11 Part 1 12 Part 1 4.1 Conference Ready Version on sexualbehaviours Table 2. Thenumberofsexualityeducationprogrammes withindicatedeffects behaviours suchashealth-seekingbehaviour, sexualharassment,violenceorunsafeabortion. that directly affect pregnancy andsexualtransmissionofHIVotherSTIs.Itdidnotreview impactonother than 30hoursoreven15hours.Thereview examinedtheimpactoftheseprogrammes onthose sexualbehaviours in schoolsandtheremainder were implementedincommunityorclinicsettings.Manywere verymodest,lastingless their righttoinformationaboutmanytopics.Allwere curriculum-basedprogrammes, 70percent were implemented unintended pregnancy orSTIs,includingHIV; theywere notdesignedtoaddress thevariedneeds ofyoungpeopleor description ofthecriteriaforselectionevaluationstudies).Allprogrammes were designedtoreduce countries, 47from theUnitedStatesand11from otherdevelopedcountries(pleaserefer toAppendixIVforadetailed The review considered 87studiesfrom around theworld(seeTable 2below);29studieswere from developing behaviour. Guidelines. ItwascommissionedbyUNESCOin2008aspartofthedevelopmenttheseInternational This sectionpresents asummaryofthe 4. • • • Sexual Risk-Taking • • • Use ofContraception • • • Use ofCondoms • • • Number ofSexual Partners • • • Frequency ofSex • • • Initiation ofSex Icesd risk Increased Had nosigni use Decreased Had nosigni Rdcd risk Reduced use Increased use Decreased Had nosigni number Increased Had nosigni frequency Increased Had nosigni Icesd use Increased number Decreased Decreased frequency Hastened initiation Had nosigni Delayed initiation Theevidencebaseforsexuality education 2008Reviewoftheimpactsexuality educationonsexual behaviour I I I I I I cant impact cant impact cant impact cant impact cant impact cant impact Countries (N=29) Developing 41 560% 35 4 17 14 61 762% 37 7 17 16 343% 53% 13 16 1 0 9 15 10013%3 1 01017%341853%141640%00000% 422 40% 23 56% 44% 20 16 2 66% 31% 21 0 10 0 14 1 0 12 11 7 15 00000% 6 8 5 00113%5 4 00000% 522 38% 23 2 15 6 ndings ofarecent review oftheimpactsexualityeducationonsexual United States (N=47) Countries (N=11) Other developed All Countries (N=87) behaviour oftenshared commoncharacteristics. the programmes thatwere effective atchangingsexual often thesameorsimilarresults were obtained;and4) when thesameprogramme wasstudiedmultiple times, similar tothosewithweakerevaluationdesigns;3) very strong research designsandtheirresults were number ofstudies;2)somethestudiesemployed experimental orquasi-experimentaldesigns,isalarge from thesestudiesforseveralreasons: 1)87,allwith Despite theselimitations,there ismuchtobe learned counteract eachother. results are positive.Fortunately, someofthesebiases are more likelytoacceptarticlesforpublicationwhen support theirtheories.Also,programmes andjournals more likelytotrypublisharticlesifpositiveresults that affect thepublicationofstudies:researchers are biological markers.Finally, there were inherent biases still measured impactonSTIorpregnancy rateswith impact uponeitherSTIorpregnancy ratesandfewer multiple testsofsigni statistically underpowered. Mostdidnotadjustfor barely adequateevaluationdesignsandmanywere same-sex sexualbehaviour. Somestudieshadonly for gayorlesbianotheryoungpeopleengagingin respective programmes. Noneexaminedprogrammes studies suffered from an inadequatedescriptionoftheir were conductedindevelopingcountries.Some by implication,tothereview. Too fewofthestudies There were anumberoflimitationstothestudiesand, Limitations andstrengthsofthereview percentages of results intheundesired direction are none ledtoanincreased numberofpartners.Thesmall partners, 56percenthadno impact inthisregard, and of theprogrammes decreased thenumberofsexual the frequency of sexual intercourse. Finally, 44percent 66 percenthadnoimpactand3increased intercourse (whichincludesreverting toabstinence),while programmes ledtoadecrease in the frequency ofsexual of sexualintercourse. Notably, noneoftheprogrammes hastenedtheinitiation important sub-sample,while62percenthadnoimpact. intercourse amongeithertheentire sampleoran intercourse, 38percentdelayedtheinitiationofsexual education programmes upontheinitiationofsexual Of sixtystudiesthatmeasured theimpactofsexuality 4.2 Impactonsexual behaviour

cance. Fewstudiesmeasured Similarly, 31percentofthe more thanathird decreased thenumberofsexual • aboutathird decreased thefrequency ofsexual • more thanathird delayedtheinitiationofsexual • behaviour. Onthecontrary: condom andcontraceptiveusedonotincrease sexual intercourse asthesafestoptionandthatalsodiscuss programmes thatemphasisenothavingsexual strong evidencethat,despitefearstothecontrary, Thus, takentogether, thesestudiesprovide very the positiveresults were probably theresult ofchance. that were examined.Alsobythesameprinciple,afewof chance, giventhelargenumberoftestssigni equal to,orlessthan,thatwhichwouldbeexpectedby positive impactsuponbehaviour isquitestrong. experimental designs.Thus, theevidencefor studies are restricted tolargestudieswithrigorous sexual risk-taking,are essentiallythesamewhen activity, namelyoncondomand contraceptiveuseand The positiveresults onthethree measures ofsexual sub-samples. risk-taking, eitheramongentire samplesorinimportant contraceptive use,whilemore thanhalfreduced sexual than athird oftheprogrammes increased condomor In summary, thesestudiesdemonstratethatmore and three percentwere foundto increase it. decreased sexualrisk-taking;43percenthadnoimpact risk-taking’. Fifty-three percentoftheprogrammes used. Thesemeasures were grouped andlabelled‘sexual sexual partnerswithwhomcondomswere not always sexual intercourse withoutcondomsorthenumber of For example,somestudiesmeasured thefrequency of as condomorcontraceptiveuseinthesamemeasure. that includedboththeamountofsexualactivityaswell contraceptive use.Somestudiesassessedmeasures impact, and7percent(asingleprogramme) reduced also increased contraceptiveuse;53percent hadno decreased condomuse.Fortypercentofprogrammes condom use,whilesixtypercenthadnoimpactandnone Forty percentofprogrammes were foundtoincrease 4.3 Conference Ready Version important sub-samples. partners, eitheramongtheentire sampleorin intercourse; and intercourse; Impactoncondomand contraceptive use cance cance

13 Part 1 14 Part 1 Conference Ready Version such alongtimespan. afterwards, butmostdidnotmeasure impactover on behaviourthatlastedforaslongeightyears Some comprehensive programmes hadeffects fourth toone-third. lower riskysexualbehaviourby, veryroughly, one- modest. Themosteffective programmes tendedto reduce riskysexualbehaviour;theireffects were more Even theeffective programmes didnotdramatically 4.5 when theyhadsuf markers failedtodemonstratesigni markers. However, otherstudiesemployingbiological positive results were demonstratedbybiological rates, agreater numberdidnot.Atleasttwoofthe that hadasigni While asmallnumberofstudiesdidevaluateprogrammes presented inTable 2. having adequatestatisticalpower, theseresults are not rates. Becausemanystudiespresent results without the impactofprogrammes uponSTIandpregnancy larger samplesare neededtomeasure adequately pregnancy orchildbearingrequire thatconsiderably use, thedistributionsofoutcomemeasures ofSTI, frequently thansexualactivity, condomorcontraceptive Because STI,pregnancy andchildbearingoccurless 4.4 Magnitudeandduration ImpactonSTI, pregnancy of impact and birthrates cant reduction inSTIand/orpregnancy cient statisticalpower. cant results, even and better-off communities. young peopleatlowerandhigherriskindisadvantaged sexually inexperiencedandexperiencedyouth, groups ofyoungpeople:e.g.bothmalesandfemales, community settingsandwhenaddressing different behaviour whenimplementedinschool,clinicand Comprehensive programmes were effective inchanging 4.6 HIV rates. still maynothave asigni concert withmutuallyreinforcing community-based elements well-designed, curriculum-basedprogrammeimplementedin Whatever theexplanation, thestudy isacaution thatevena difference inrates ofpregnancy, STIandHIV. not have changed behaviours tosuch anextent astomake a impact onpregnancy, STIsandHIV. Third, theprogrammemay have changed thespeci programme mayhave changed riskbehaviours, butmaynot may nothave actuallychanged sexual behaviour. Second, the sexual behaviour mayhave beenbiasedandtheprogramme explanations forthis.First, study participants’reports of other STIorpregnancy rates. There are atleastthree possible However, theprogrammedidnothave anyimpactonHIV, casual sexual partnerfrom31percentto45cent. percentage offemaleswhoreported usingacondomwith partners from48percentto40cent.Italsoincreased the percentage ofmaleswhoreported fourormore lifetimesexual after aperiodofeightyears theprogrammereduced the positive effectsonreported sexual behaviour. Forexample, A rigorousrandomised trialfoundthattheprogrammehadsome environment fortheinterventions. with acommunitysensitisationefforttocreate asupportive condom promotionanddistributionforby peers, together youth-friendly reproductive healthservices, community-based programme comprisedofastrongclassroom-basedcurriculum, Tanzania. This study evaluated theimpactofamulti-component Mema Kwa Vijana programme(MKV)intheUnitedRepublicof A particularlystrongandinteresting study isthatofthe http://www.memakwavijana.org (Good thingsforyoung people) Box 3. MemaKwa Vijana Breadthofbehaviour results I c behaviours thathave thegreatest I cant impactonpregnancy, STIor implemented inclassroom settings. evaluated incommunitysettings,butwere subsequently condom use,orwhentheywere designedforand when theyomittedactivitiesthatfocusedonincreasing effective whentheirdurationwasshortenedconsiderably, positive results. Programmes were lesslikelytoremain the sameordifferent researchers, theyconsistentlyyielded in onestudywere replicated insimilarsettings,eitherby programmes foundtobeeffective atchangingbehaviour are encouraging Results from severalreplication studiesintheUnitedStates 4.7 States programmes, allofwhichwere conductedintheUnited programs describedabove,elevenabstinence-only In additiontotheeffects ofthesexualityeducation 4.8 studies, tworeported thattheevaluatedprogramme impact forshorterperiodsoftime.Ofthese weaker statisticalanalysisormeasured programme not alwayswell-matched.Somehadhighattritionrates, experimental designswithcomparisongroups that were were methodologicallyweaker. Theseemployed quasi- Studies oftheremaining abstinence-onlyprogrammes intercourse. of sexualpartners,orcondomuseduring abstinence intheprevious twelvemonths, number intercourse, ageofinitiationsexualintercourse, that thecurriculahadnoeffects oninitiation of sexual and usedstatisticalanalyses.Resultsdemonstrated experimental designs,measured long-term impact, of thestudieswere particularlyrigorous: employed 13 Abstinence-only Resultsofreplication , mettheselectioncriteriaforreview. Six programmes studies 12 . These studies demonstrate that when . Thesestudiesdemonstratethatwhen ve weaker ve Few studieshavemeasured theimpactof speci 4.9 young womenandoldermales. amount ofunprotected sexualintercourse between to beimportantbothinitselfandasanindicatorofthe (Dupas, 2007).Thisbiologicalmarkerwasperceived the dangerofhavingsexualintercourse witholder men likely tobeHIV-positive); andshowingavideoabout having sexualintercourse witholdermen(who are more age andsex;emphasisingtheriskofyoungwomen men: providing HIVprevalence rates,disaggregated by the rateofpregnancy amongteenagegirls toolder reported thatthefollowingallsigni use condoms(Du from HIV, studentswere subsequentlymore likelyto an essayaboutwaystheycouldprotect themselves should betaughthowtousecondomsandthenwrote people observedadebateonwhetherschoolchildren schools. The programmes, integratedwithinmultiplecourses in within larger, more comprehensive HIVprevention studies considered theimpactofparticular activities activities withincurriculum-basedprogrammes. Two a signi either condomorothercontraceptiveuse,nonefound quasi-experimental designsthatmeasured impacton people. Ofthestudieswitheitherexperimentalor number ofsexualpartnersamongparticipatingyoung found thatthecurriculumresulted inareduction inthe programme impactuponthenumberofsexualpartners of sexualintercourse. Thesinglestudythatmeasured reported thattheprogrammes reduced thefrequency who hadpreviously hadsexualintercourse. Both frequency ofsexualintercourse amongyoungpeople Two ofthesemeasured programme impactonthe showed nosigni delayed sexualinitiation.Thethree remaining studies Conference Ready Version cant effect. cant Speci activities rst studyfoundthat,whenyoung cant effect uponsexualbehaviour. o W c curriculum-based et al ., 2006).Thesecondstudy cnl decreased cantly c

15 Part 1 16 Part 1 Conference Ready Version Curriculum-basedprogrammes implementedin • 4.11 • • • • • • • • contraceptive usetypicallyfocusedon: or reducing sexualactivityorincreasing condomor Those programmes thatwere effective ateitherdelaying strove tochangeotherfactorsthataffect sexualbehaviour. to reduce sexualriskandemployedalogicmodelalso primary role ofschools.Programmes thatwere designed This isimportant,becauseincreasing knowledgeisa aspects ofsexualityandriskpregnancy orHIV/STIs. been studiedincreased knowledgeaboutdifferent Nearly allsexualityeducationprogrammes thathave 4.10 sexual behaviour. factors, whichthenpositivelyaffected young people’s actually changedbehaviourbyhavinganimpactonthese there isconsiderableevidencethateffective programmes an impactonadolescentsexualdecision-making.Thus, have studies havedemonstratedthatthesefactors,inturn, that particularprogrammes improved thesefactors.Other It shouldbeemphasisedthatsomestudiesdemonstrated reducing HIV, STIorpregnancy rates. insuf the community, theseprogrammes are sometimes However, isolatedfrom broader programmes in necessarily always)reduce sexualriskbehaviour. important componentthatcanoften(butnot schools orcommunitiesshouldbeviewedasan Communication restrict sexualactivityorpartners; Intention use condoms; Self-ef activity, condomsandcontraception; Perceptions ofpeernorms Attitudes abstinence; Personal values pregnancy; Perceptions ofrisk and pregnancy, includingmethodsofprevention; Knowledge and potentiallywithsexualpartners. Summary ofresults Summary Impactoncognitivefactors cient tohaveasigni ( cacy toabstainfrom sexualintercourse orto aboutcondomsandcontraception; e.g.ofsexualissues,HIV, otherSTIs torefuse sexualintercourse andto e.g.withparents orotheradults aboutsexualintercourse and e.g.ofHIV, otherSTIsandof cant impactintermsof e.g.aboutsexual Thesexualityeducationprogrammes studiedhad • Evenifsexualityeducationprogrammes improve • Comparativeanalysisofeffective andineffective • More thanone-fourthofthestudies improved • Nearlyallstudiesofsexualityeducationprogrammes • There isstrong evidencethatprogrammes didnot • anal) sexualintercourse betweenmen. the contextofsexworkandunprotected (mainly unsafe injectingdruguse,sexualactivityin the CaribbeanandAsia).Thosebehavioursare parts oftheworld(i.e.Europe, LatinAmericaand most HIVinfectionsamongadolescentsinlarge to focusonthebehavioursthatcausebyfar one biggapincommon:noneofthemappeared available. not supportriskreduction orclinicservicesare not be challengingtoyoungpeopleifsocialnormsdo risk ortouseclinicservices,reducing theirrisk may knowledge, skillsandintentionstoavoidsexual put youngpeopleatriskofSTIsandpregnancy. can beeffective atchangingthebehaviours that programmes thatincorporatekeyrecommendations programmes provides strong evidencethat consistent results. research designsandreplication studieswith behavioural results includestudieswithstrong people. Encouragingly, thesestudieswithpositive two ormore sexualbehavioursamongyoung important sub-sample. behaviour amongeithertheentire sampleoran thirds ofthemdemonstratepositiveresults on demonstrate increased knowledgeandabouttwo- people. Rather, itcanbebothrealistic andeffective. who are sexuallyactiveisnotconfusingtoyoung abstinence togetherwithuseofprotection forthose contraception. Inotherwords, adualemphasison increase theuseofcondomsorotherforms programmes, todelaysexualintercourse andto also demonstratethatitispossible,withthesame hasten orincrease sexualbehaviour. Thestudies have negativeeffects: inparticular, theydidnot skills andimpactinguponbehaviour knowledge, clarifyingvaluesandattitudes,increasing have beenfoundtobeeffective intermsofincreasing of evaluatedsexualityeducationprogrammes that This sectionsetsoutthecommoncharacteristics 5. years. Whengivingyoung people clearmessages covered inanage-appropriate manneroverseveral To different maximiselearning, topicsneedtobe Include severalyears. sequentialsessionsover 3. 50 minutesorso. and sometimes30ormore sessions,thatlastroughly term behaviourhaveincluded12ormore sessions, in schoolsfoundtohaveapositiveeffect uponlong- these approaches taketime:nearlyalltheprogrammes affect decision-makingneedtobeaddressed. Bothof young people,bothriskandprotective factorsthat covered. Inorder toreduce sexualrisk-takingamong information aboutsexuality, multipletopicsneedtobe In order toaddress therightsofyoungpeopleto Implement programmesthatinclude atleast 2. who are more likelytobeinschool. numbers ofyoungpeople,especiallyyoungerchildren places, schoolsare theeasiestplacetoreach large that wasimplementedinschools.Moreover, in many at leastincludedanimportantcurriculumcomponent on behaviourhavebeenimplementedinschools,or the programmes thathadlong-termpositive effects clinic andcommunitysettings.However, amajorityof Programmes havebeenfoundtobeeffective inschool, Implement programmesinschoolsandother 1. and veri 3b). Thesecharacteristicsbuilduponthoseidenti twelve ormoresessions. numbers ofyoungpeople. youth-oriented organizationsthatreachlarge Characteristics ed through independentreview programmes of effective 14 (seeTables 3aand 15 . ed ed community-wide componentsinsubsequentyears. couldbereinforcedtheir learning through schoolor within theclassroom fortwoorthree yearsandthen Thus, studentscouldbeexposedtothecurriculum or community-wideactivitiesoversubsequentyears. these programmes havealsoimplementedschool- concepts overthecourseofseveralyears.Afew It alsomakesitpossibletoreinforce important provided thanmightotherwisehavebeenpossible. or evenyears,later. Thisenablesmore sessionstobe followed upwith‘booster’sessionsdelivered months, sessions havebeenprovided duringthe years, orelsetheyare programmes inwhichmost sequential sessionsoverthecourseoftwoorthree years follow-uphaveeitherinvolvedtheprovision of to haveenduringbehaviouraleffects attwoormore messages overtime.Mostoftheprogrammes found about behaviour, itisalsoimportanttoreinforce those 4. speci students. Someeffective curriculahavebeendesignedfor with thecommunity, culture, ageandsexualexperienceof To bemaximallyeffective, curriculamustbeconsistent Employactivities, instructionalmethodsand 6. need tobematchedspeci re or community, followedbyaperiodofdiscussionor students inataskoractivity, conductedintheclassroom Typically thesepromote theactiveinvolvementof been usedintheimplementationofeffective curricula. A broad rangeofparticipatoryteachingmethods have Employeducationally soundmethodsthat 5. attitudes andskillsrequired toavoidthem. before goingontoaddress thespeci by emphasisingsusceptibilitytoandseverityofthese, motivation toavoidSTI/HIVinfectionandpregnancy effective curriculafocus Topics shouldbetaughtinalogicalsequence.Many among those groups and emphasise the need for young among thosegroups andemphasisetheneedforyoung attention tothehighratesofHIV, otherSTIsorpregnancy Conference Ready Version

ection inorder todrawoutspeci c racialorethnicgroups. These programmes draw Cover topicsinalogicalsequence. Cover sexual experience. young people’s culture, developmental ageand behavioural messagesthatareappropriateto personalise information. actively involveparticipantsandassistthemto rst uponstrengthening objectives. c learning c learning. Methods c learning. c knowledge, c rst yearand

17 Part 1 18 Part 1 less complexactivities. basic information,lessadvancedcognitivetasks,and Activities foryoungerstudentstypicallyincludedmore consistent withthedevelopmentalageofstudents. Teaching methodsusedineffective curriculaare Conference Ready Version gender inequalitiesandstereotypes. Forexample,they effective curricula needtoexamineandaddress these In order tobeeffective atreducing sexualriskbehaviour, peers toful by oldermen.Menmayalsofeelpressure from their vulnerable, insomesettings,toabuseandexploitation or control intheirrelationships, makingthemmore is commonandyoungwomenoftenhavelesspower behaviour andreproductive health. Genderdiscrimination Gender affects theexperienceofsexuality, sexual Addressgenderissuesandsensitivitiesinboth 8. programme forparents mayalsobeneeded. important reproductive healthissues,aconcentrated where parents maynotbeadequatelyinformedabout own children aboutsexualmatters.Incommunities skills toenablethemtalkmore comfortably with their with relevant informationorelsehelpthem acquire Some programmes prepare parents byproviding them more sensitiveones. begin withrelatively safetopicsandprogress towards parents orothertrustedadults.Suchassignments can homework assignmentstodiscussselectedtopicswith communication aboutsexualityistoprovide student The mosteffective waytoincrease parent-to-child Include homeworkassignmentstoincrease 7. with-men develop speci with-men, efforts are underwayinsomecountriesto higher ratesofHIVinfectionamongmen-who-have-sex- condom iftheyhavesexualintercourse). Giventhemuch intercourse whentheydonotwanttoandalwaysusinga and incontrol ofsexualsituations(i.e.bynothaving women, emphasisingthatyoungwomencanbepowerful Other curriculahavebeendesignedspeci being responsible forthemselvesandtheircommunities. people toavoidunprotected sexualactivityasawayof the contentandteachingapproach. communication withparentsorotheradults. 16 . l malestereotypes. c curriculaforyoungmen-who-have-sex- cally foryoung entrenched genderinequalityandstereotyping. also contributeinasmallwaytothereduction of intercourse inthosesituations.Suchactivitiesmight methods ofavoidingunwantedorunprotected sexual young women(ormen)andgenerateeffective need todiscussthespecialcircumstances facedby comply withexistingpolicyand practice. sequencing, testingandother requirements inorder to review andapproval, teacheraccreditation, grade-level These programmes mayneedtoundergoof the introduction ofsexualityeducationprogrammes. may needtobeundertakeninorder topavethewayfor the implementationofeffective programmes, advocacy alike. Where lawsorpoliciesexistthatcouldpreclude discrimination giveclearmessagestostaff andstudents tolerance ofsexualharassment,abuse,violenceand policies insupportofsexualwell-beingsuchaszero society, includingyoungpeople.Forexample,robust communities, NGOsandotherrepresentatives ofcivil with keystakeholders,suchasteachers’unions,faith These policiesare bestdevelopedinconsultation discrimination orexclusion). on health(e.g.HIVandAIDS)socialissues development frameworks,togetherwithrelevant policies are implementedwithinappropriate, overarching national Programmes are more likelytorunsmoothlywhenthey or sanctionedatstatelocallevel. health, butinsomesettingstheyneedtobereinforced primarily bythenationalministriesofeducationor individual teacher. Suchpoliciesare usuallydeveloped institutional policyratherthanthepersonalchoiceofan and curriculaofsexualityeducationare amatter of policies are inplace,demonstratingthatthe delivery sexuality educationmakesitimportantthatsupportive The sensitiveandsometimescontroversial nature of Ensurethat asupportivepolicy environmentis 9. in supportofsuchefforts isnotyetavailable. need tobeaddressed, evenifarigorous evidencebase grammes, thefollowingkeycontextualfactorsalso In additiontothesecharacteristicsofeffective pro- to consider Important contextual factors in place. cial re demonstrate positiveeffects onbehaviour. However, this adult-led (ascompared topeer-led) programmes education curricula.There isstronger evidencethat ef Debate continuesregarding therelative potential effectively delivered bybothgroups ofeducators. Studies havedemonstratedthatprogrammes canbe to community-basedreproductive healthservices. regularly updatedinformation;andtheycan be linked participatory activities;theycanbeprovided with trained tocoverthissensitivetopicandimplement education educatorsinclude:theycanbespecially subjects. Theadvantagesofusingspecialistsexuality integrate sexualityeducationmessagesintodifferent established relationshipsandtheycan withlearners; and trustedbythecommunity;theyhavealready are partoftheschoolstructure; theymaybeknown general classroom teachersincludethefollowing: they the relevant classesintheschools.Theadvantages of and movefrom classroom toclassroom coveringallof trained teacherswhoonlyteachsexualityeducation (especially healtheducationteachers)orspecially Educators maybetheregular classroom teachers recruit more women. educators, thenstrategiescanbeimplementedto If itismostlymenwhoare likelytobeselectedas can beprovided bytraining(seenextcharacteristic). If theylackknowledgeaboutthetopic,that methodologies. skill intheuseofparticipatorylearning sexuality; abilitytocommunicatewithstudents;and teaching thecurriculum;personalcomfortdiscussing desirable characteristics.Theseinclude:aninterest in than peer-led programmes. that adult-ledprogrammes are more orlesseffective been inconclusive.Nonehavefoundstrong evidence effectiveness ofadult-andpeer-led programmes have and aformalmeta-analysiscomparingtherespective on adult-ledprogrammes. Three randomisedtrials a transparent process thatidenti who delivercurriculashouldbeselectedthrough impact ontheeffectiveness ofthecurriculum.Those The qualitiesoftheeducatorscanhaveahuge Selectcapableandmotivated educatorsto 10. cacyofpeer-led versusadult-leddeliveryofsexuality ects thelargernumber ofstudiesthathavefocused implement thecurriculum. es relevant and increase thecon rehearse keylessonsinthecurriculum.Allofthiscan be implemented,andshouldprovide opportunitiesto and skills,shouldbebasedonthecurriculumthatisto should providecontent agoodbalancebetweenlearning and providemethods, practiceinparticipatorylearning should havecleargoalsandobjectives,teach and thusspecialisedtrainingisimportant.This methods involves bothnewconceptsandlearning For teachers,deliveringsexualityeducationoften qualitytrainingtoeducators. Provide 11. made totheschool’s programme. education sothatanynecessaryadaptationscanbe of importantdevelopmentsinthe of theirwork.Supervisorsshouldalsokeepabreast and challengingsituationsastheseariseinthecourse teachers haveaccesstosupportinresponding tonew parts thatoftenmaybepartofexaminations),and all partsare fullyimplemented(notjustthe biological the curriculumisbeingimplementedasplanned,that involved indeliveringit.Supervisorsshouldmakesure encouragement, guidanceandsupporttoteachers in manyschools,schoolmanagersshouldprovide Because sexualityeducationisnotwellestablished on-goingmanagement, Provide and supervision 12. training shouldbesolicited. At theendoftraining,participants’feedbackon be taughtbyexperiencedandknowledgeabletrainers. health andHIVstatus,ifappropriate. Finally, it should address abouttheirsexual teachers’ownconcerns and raisequestionsissues.Ifpossible,itshould and toallowparticipantstimepersonalisethetraining cover themostimportantknowledgecontentandskills of teachingtoexams.Itshouldlastlongenough communities e.g.verylargeclasssizesandpressures It shouldaddress challengesthatwilloccurinsome curriculum completelyandwith Itshouldencourageeducatorstoteachthe learners. their personalvaluesandthehealthneedsof The trainingshouldhelpeducatorsdistinguishbetween Conference Ready Version oversight. dence andcapabilityoftheeducators. delity, notselectively. eld ofsexuality

19 Part 1 20 Part 1 Conference Ready Version to reduce sexual riskbehaviour, thenthecurriculum curricula. Inaddition,ifprogrammes are designed be involvedindevelopingor selectingandadapting people familiarwiththisresearch andknowledgeshould an extensivebodyofresearch andknowledge.Thus, Just likemathematics,science,languagesandother Involve multiplepeoplewithexpertise inhuman 14. completed toincrease effectiveness: maximum effectiveness. Thefollowingstepsshouldbe objectivesinthenextsectionwillnotensurethe learning Simply incorporatingtheprinciplesaboveandcovering curriculum canhavealargeimpactonitseffectiveness. The process ofdevelopingorselectingandadapting a Programme development humiliated, rejected ormistreated. aboutbeingputdown, themselves withoutconcern need tobe‘safeplaces’wherecanexpress learners with thevaluesandgoalsofcurriculum.Schools generally, theethosofschoolshouldbealigned policies thatare consistentwiththecurriculum. More by anti-homophobicandanti-genderdiscrimination Safety intheclassroom environment shouldbereinforced environment.with asafelearning between teachersandstudentsare utterlyincompatible for partorallofaprogramme. Sexualrelationships programmes separatestudentsintosame-sex groups, positive reinforcement ofstudentparticipation.Some promote participation,somecurriculaalsoencourage of others;andmaintainingcon legitimate; notinterrupting;respecting theopinions to answerquestions;recognising thatallquestionsare not askingpersonalquestions;respecting therightnot Typical examplesinclude:notexpressing ‘put-downs’; ofsexualityeducation. during teachingandlearning at theoutset,ofasetground rulestobefollowed education. Thisusuallyincludestheestablishment, to create aconduciveenvironment forsexuality activities, theyneedtofeelsafe.Itistherefore essential comfortable participatinginsexualityeducationgroup In order forstudentstobeablepayattentionandfeel Createasafeenvironmentforyouthto 13. elds, humansexuality isanestablished sexual behaviour. sexuality, sexual healthandyoungpeople’s education. participate andlearn–linkwithquality dentiality. Inorder to eld basedon to address thosefactors. cognitive factorsaffect thosebehaviours,andhowbest at different ages,whatenvironmental andinternal behaviours youngpeopleare actuallyengagingin developers mustbeknowledgeableaboutwhatrisky 6 Assessrelevant needsandassetsofthetarget 16. in allactivitiesduringpilot-testing. play scenariosmore realistic, andsuggestre activities thataddresshelpmakerole- suchconcerns, and commonlyheldbeliefsaboutsexuality, suggest they canidentifysomeoftheirparticularconcerns multiple roles thatyoungpeoplecanplay. Forexample, play arole indevelopingthecurriculum.There are to youngpeopleandmore effective ifyoungpeople Sexuality educationprogrammes canbemore attractive Involveyoungpeopleinthedevelopmentof 15. examples ofpeoplewhodeveloped curriculathatcould characteristic mayseemobvious, there are numerous This isanimportantstepforall programmes. Whilethis Designactivitiessensitivetocommunity 17. or similarpopulations. well asreviews ofresearch datafrom thetargetgroup interviews withprofessionals whoworkwiththemas assessed through focusgroups with youngpeopleand The needsandassetsofyoungpeoplecanbe address de programmes shouldbuildontheseassetsas wellas knowledge, positiveattitudesandskills.Thus,effective It isalsoimportanttobuilduponyoungpeople’s existing they mustbeidenti programmes shouldstrivetoaddress thesereasons, intercourse. Becauseeffective sexualityeducation avoid unwanted,unintendedandunprotected sexual attitudes andskills,theirreasons for failing to and agegroups intheirknowledge,beliefs, their are alsomanydifferences across communities,settings people intermsoftheirneedsregarding sexuality, there While there isconsiderablecommonalityamong young group. curriculum. supplies). (e.g. stafftime, staffskills, facility spaceand values and consistentwithavailable resources cits. ed. nements stronger andmore effective. and didnotworkonwaystomakeweakelements participants shouldbeobtained,especiallyonwhatdid should bepilot-testedandpracticalfeedbackfrom intended implementationsetting.Theentire curriculum conditions shouldbeasclosetothoseprevailing inthe to theprogramme participants.Duringpilot-testing, role playsothatitismore familiarorunderstandable to makeitmore appropriate, orchangewording ina example, theymaychangeascenarioinrole play as todiscoverimportantandneededchanges.For an opportunityto implementation. Thisgivesprogramme developers made toanyprogramme componentbefore formal the targetpopulationallowsforadjustmentstobe Pilot-testing theprogramme withindividualsrepresenting Pilot-testtheprogrammeandobtainon-going 18. implemented orwere prematurely terminated. consequently, theseprogrammes were notfully not sensitivetocommunityvaluesandresources; not orwere notfullyimplementedbecausetheywere curriculum: 1)theyidenti rates, usedaclearfour-step process for creating the especially thosethatreduced pregnancy orSTI effective programmes thatchangedbehaviour, and developers toplananddesign aprogramme. Most A logicmodelisaprocess ortoolusedbyprogramme Usealogic modelapproachthatspeci 1. achieving behaviourchange for Characteristics necessary rights. (see Table 3a).Characteristic19onlyaddresses human address humanrightsandleadtobehaviour change Programme characteristics1-18outlined above acomprehensivearrayoftopicsthat Cover 19. programme ismeetingtheirneeds. feedback fromthelearnersabouthow learning objectivesinPart II). address theneedsofyoungpeople(see to changethoseriskandprotectivefactors. affecting thosetypesofbehaviour, andactivities those goals, theriskandprotectivefactors health goals, thetypesofbehaviouraffecting ne-tune theprogramme aswell ed thehealth goals(e.g. W es the or basisfortheireffective programmes. to changeeachfactor. Thislogicmodelwasthetheory norms, skills,etc);and4)theycreated multipleactivities that affect thosebehaviours(e.g.knowledge,attitudes, identi and HIV/STIratesthattheycouldchange;3) identi reducing unintendedpregnancy orHIV/STIs);2)they that addressed similarcommunitiesandyoung people. programmes thatchangedbehaviour, especially those they needknowledgeaboutothersexualityeducation methods forchangingthosefactors.And,ofcourse, affecting sexualbehaviourandeffective teaching that theyare pro methods toaddress eachofthosefactors.This requires curriculum developersmustuseeffective instructional the factorsprogramme willaddress. Then,the about thefactorsaffecting sexualbehaviourto identify curriculum developersmustusetheoryandresearch To create programmes thatreduce sexualriskbehaviour, Involvemultiplepeoplewithexpertise in 2. and unintendedpregnancy. curricula motivateyoungpeopletowantavoidSTIs occurrences. Intheprocess of doing this,effective are negativeconsequencesassociatedwiththese pregnant (orofcausingapregnancy), andthatthere are potentiallyatriskofHIV, otherSTIsorofbecoming unprotected sexualintercourse on aregular basisthey messages aboutthesegoals:i.e.ifyoungpeoplehave of theseoccurrences. Effective curriculagiveclear STIs orpregnancy) andthenegativeconsequences young people’s susceptibility(forexample,toHIV, other relation tosexualityeducation,thismeansfocusing upon Effective curriculaare focusedcurricula.Speci Focuson clear goalsindeterminingthe 3. Conference Ready Version develop thecurriculum. factors, andsexuality andSTI/HIVeducationto instructional methodsforchangingthose factors affectingsexual behaviour, effective aboutbehaviourchange,theory researchabout HIV, otherSTIsand/orunintendedpregnancy. These goalsshouldinclude thepreventionof curriculum content, approachandactivities. ed thecognitive(orsexualpsychosocial)factors ed thespeci cient intheory, psychosocialfactors c behavioursthataffected pregnancy cally in cally

21 Part 1 22 Part 1 Conference Ready Version they willbeconsistentwith the message.Giventhat curriculum are designed tochangebehaviourssothat protective behaviours. Infact,mostactivitiesinthe ways, reinforce clearandconsistentmessagesabout effective programmes repeatedly, andinavariety of characteristics ofeffective programmes. Nearlyall behaviours appearstobeoneofthemostimportant Providing clearmessagesaboutriskandprotective Giveclear messagesaboutbehavioursto 5. circumcision the riskofbecominginfectedwithHIVthrough male (HPV) andHepatitisB).Mencanalsofurtherreduce for whichvaccinationsexist(i.e.HumanPapillomaVirus necessary) forSTIsandvaccinatedagainstthose exclusive sexualrelationships, betested(andtreated as avoid concurrent sexualpartnerships,remain inmutually consistently, reduce thenumberofsexualpartners, or pregnancy, theyshouldusecondomscorrectly and intercourse andwishtoreduce therisksofHIV, STIs intercourse (vaginal,analororal).Iftheydohavesexual young peopleneedtoavoidunprotected sexual To eliminatetheriskofacquiringHIVorotherSTIs, Focusnarrowlyonspeci 4. testing, forexample. These havefacilitatedtheuseofcontraceptionandSTI close linkageswithnearbyreproductive healthservices. A feweffective programmes haveestablisheddirect and treatment forSTIs). cost andcon speci to obtainingorusingthese,forexample,identifying correctly. waysofovercoming Theyalsolearn barriers howtousecondomsorcontraceptives people learn and explored copingstrategies.Duringsessions, young lead tounwantedorunprotected sexualintercourse Curricula haveidenti people andsuggestedwaysofresponding tothis. the pressures tohavesexualintercourse facingyoung contraceptive use.Forexample,theyhaveidenti intercourse, havingfewerpartnersandcondom useand variety ofways.First,theytalkexplicitlyaboutsexual Effective curriculafocusonparticularbehaviours ina else useaneffective methodofcontraception. the frequency ofunprotected sexualintercourse, or people shouldavoidvaginalsexualintercourse, reduce reduce riskofSTIsorpregnancy. health goals. protective behavioursleadingdirectlytothese c placeswhere youngpeoplecanobtainlow 17 . To reduce theriskofpregnancy, young dential services(includingtestingand e speci ed W c sexual and c situationsthatcould ed consistent withthesevalues. speci do appealtothesevalues,theymakeveryclearthe responsible’, or‘respectWhenprogrammes yourself’. to importantcommunityvaluese.g.‘beproud’, ‘be intercourse. Someprogrammes identifyandappeal should usecontraceptioneverytimetheyhavesexual prevention tendtoemphasisethatyoungpeople including HIV. Programmes withpregnancy concerned programmes encouragetestingandtreatment forSTIs often implicitlyinreturnforsexualintercourse). Other of ‘sugardaddies’(oldermenwhooffer giftsortreats, Saharan Africancountriesalsoemphasisethedangers partners. Culturally-speci being faithfulandavoidingmultipleorconcurrent sexual partner. Someeffective programmes alsoemphasise every timetheyhavesexualintercourse withevery either avoidsexualintercourse orelseuseacondom messages disseminatedare thatyoungpeopleshould to reduce HIVandotherSTIs,themostcommon the majorityofeffective programmes are designed access reproductive healthservices. cognitivefactors,buttheyalsodescribe howto internal especially thoseinschools,typically focusprimarilyon support services.Curriculum-based programmes, such asaccesstoadolescent-friendly healthandsocial factors, attitudes, skillsandintentions,aswellexternal such asknowledge,values,perception ofpeernorms, behaviour. cognitivefactors, Theseincludeinternal on youngpeople’s decision-makingaboutsexual Risk andprotective factorshaveanimportantimpact Focusonspeci 7. impact ofdrugsandalcoholonsexualbehaviour. sexual intercourse, itisimportantalsotoaddress the where drugand/oralcoholuseleadstounprotected avoiding andgettingoutofthem.Inthosecommunities sexual intercourse andtorehearse strategiesfor young peopleare likelytobemostpressured tohave themselves, toidentifythespeci It isimportant,ideallywiththeinputofyoungpeople 6. Address speci attitudes, norms, skills). based programme(e.g. knowledge, values, that areamenabletochangebythecurriculum- that affectparticularsexual behavioursand them. and howtoavoidthesegetoutof unwanted orunprotectedsexual intercourse c sexualandprotective behavioursthatare W c situationsthatmightleadto W c riskandprotectivefactors c messagesinsomesub- c situationsinwhich self-ef risk orprotective factorse.g.role playingtoincrease strategies thatare designedtochangetheassociated In addition,theactivitiesneedtoincludeinstructional usually lastforatleasttwelvetotwentysessions. needed. Thisisonereason whysuccessfulprogrammes each riskandprotective factor;thus,manyactivitiesare Multiple activitiesare usuallynecessarytoaddress Implementmultiple, educationallysound 8. parents. homework assignments,including communicationwith have beenexplored through surveys,role plays and mutually faithfulsexualrelationships. Thesevalues demonstrating affection; andbeinginlong-term,loving, following values:abstinence;non-sexualwaysof behaviour. Effective programmes have promoted the Personal valueshavesigni Addresspersonalvalues abouthavingsexual 11. concepts ofsusceptibilityandseverity. statistical andotherfactualinformationinexploringthe playing haveallbeenfoundtobeusefuladjuncts pregnancy. Personaltestimony, simulations and role and theseverityofHIV, otherSTIsandunintended Effective curriculafocusonboththesusceptibility to Addressperceptionsofrisk(especially 10. of condomsorotherformscontraception. exaggerating norunderstatingtherisksoreffectiveness based, scienti Information withinacurriculumshouldbeevidence- 9. Provide scienti unwanted sexualintercourse. intercourse orpossiblesituationsthatmightleadto targeted riskandprotectivefactors. activities designedtochangeeachofthe partners. about havingsexual intercourseandmultiple and perceptionoffamily andpeernorms intercourse and/orhavingmultiplepartners susceptibility). methods ofprotection. intercourse andtheeffectivenessofdifferent about therisksofhavingunprotectedsexual cacy andskillstorefuse unwantedsexual cally accurateandbalanced,neither W cally accurateinformation cant impactonsexual change (seeTable 3b). Programme characteristics1–13allleadtobehaviour available. demonstration andvisitstoplaceswhere they are and acquisitionskillsare typicallyacquired through in progressively complexscenarios.Condomuse with elementsofeachskillidenti situations, iscommonlyusedtoteachtheseskills partner. Roleplaying,representing arangeoftypical correctly. The contraception; andtheabilitytoobtainusethese intercourse; theabilitytoinsistonusingcondoms or to refuse unwanted,unintendedorunprotected sexual intercourse, youngpeopleneedthefollowing: the ability In order toavoidunwantedorunprotected sexual Addressbothskillsandself-ef 13. to useacondom,oranydif possible embarrassmentwhenaskingone’s partner use e.g.dif contraception andidenti to explore theirattitudestowards condomsand their effectiveness. Theyhavealsohelpedstudents these, togetherwithaccurateinformationabout programmes havepresented clearmessagesabout condom andcontraceptiveuse.Thus,effective Similarly, personalvaluesandattitudesalsoaffect Addressindividualattitudesandpeernorms 12. these barriers condom andthendiscussedmethodsofovercoming Conference Ready Version those skills. towards condomsandcontraception. culties obtainingandcarryingcondoms, rst tworequire communicationwitha ed perceived barrierstotheir culties actuallyusinga ed before rehearsal W cacy touse

23 Part 1 24 Part 1 Conference Ready Version behaviour change that address humanrightsandleadto Table 3a. Summaryofcharacteristics 18. 17. 16. 15. 14. 13. 12. 11. 10. 9. 8. 7. 6. 5. 4. 3. 2. 1. Characteristics Assure asupportivepolicy environmentisinplacefor Whenever appropriate, address genderissuesand Includehomework assignmentstoincrease Employ activities, instructionalmethodsandbehavioural Employ educationallysoundmethodsthatactivelyinvolve Cover topicsinalogicalsequence. Includesequentialsessionsover several years. Implementprogrammesthatincludeatleasttwelveor Implementprogrammesinschools andotheryouth- Pilot-testtheprogrammeandobtainon-goingfeedback Designactivitiesconsistentwithcommunityvalues and Assessrelevant needsandassetsofthetarget group. Involveyoungpeopleinthedevelopmentof Involvemultiplepeoplewithexpertise inhumansexuality, Create asafeenvironmentforyouthtoparticipateand Provide on-goingmanagement, andoversight supervision Provide qualitytraining toeducators. Selectcapableandmotivated educatorstoimplement their needs. abouthow theprogrammeismeeting from thelearners space andsupplies). available resources (e.g. stafftime, staffskills, facility curriculum. sexual healthandyoungpeople’s sexual behaviour. learn. of educators. the curriculum. instruction. sensitivities inboththecontentandteaching approach. communication withparents orotheradults. developmental ageandsexual experience. messages thatare appropriatetoyoungpeople’s culture, participants andassistthemtopersonaliseinformation. more sessions. people. oriented organizations thatreach large numbersofyoung lead tobehaviour change Table 3b. Summaryofcharacteristics that 13. 12. 11. 10. 9. 8. 7. 6. 5. 4. 3. 2. 1. Characteristics Provide scienti Implement multiple, educationallysoundactivities Focusonspeci Address speci Giveclearmessages aboutthesebehaviours toreduce Focusnarrowly onspeci Focus on clear goals in determining thecurriculum Focusoncleargoalsindetermining Involve multiple people with expertise in theory about Involvemultiplepeoplewithexpertise intheory Usealogicmodelapproach thatspeci Address bothskillsandself-ef toward Address individualattitudesandpeer norms Address personalvalues abouthaving sexual intercourse Address perceptions ofrisk(especiallysusceptibility). condoms andcontraception. partners. abouthaving sexualnorms intercourse andmultiple or multiplepartnersandperception offamilyandpeer sexual intercourse orusingprotection. of having sexual intercourse andmethodsofavoiding protective factors. designed tochange each ofthetargeted riskand knowledge, values, attitudes, norms, skills). to change by thecurriculum-basedprogramme(e.g. particular sexual behaviours andthatare amenable situations. or unprotectedsexual intercourse andhow toavoid those risk ofSTIsorpregnancy. behaviours leadingdirectly tothesehealthgoals. unintended pregnancy. include theprevention ofHIV, otherSTIsand/or content, approach andactivities. These goalsshould education todevelopthecurriculum. changing thosefactors, andsexuality andSTI/HIV sexual behaviour, effectiveinstructionalmethodsfor behaviour change, research aboutfactorsaffecting protective factors. of behaviour, andactivitiestochange thoseriskand the riskandprotectivefactorsaffectingthosetypes goals, thetypesofbehaviour affectingthosegoals, I c situationsthatmight leadtounwanted I I cally accurate information about therisks cally accurate information c riskandprotective factorsthataffect I c sexual andprotective I cacy tousethoseskills. I es thehealth Part 2: Topics and learning objectives

Conference Ready Version 26 Part 2 Conference Ready Version because ofpersonaldiscomfort orperceived opposition. of course,beadjusted.However, thisshouldbedoneinresponse totheavailable dataandevidenceratherthan objectiveswhendeveloping curricula,materialsandprogrammes.objectives can, of particularlearning Learning debut, varyconsiderablywithin andacross regions.islikelyto affect This,inturn, theperceived appropriateness The sexualandreproductive ofchildren health needsandconcerns youngpeople,aswelltheageofsexual disabilities. would beinkeepingwiththeircognitiveabilitiesastoinclude children andyoungpeoplewithintellectual/learning with more matureintertiaryinstitutions.Allinformationdiscussedwiththeabove-mentionedage groups learners objectivescanalsobeused inthe secondarylevelmaybeolderthan18andthatthetopicslearning learners who mightbeinthesameclass.Level4addresses from learners ages15to18+acknowledgethat some There isadeliberateoverlapbetweenlevels3and4inorder toaccommodatethebroad agerangeoflearners ages15to18+ (Level4). 4. ages12to15(Level 3) 3. ages9to12(Level2) 2. ages5to8(Level1) 1. objectivesaddressThe topicsandlearning fouragegroups andcorresponding levels: debut andsexualexploitationabuse. those whomaybemarginalisedforavarietyofreasons, andparticularlyvulnerabletoanearly, unprepared sexual It isequallyimportanttoprovide sexualityeducation tochildren andyoungpeopleoutofschool,especiallyfor training andcurriculumdevelopmentorsimplyasachecklisttoreview existingcurriculaandprogrammes. relationships, objectivesmayprove andbesexuallyactive.Inaddition, thetopicsandlearning usefulforteacher be especiallycritical,giventhatmanystudentswilllivingawayfrom homeforthe also bene many peoplehavenotreceivedintertiaryinstitutionsmay anysexuality education atthoselevelsandsolearners The 1. issues, remove socialandattitudinalbarriersincrease knowledge. objectiveswillattempttochangesocialnorms,facilitatecommunicationofsexual sexual behaviourmostlearning and education.However, objectivesare whileonlysomeoftheselearning speci As acomprehensiveobjectivesaddress package,alllearning children’s andyoungpeople’s righttoinformation encouragechildren andyoungpeopletoassumeresponsibility fortheirownbehaviourandtorespect the • promote theacquisitionofskills;and • provide children andyoungpeoplewithopportunitiestoexplore values,attitudesandnormsconcerning • provide accurateinformationabouttopicsthatchildren andyoungpeopleare curiousaboutandwhich • for acomprehensive sexualityeducationprogramme.objectivesare Thegoalsofthetopicsandlearning to: This sectionofthe rights ofothers. sexual andsocialrelationships; they haveaneedtoknow; topics andlearningobjectives Age range t from these International Guidelines International Guidelines are intendedforyoungpeopleatprimaryand secondary schoollevels.However, presentsobjectives the‘basicminimumpackage’oftopicsandlearning . Indeed,theneedforsexualityeducationattertiarylevelmay cally designedtoreduce risky rst time,maydevelop . Values, attitudesandsocialnorms: 2. 1. Information: process: objectivescoverfourcomponentsofthelearning The topicsandlearning 2. within existingsubjectssuchassocialscience,biologyor guidance andcounselling. it maybemore practicaltobuilduponandimprove whatteachersare already teaching,andlooktointegrateit response mightacknowledgethat,whileitwouldbeidealtointroduce sexualityeducationasaseparatesubject, communitysupportforsexualityeducationprogrammesneeds oflearners, andtimetablingissues.Apragmatic supportive schooladministration,trainedteachersandmaterials), competingprioritiesintheschoolcurriculum, Decisions willbein and counselling(upuntilrecently inKenya). delivered across severalothersubjects,suchascivics,healthandbiology(asinNigeria);orincludedguidance it isinMalawi);integratedwithinanexistingmainstream subject,suchashealthorbiology(asitisinJamaica); Decisions needtobemadeaboutwhethersexualityeducationshouldbe:taughtasastand-alonesubject(as 3. 4. Responsibility: Interpersonaland relationship skills: 3. violence; andharmfultraditionalpractices. equality andgenderroles; sexualbehaviour;diversity;pleasure; sexualabuse; gender-based and AIDS;STIs;familylifeinterpersonalrelationships; culture andsexuality;genderrights; empowerment; and development;sexualanatomyphysiology;reproduction; contraception;pregnancy andchildbirth;HIV condoms andcontraceptives. resisting early, unwantedorcoerced sex;andpractisingsafersex,includingthecorrect andconsistentuseof and empathyforallpeopleregardless oftheirhealthstatusorsexualorientation;insistingongenderequality; as welltheirbehaviourtowards otherpeople through thestrategiesof:respect; acceptance;tolerance and more productive relationships withfamilymembers,peers,friendsandromantic orsexualpartners. decision-making; assertiveness;communication;negotiation;andrefusal. Suchskillscancontributetobetter and decision-makinginconsiderationoftheprinciplestolerance,respect, genderrightsandequality. attitudes andnorms(personal,family, peerandcommunity)inrelation tosexualbehaviour, health,risk-taking Points ofEntry Componentsoflearning sexualityeducationprovides accurateinformationabouthumansexuality, including:growth uenced bygeneraleducationalpolicies,theavailabilityofresources (includingtheavailabilityof sexualityeducationencouragesstudentstoassumeresponsibility fortheirownbehaviour sexualityeducationoffers studentsopportunitiestoexplore values, sexualityeducationpromotes theacquisitionofskillsinrelation to: Conference Ready Version

27 Part 2 28 Part 2 Conference Ready Version early andcomprehensively aspossible,andhaveaneedtoreceive thisimportantinformation. most expertsbelievethatchildren andyoungpeoplewantneedsexualitysexualhealthinformation as objectivescouldbeadjustedtoincludedwithinearlierorlateragelevels.However,the contentsoflearning needs andcountry/region-speci objectivesfromwith olderstudents,itmaybenecessarytocovertopicsand learning earlieragelevels.Basedon should be are objectivesare theintendedoutcomesofworkingonparticulartopics.Learning de Each topicislinkedtospeci Sexualandreproductive health 6. 5. Sexual behaviour 4. Human development Culture, societyandlaw 3. Values, attitudesandskills 2. 1. Relationships concepts: The overarchingobjectiveshavebeende topicsunderwhichlearning 4. curricular content. approachesThe strategyandpeersupportreinforced alsomakes useofparticipatory by aparallel parental In Viet Nam, extra-curricular component, ofHealthisintheprocessdevelopingacompulsory theMinistry which willcomplem Viet Nam Tanzanian caseproves thatsexuality educationdoesnotneedtobemadeanentirely separate subjectinorder tobeexaminable. In theUnitedRepublicof Tanzania, sexuality educationisintegratedwithincarriersubjectssuch asascienceandcivicseduc United RepublicofTanzania school. secondary fact thatsexuality ispartofmanyaspectslife. Sexuality (aged15-18 educationmaybecomeaseparate subjectforlearners In Mexico, sexuality educationisintegratedwithinvarious partsofthecurriculumsuch asscienceandcivicseducation, inre Mexico teachers usingspeci In Malawi, school sexualityonwards. educationisastand-aloneandexaminable subjectfromprimary Sexuality educationistaug Malawi being taughtatall. and familyliving. The strategy ofteaching sexuality educationasastand-alone subjectensures thatcompetingprioritiesdon In Jamaica, sexuality educationistaughtasastand-alonesubjectby arange ofteachers includingthoseresponsible forbiolo Jamaica Box 4. Sexualityeducation–Points ofentryexperiencesin Structure rst introduced, buttheyneedtobe reinforced across different agelevels.Whenaprogramme begins I cally designedmaterials. c learning objectives,groupedc learning according objectives tothefouragelevels.Thelearning c characteristics,suchassocialandculturalnormsepidemiologicalcontext, ned are organizedaround sixkey V ve countries ned atthe levelwhenthey ot prevent it from ot prevent itfrom gy, health, home cognition of the cognition ofthe years) in upper years) inupper programme. ht by trained ht by trained ation. The ation. The ent intra- curriculum development. upon experiencesinthe behaviour-changebase concerning objectives based curricula,butgobeyondthistoincludetopicsandlearning The tablesbelowre 5. 6. 4.1 Topics: Human Development Key Concept 4: 1.2 1.1 Topics: Relationships Key Concept 1: 4.5 4.4 4.3 4.2 1.4 Long-term Commitment, 1.3 Sexual andReproductive Friendship, Love and Families Body Rights Body Image Puberty Reproduction Tolerance andRespect Anatomy andPhysiology Marriage, andParenting Romantic Relationships Overview of keyconceptsandtopics Overview Presentation ect abroad, rights-based approach tosexualityeducation.Theydrawfrom theevidence eld, togetherwithexpertopinion,inorder toprovide acomprehensive ‘menu’for 5.2 5.1 Topics: Sexual Behaviour Key Concept 5: 2.2 2.1 Topics: Attitudes andSkills Key Concept 2:Values, 2.5 2.4 2.3 Shared Sexual Behaviour and Sex, Sexuality andtheSexual andPeerIn Norms Values, Attitudes andSources Finding HelpandSupport Communication, Refusaland Decision-making Sexual Response Life Cycle of Sexual Learning Negotiation Skills Sexual Behaviour Conference Ready Version J uence on 3.4 3.3 3.2 3.1 Topics: Culture, SocietyandLaw Key Concept 3: 6.3 6.2 6.1 Topics: and Reproductive Health Key Concept Gender-Based Violence, The SocialConstructionof Sexuality andtheMedia Sexuality, Culture andLaw HIV and AIDS Stigma, Care, Understanding, Recognising Pregnancy Prevention Traditional Practices Sexual Abuse andHarmful Gender Treatment andSupport including HIV and ReducingtheRiskofSTIs 6: Sexual

29 Part 2 30 Part 2 Conference Ready Version Key Concept1 • • • Key Ideas: kinds offamilystructures De Learning Objectives forLevel I(5-8) • • • • • • • • Key Ideas: they mature Describe howresponsibilities offamilymemberschangeas Learning Objectives forLevel III(12-15) – Relationships

ne theconceptof ‘family’ with examples ofdifferent Gender inequalityisoftenre though sometimestheymaynotwant toorbeable Family memberscantake care ofeach otherinmanyways, Family membershave different needsandroles etc.) extended andnuclearfamilies, same-sex coupleparents, two-parent, singleparent, child-headed, guardian-headed, Many different kindsoffamiliesexist aroundtheworld (e.g. Families are importantinteaching values tochildren responsibilities offamilymembers usually illegal Forced marriagesandchild and marriagesare harmful important beyond thefamily. Friendsandpeersbecomeparticularly As theygrowup, children’s worlds andaffectionsexpand relationships are importantforgoodfamilyfunctioningandhealthy Love, cooperation, genderequalityandmutual respect usually resolvable withmutualrespect children are common, especiallyduring puberty, and Con increasing responsibility forselfandothers Increasing independenceisusuallyaccompaniedby respect andgenderequality Family relationships shouldbebasedonmutualcaring, J ict andmisunderstandingsbetweenparents and J ected intherolesand 1.1 Families • • • • Key Ideas: family members Describe theroles, rightsandresponsibilities ofdifferent Learning Objectives forLevel II(9-12) • • • • Key Ideas: relationship unintended pregnancy, abortion, beinginasame-sex on thefamily-e.g. disclosinganHIV-positive status, an Discuss howsexualandrelationships issuescanimpact Learning Objectives forLevel IV(15-18) in timesofcrisis There to are supportsystemsthatfamilymembers canturn or comesoutasbeinggay Families helpchildren toacquire values andin children’s decisions Importance ofparents guidingandsupportingtheir between parents andchildren Importance ofcommunicationwithinfamilies, inparticular responsibilities withinfamilies ofrolesand Importance ofgenderequalityinterms structure, rolesandresponsibilities oftheir Health anddiseasecanaffectfamiliesinterms personality pregnant, hasanabortion member disclosesanHIV-positive status, becomes Family members’rolesmaychange whenayoungfamily with mutualrespect criseswhenthey supportoneanother Families cansurvive 18 , refuses anarranged marriage J uence their De Learning Objectives forLevel I(5-8) • • • • • • • Key Ideas: Differentiate between different kindsofrelationships Learning Objectives forLevel III(12-15) • • • • Key Ideas:

ne a ‘friend’ abuse andviolence Links betweengenderrolestereotypes andrelationship relationships Gender stereotypes, genderrolesandromantic relationships Characteristics andqualitiesofhealthy andunhealthy Friends canin attraction Differences betweenlove, friendship, infatuationandsexual Sometimes closerelationships canbecomesexual Bene Key characteristics ofdifferent kindsofrelationships Different kindsoflove anddifferent ways ofexpressing it Feelings, trust, sharing, empathy andsolidarity friends, boyfriends, girlfriends) Different kindsoffriends(e.g. goodfriendsversusbad I ts offriendship J uence oneanotherpositivelyandnegatively 1.2 Friendship, Love andRelationships • • • • • • • Key Ideas: Identify skillsneededformanagingrelationships Learning Objectives forLevel II(9-12) • • • • • Key Ideas: Identify relevant laws concerningabusive relationships Learning Objectives forLevel IV(15-18) Conference Ready Version Different kindsofrelationship abuse relationships Characteristics ofhealthy andunhealthy (abusive) Abusive relationships andwhy theyhappen relationships The needtopromotegenderequalityforhealthier relationships Gender rolestereotypes canaffectallkindsofpersonal themselves Friendships andlove helppeoplefeelgoodabout person Different ways toexpress friendshipandlove toanother Know where to Recognising andreporting abuse relationships A person’s rightsandresponsibilities regarding abusive Concept ofempowerment Legal sanctionsagainstabuse I nd support

31 Part 2 32 Part 2 Conference Ready Version Key Concept1 • • • • Key Ideas: De Learning Objectives forLevel I(5-8) • • • • Key Ideas: Explain whydiscriminationandbullyingare harmful Learning Objectives forLevel III(12-15) – Relationships

ne ‘respect’ Making funofpeopleisharmful respect humanbeingdeserves Every and peoplelivingwithHIV relationship andby givinglove, includingdisabledpeople contribute tosocietyby beingafriend, beingina humanbeingisuniqueandvaluable andcan Every Concepts oftolerance, acceptanceandrespect Knowing where to Speaking outagainstbiasandintolerance self-stigma Consequences ofstigmaanddiscrimination, including orientation because ofdisability, HIVstatus, genderidentityorsexual tostigmatise ordiscriminateagainstpeople It isharmful I nd helpwhenpeople are beingharmed 1.3 Tolerance andRespect • • Key Idea: against thoseperceived tobe«different» Explain whyitisimportanttochallengediscrimination Learning Objectives forLevel IV(15-18) • • • Key Ideas: harassment, rejection andbullying De Learning Objectives forLevel II(9-12)

ne theconceptsofbias, prejudice, stigma, intolerance, Cite supportivelaws society Impact ofdiscriminationuponindividuals, communities, Defending peoplewhoare beingharassed orbullied transphobia andabuseofpower Concepts ofstigma, discrimination, homophobia, of humanrights sexual orientation)isdisrespectful, hurtfulandaviolation as different (regardless ofhealthstatus, colour, originor Harassing orbullyingpeopleparticularlythoseperceived • • • Key Ideas: Explain theconceptsof ‘family’ and ‘marriage’ Learning Objectives forLevel I(5-8) • • • • • Key Ideas: commitments Identify thekey responsibilities ofmarriageandlong-term Learning Objectives forLevel III(12-15) 1.4 Long-termCommitments, MarriageandParenting arrangements, rolesandresponsibilities Different familystructures affectchildren’s living Separation anddivorce arranged marriages Some peoplechoose theirmarriagepartners, othershave Divorce andcopingwithitseffects parenting Dif parents Impact ofculture andgenderrolestereotypes onrolesof Roles andresponsibilities ofparents/guardians child marriageandteenageparenting Negative socialandhealthconsequencesofearlymarriage, I culties andchallenges associatedwithteenage • • • • • Key Ideas: marriage andparenting Explain thekey features oflong-termcommitments, Learning Objectives forLevel II(9-12) • • Key Ideas: needs ofchildren andassociatedresponsibilities ofparents Identify key physical, emotional, economic, andeducational Learning Objectives forLevel IV(15-18) • • Conference Ready Version fertility technologies andsurrogateparenting unintended pregnancy, adoption, fostering, useof assisted Adults canbecomeparents inseveral ways: intendedand Responsibilities ofparenting basic humanrights Child marriageandforced marriageare inconsistentwith parent includingdisabledpeopleandlivingwithHIV personhastherighttodecidewhetherbecomea Every children Legal restrictions ontherighttomarriageandhave Coping withdif commitments Challenges oflong-term Qualities neededforsuccessfulloving relationships Reasons tohave children (ornot) I culties inrelationships

33 Part 2 34 Part 2 Conference Ready Version Key Concept2 • • • Key Ideas: De Learning Objectives forLevel I(5-8) • • Key Idea: own decisionsandbehaviour Provide clearexamplesofhowpersonalvalues affecttheir sexuality andreproductive healthissues Describe theirownpersonalvalues inrelation toarange of Learning Objectives forLevel III(12-15) – Values, AttitudesandSkills

ne values andidentify three importantpersonalvalues different values Individuals, peers, familiesandcommunitiesmayhave relationships Values andbeliefsguidedecisionsaboutlife communities aboutimportantissues Values are strongbeliefsheldby individuals, familiesand people’s values, beliefsandattitudes The needtotolerate andrespect differences inother and how tostandupforthem The needtoknow one’s own values, beliefsandattitudes 2.1 Values andAttitudesSources ofSexual Learning • • Key Ideas: questions aboutbasicsexualmatters Demonstrate con Identify sources ofvalues, attitudesandsexuallearning Learning Objectives forLevel II(9-12) • • Key Ideas: ones’ ownvalues Explain howtobehave inways thatare consistentwith Learning Objectives forLevel IV(15-18) expectations andequality Cultural values affectmaleandfemalegenderrole and decision-making sexuality andreproduction in Values regarding gender, relationships, intimacy, love, that theirchildren mightfromdifferent values able tore Parents teach andmodeltheirvalues totheirchildren, are values Relationships bene J ect onthisinteraction andcanrespect thefact V dence indiscussingandasking I t whenpeoplerespect each other’s J uence personalbehaviour De Learning Objectives forLevel I(5-8) • • • Key Ideas: • Key Ideas: sexual decisionsandbehaviour Explain howpeerin Learning Objectives forLevel III(12-15) • • •

ne peerpressure Resisting in Examples ofdifferent kindsofpeerpressure The righttoself-determination Ways andpeerin inwhich socialnorms peer pressure ofbullyingandnegative consequences ofallforms Harmful Sticking toone’s own decisionsaboutsexual activity and ‘no’ Saying ‘yes’ behaviourindividual andgroup 2.2 NormsandPeer In J uence ofnegativepeerpressure

uence andsocialnormsin J uence canaffect

uence W uence onSexualBehaviour • • • Key Ideas: Describe socialnormsandtheirin Learning Objectives forLevel II(9-12) • • Key Ideas: Demonstrate skillsinresisting peerpressure Learning Objectives forLevel IV(15-18) • Conference Ready Version pressure Resisting thein Assertive behaviour sexual values andbehaviour in Social norms People canresist negativepeerin People canmake rational decisionsaboutsexual activity People canstandupfortheirrighttoself-determination making J J uence of negative social norms andpeer uence ofnegativesocial norms uence values andbehaviour, including

uence onbehaviour J uence intheirdecision-

35 Part 2 36 Part 2 Conference Ready Version Key Concept2 • • • • Key Ideas: consequences Identify examplesofgoodandbaddecisionstheir Learning Objectives forLevel I(5-8) • • • • • Key Ideas: or reproductive healthconcerns Apply thedecision-makingprocess toaddress sexualand/ different decisions Evaluate advantages, disadvantages andconsequencesof Learning Objectives forLevel III(12-15) – Values, AttitudesandSkills decisions Children mayneedhelpfromadultstomake certain Decision-making skills People have therighttomake theirown decisions Decisions andtheirconsequences Role ofemotionsindecision-making Effects ofalcoholanddrugsondecision-making Decisions canaffectpeople’s health, future, andlifeplans making decisions how toreLearning Barriers todecisions J ect ontheconsequences before 2.3 Decision-Making • • Key Idea: sexual decision-making Identify potentiallegal, socialandhealthconsequencesof Learning Objectives forLevel IV(15-18) • • • • • • Key Ideas: Apply thedecision-makingprocess toaddress problems Learning Objectives forLevel II(9-12) Defending people’s righttoself-determination Defending myrighttomake myown decisions Knowing where to stereotypes, peersandmedia) In Choosing actionswiththebestoutcome Anticipating consequences Steps inthedecision-makingprocess People have different ways ofmakingdecisions J uences ondecisions (e.g. friends, culture, genderrole I nd helpwithdecision-making • • • • Key Ideas: skills Demonstrate con Learning Objectives forLevel III(12-15) • • • • • Key Ideas: communication Demonstrate understandingofdifferent typesof Learning Objectives forLevel I(5-8) and refusing sexual contact Role ofgenderexpectations andstereotypes innegotiating and consensualsex If sexual active, usingcommunicationskillstopractice safe pressure Using communicationskillstoresist unwanted sexual Barriers toeffectivecommunication Communication isusedtoexpress rights trusted adultsandbetweenparents andchildren Importance ofgoodcommunicationbetweenfriends, with All peoplehave therighttoexpress themselves People have different ways ofcommunicating Verbal andnon-verbalcommunication 2.4 Communication, RefusalandNegotiationSkills

dence inusingnegotiationandrefusal • • • • • • • Key Ideas: communication Demonstrate examplesofeffective andineffective Learning Objectives forLevel II(9-12) • • Key ideas: and sexuallimits Demonstrate effective communicationofpersonalneeds Leaning Objectives forLevel IV(15-18) Conference Ready Version Assertive communication people Ways inwhich gendercanaffectdecision-makingbetween compromise fromallparties Negotiation requires mutualrespect, cooperation andoften trusted adultsandbetweenparents andchildren Importance ofgoodcommunicationbetweenfriends, with Different modesofcommunicationandstyles Elements ofeffectiveverbalandnon-verbalcommunication People have different ways ofcommunicating to practice safersex resist unwanted sexual pressure orreinforce theintention Assertiveness andnegotiationskillscansometimeshelpto romantic, school andwork relationships Good communicationisessentialtopersonal, family,

37 Part 2 38 Part 2 Conference Ready Version Key Concept2 • • • • Key Ideas: Identify speci Learning Objectives forLevel I(5-8) • • • • • • • Key Ideas: Identify appropriate sources ofhelp Learning Objectives forLevel III(12-15) – Values, AttitudesandSkills Characteristics ofgoodsources ofhelp The rightofallpeopletobeprotectedandsupported Sources ofhelpinthecommunity can andshouldhelpeach other Friends, family, teachers, clergy andcommunitymembers legal), homophobia, stigmaanddiscrimination domestic andgender-based violence, abortion(where for STIs/HIV;contraception, services sexual abuse, rape, reproductive health(e.g. counselling, testingandtreatment Places where peoplecanaccesssupportforsexual and Speci help/support Right toprivacy, respect andcon or helpwithaproblem obtain information Potential usesanddangersofusingmedia(e.g. to internet) Ways toseekadditionalhelp, resources, orinformation Shame/guilt shouldnotbeabarriertoseekinghelp Trusted adultswhomightbeabletoprovide help I c stepsinvolvedinbeing testedforHIVandSTIs

c ways inwhichpeoplecanhelpeachother 2.5 FindingHelpandSupport I dentiality whenseeking • • • Key Ideas: Identify speci Learning Objectives forLevel II(9-12) • • Key Ideas: Demonstrate appropriate help-seekingbehaviour Learning Objectives forLevel IV(15-18) contraception, includingemergency contraception Speci Sources ofsupportintheschool andcommunity Some problemscanbeaddressed withoutsidehelp con Stand upfortherighttoaffordable, respectful and help/support Right toprivacy, respect andcon I dential help I c stepsinvolvedinobtainingandusingcondoms

c problems andrelevant sources ofhelp I dentiality whenseeking Key Concept3 • Key idea: Identify sources ofourinformationaboutsexandgender Learning Objectives forLevel I(5-8) • • • • • • Key Ideas: relating tosexuality Identify key cultural normsandsources ofmessages Learning Objectives forLevel III(12-15) – Culture, SocietyandLaw from theircultures andreligions People receive messagesaboutsex, genderandsexuality of genderandsexuality Impact ofculture, andlawsonpersonalexpressions norms orientation e.g. ageofconsent, rape, sexual abuse, abortion, sexual Diversity oflawsrelating tosexual andreproductive health expression andorientation Rights ofandrespect forpeoplewithdiversesexual restrictions Diversity ofsexual expression, orientationandcultural their culture, religion andsociety Speci Sources ofmessagesaboutsexuality I c messagespeople receive aboutsexuality from 3.1 Sexuality, Culture andLaw • • • Key Idea: regarding sexuality Demonstrate willingnesstolistentheopinionsofothers messages aboutsexuality Identify key cultural, religious andlegalnorms Learning Objectives forLevel II(9-12) • • • • • • • • Key Ideas: sexual andreproductive rights Identify speci Explain theconceptofsexualandreproductive rights Learning Objectives forLevel IV(15-18) Conference Ready Version Identify ritesofpassagetoadulthood gender andhow theyhave changed over time De in Recognise theimportanceofculture, societyandlawin Gender equalityasahumanright services, etc.) abortion, sexual orientation, rightsofyoungpeopletoSRH marriage, femalegenitalcutting(FGC), ageofconsent, sexualLaws governing andreproductive health(e.g. child instruments international Sexual andreproductive rightsasarticulatedin equality ofgirlsandwomen Culture, lawandtraditional practices affecttherightsand in thesociety considered acceptableandunacceptablesexual behaviour whatis Impact ofculture andlawindetermining andtaboosaboutsexualityCultural norms sexuality Respect forthediversityofviewsandbeliefsabout over time onsexualityCultural differbetweencultures norms and J uencing people’s well-being I ne cultural norms andtaboos relatedne cultural tosexuality norms and

c legislationaffectingtheimplementation of

39 Part 2 40 Part 2 Conference Ready Version Key Concept3 • Key Idea: (e.g. television, internet) Distinguish between examplesfrom reality and Identify different formsofmedia Learning Objectives forLevel I(5-8) • • • • Key Ideas: stereotyping Describe theimpactoftheseimagesongender sexual relationships, sexualityandreproduction Identify unrealistic imagesinthemassmediaconcerning Learning Objectives forLevel III(12-15) – Culture, SocietyandLaw representation ofpeople Different massmediaare positiveandnegativeintheir Gender stereotyping inpornography women Self-esteem andhow themassmediaportrays menand stereotypes Mass mediarepresentations ofbeautyandgender In J uence ofmassmedia onvalues andattitudes 3.2 SexualityandtheMedia

ction • • Key Ideas: gender equality positive contributiontopromoting safersexualactivityand Identify ways inwhichthemassmediacouldmake a behaviour andrisk-taking messages aboutsex, genderandsexualityonsexual Critically assessthepotentialin Learning Objectives forLevel IV(15-18) • • Key Ideas: attitudes andbehaviour relating tosexandgender Describe theimpactofmassmediauponpersonalvalues, the massmedia Identify examplesofhowmenandwomen are portrayed in Learning Objectives forLevel II(9-12) Challenging negativeorinaccurate massmediamessages Importance ofcriticalreading ofmassmedia Mass mediamessagesaboutsexuality sexual andreproductive health Mass mediain J uences on social norms concerning gender, concerning uences onsocialnorms

uence ofmassmedia • • • • • Key Ideas: bias anddiscrimination Explain themeaningofandprovide examplesofgender Learning Objectives forLevel III(12-15) De Learning Objectives forLevel I(5-8) • • • Key Ideas:

ne gender Gendered ‘double standards’, includingsexual behaviour sexual behaviour andfamilyplanning Impact ofgenderrolesoncommondecision-makingin Impact ofgenderroleexpectations onsexual behaviour gender onpeople’s behaviour The impactofsocial, cultural about andreligious norms Personal values regarding genderequalityandbias Gender inequality Examples ofgenderstereotypes Gender rolesandgenderbias 3.3 TheSocialConstructionofGender • • • • Key Ideas: affects people’s lives Identify personalexamplesoftheways inwhichgender Learning Objectives forLevel IV(15-18) • • • • • • Key Ideas: boys andgirls, women andmen Identify speci Learning Objectives forLevel II(9-12) Conference Ready Version gender bias Strategies forpromotinggenderequalityandreducing and familyplanning Equal decision-makinginmattersrelated tosexual activity Personal values aboutgenderrolesandequality the riskofsexual coercion, abuseandviolence Rigid genderrolescanreinforce behaviour thatincreases Factors thatin Gender rolesimilaritiesanddifferences Examples ofgenderinequality messages aboutgender Families, schools, friends, mediaandsocietyassources of Gender rights Overcoming genderbiasandinequality

c ways inwhichgenderinequalityaffects J uence genderroles

41 Part 2 42 Part 2 Conference Ready Version Key Concept3 • • • • • • Key Ideas: Describe theconceptofgender Describe examplesofpositive andharmfulpractices Learning Objectives forLevel I(5-8) • • Key Idea: to situationsofpotentialsexualharm Demonstrate assertive communication skillsinresponding violence, includingrape andsexualabuse Identify speci Learning Objectives forLevel III(12-15) – Culture, SocietyandLaw sex Difference betweenconsensualsexual activityandforced Concepts ofbody rightsandsexual abuse Male/son preference andculture De Gender roles, stereotypes andgender-based violence well-being cultural/traditionalHow harmful practices affecthealthand know where to Recognising andresponding togender-based violenceand marriage, forced marriage, etc traditional practicesEliminating harmful such asFGC, child I nition ofgenderinequality

c strategies forreducing gender-based 3.4 Gender-Based Violence, SexualAbuse, I nd help and HarmfulTraditional Practices • • • • • • Key Ideas: discrimination andsexualharm (e.g. assertiveness, refusal) inresisting gender Demonstrate relevant communicationskills and itsprevention De sexual activityandabuse Explain howgenderrole stereotypes contributetoforced Learning Objectives forLevel II(9-12) • • • Key Ideas: practices andgender-biased violence role stereotypes andinequality, harmfultraditional Demonstrate abilitytoargue fortheeliminationofgender Learning Objectives forLevel IV(15-18)

ne anddescribegender-based violence, includingrape gender equalityandhealth traditional practicesLegality ofharmful andimplicationson unintended pregnancy traditional practicesand harmful andSTIsincludingHIV Relationship betweengender-based violence, sexual abuse, traditionalPreventing/minimising practices harmful regarding genderrolesandsexual behaviour) honour killings, bridekillings, polygamy, doublestandards son preference, nutritionaltaboos, FGC, child marriage, traditional practicesExamples ofharmful (e.g. male/ Positive traditional beliefsandpractices What todoifsomeoneissexually abusedorraped abortion Advocacy topromotetherightand accesstosafe traditional practices andgender-based violence social injusticessuch asgenderinequality, harmful Personal responsibility tostandupandspeakoutagainst Advocacy topromoteequalityandhuman rights Key Concept4 • • • • • • Key Ideas: sex andgender Distinguish between thebiologicalandsocialaspectsof Learning Objectives forLevel III(12-15) • • • • • Key Ideas: Distinguish between maleandfemalebodies Learning Objective forLevel 1(5-8) 4.1 SexualandReproductive AnatomyandPhysiology – HumanDevelopment and gendere.g. virginity. Nature andimpactofsocialcultural beliefs about sex circumcision andFGC sex, gender, pubertyandreproduction (includingmale Cultural, traditional andreligious practices relating to systems Differences betweenthesexual response andreproductive reproductive andsexual functioning in growth,Role ofhormones development, andregulation of Sexual differentiation duringpre-natal development thesexRole ofchromosomes ofthefoetus indetermining Nakedness andshame privateAppropriate publicbehaviour concerning body parts pleasurable whentouched by oneself Girls andboys have private body partsthatcanfeel Differentiate betweenmaleandfemalesexual organs Appropriate namesforbody partsandtheirfunctions • • • Key Ideas: reproductive organs Describe thestructure andfunctionofthesexual Learning Objectives forLevel II(9-12) • • Key Ideas: and femalesover thelifecycle Describe thesexualandreproductive capacityofmales Learning Objectives forLevel IV(15-18) Conference Ready Version Describe commongenitalproblems Both menandwomen cangiveandreceive sexual pleasure and erection, wetdreams andejaculation physiology, includingthemenstrualcycle, spermatogenesis Basic principlesofsexual andreproductive anatomyand sexual pleasure throughoutlife Men andwomen canexperience givingandreceiving functioning acrossthelifecycle Changes inhormones, reproductive capacityandsexual

43 Part 2 44 Part 2 Conference Ready Version Key Concept4 • • Key Ideas: Describe where babiescomefrom Learning Objectives forLevel 1(5-8) • • • • Key Ideas: pregnancy methods ofcontraception inpreventing unintended Describe thecorrect andconsistentuseofdifferent development andchildbirth Describe thesignsofpregnancy, andthe stagesoffoetal Learning Objectives forLevel III(12-15) – HumanDevelopment pregnancy Basic processesoffertilisation, conception, and delivery Reproduction requires andanegg asperm abortion, andwithillegalunsafe abortion Health risksassociatedrespectively withsafeandlegal De contraception Effectiveness rates ofthedifferent methodsof Health risksofearlypregnancy I nition, reasons for, andlegalityofabortion 4.2 Reproduction • • • • • • • • Key Ideas: Identify basiccontraceptive methods prevented Describe bothhowpregnancy occursandhowitcanbe Learning Objectives forLevel II(9-12) • • • • • Key Ideas: desires Differentiate between reproductive andsexual functionand Learning Objectives forLevel IV(15-18) HIV-positive Health issuesandrisksinvolvedinbeingpregnant and using alcoholanddrugsduringpregnancy Health issuesandrisksofpoornutrition, smokingand pregnancy andbirth andforced),Health risksofearlymarriage(voluntary early penile erection andejaculation Relationship betweenexcitement andvaginal lubrication, likely tooccur Ovulation andwhenconceptionismostlikely andleast prevent pregnancy, HIVandotherSTIs Correct andconsistentuseofcondomscontraception Speci Relationship betweenvaginal intercourse andpregnancy Infertility andfertilitytreatment options function Menopause andmaleclimactericinrelation toreproductive transmitted infection)needstobeconsidered beforehand Prevention (ofunintendedpregnancy andsexually consent Sexual activityshouldonlyoccurwhenthere is mutual Sexual activitycanprovide pleasure I c meansofpreventing unintendedpregnancy • Key Idea: Describe thekey features ofpuberty Describe howbodieschangeaspeoplegrow Learning Objectives forLevel I(5-8) • • • Key Ideas: Distinguish between pubertyandadolescence changes associatedwithpuberty and boys inrelation tothephysical, emotional, andsocial Describe thesimilaritiesanddifferences between girls Learning Objectives forLevel III(12-15) happens aschildren growandmature Puberty isatimeofphysical andemotionalchange that without actinguponthem Pleasurable sexual feelingsandthoughtscanbeenjoyed pubertal development Pleasurable sexual thoughtsandfeelingsare partof teens Some peopledonotreach fullpubertyuntilthemidorlate 4.3 Puberty • • • • • Key Ideas: sexual andreproductive system Describe theprocess ofpubertyandthematuration ofthe Learning Objectives forLevel II(9-12) • • • • Key Ideas: puberty thatoccurasaresult ofhormonalchanges Describe thekey emotionalandphysicalchangesin Learning Objectives forLevel IV(15-18) Conference Ready Version Wet dreams How pubertyrelates toreproductive capability menstrual aids pads andother Access andproperuseofsanitary washing thegenitals, menstrualhygiene, etc.) Importance ofgoodhygiene asthebody matures (e.g. with puberty Range ofsocial, emotionalandphysical changes associated Dealing withphysical andemotionalchanges in spermatogenesis Role ofhormones involvedin ovulation andthemenstrualcycleHormones emotional andphysical changes Speci I c role and function of male and female hormones on c roleandfunction of maleandfemalehormones

45 Part 2 46 Part 2 Conference Ready Version Key Concept4 • • Key Ideas: Recognise thatbodiesare alldifferent Learning Objectives forLevel I(5-8) • • • • Key Ideas: affect theirhealth, self-imageandbehaviour Describe howpeoples’feelingsabouttheirbodiescan Learning Objectives forLevel lll(12-15) – HumanDevelopment Everyone canbeproudoftheirbody Everyone unique All bodies(includingthosewithdisabilities)are specialand bulimia associatedwitheatingdisorders e.g.Harm anorexia and unrealistic, gendered standards of beauty to associatedwithtakingdrugsinorder toconform Harm people feelaboutandbehave towards them The appearance ofaperson’s body canaffecthow other partner do notaffectreproduction ortheabilitytobeagoodsexual The sizeandshapeofthepenis, vulva orbreastsand vary 4.4 BodyImage • • • • • Key Ideas: to physicalappearance Differentiate between cultural idealsandreality inrelation Learning Objectives forLevel ll(9-12) • • • • Key Ideas: how theycanaffectpeopleandtheirrelationships Identify particularculture andgenderrole stereotypes and Learning Objectives forLevel IV(15-18) between cultures Ideals ofphysical attractiveness change over timeand appearance A person’s value by shouldnotbedetermined their beauty tostereotypical imagesof Most peopledonotconform people feelabouttheirbodiesandthemselves Mass mediaimagesofourbodiesandhow theyaffecthow environment andhealthhabits Physical by appearance isdetermined heredity, behaviour Body imagecanaffectself-esteem, decision-makingand attraction Physical appearance isonlyonefactorinvolvedinpersonal Understanding theimpactofplasticsurgery appearance Critically assessingunrealistic standards regarding bodily • • • • • • Key Ideas: Describe themeaningof ‘body rights’ Learning Objectives forLevel I(5-8) • • • • Key Ideas: harm Identify key elementsofkeeping oneselfsafefrom sexual Learning Objectives forLevel III(12-15) Knowing thatsexual abuseinthefamilyisalways wrong Knowing where toaskforhelpifinappropriatelytouched Bullying andwhattodoaboutit or behaviour Saying “no” andrefusing inappropriateorunwanted touch between appropriateandinappropriatetouch Difference between “public” and”private” body partsand what way The righttodecidewhocantouch mybody, where, andin sexual encounters Risks associatedwithtransactional andtransgenerational attention, phone-andcyber-bullying e.g.Risks associatedwiththeinternet unwanted sexual will notdosexually The importanceofbeingincontrolover whatwewilland Exercising body rights 4.5 BodyRights • • • • • • Key Ideas: Demonstrate ways ofresisting unwanted sexualattention De Learning Objectives forLevel ll(9-12) • • • Key Ideas: behaviour gender roles canaffectsocialinteractions andsexual Describe someways inwhichsociety, culture, law and Learning Objectives forLevel IV(15-18) Conference Ready Version

ne unwanted sexualattention coercion Avoiding andresponding tosexual harassment and rape De Dealing withpressure tohave sex Bullying (includingphoneandcyber-bullying) What todoandwhere togoforhelp Right torefuse unwanted sexual attention violence Role ofgenderequalityinpreventing gender-based violence Relationship betweengenderrolestereotypes andsexual and sexual interactions Double standards ofsexual behaviour andimpactonsocial I ning sexual harassment andcoercive sex, including

47 Part 2 48 Part 2 Conference Ready Version Key Concept5 • • • • • • Key Ideas: Explain theconceptofprivate partsofthebody Learning Objectives forLevel I(5-8) • • • • • • Key Ideas: life cycle Explain ways inwhichsexualityisexpressed across the Learning Objectives forLevel III(12-15) – Sexual Behaviour Masturbation isnotharmful, butshouldbedoneinprivate Some peoplemasturbateandsomedonot Touching andrubbingone’s genitalsiscalledmasturbation Bodies canfeelgoodwhentouched It isnatural toexplore andtouch partsofone’s own body Most children are curiousabouttheirbodies needed fantasies andfeelingsare abletocontrolthemwhen People donothave toact upontheirsexual thoughts, throughout life Sexual feelings, fantasiesanddesires are natural andoccur Masturbation isasafeandvalid expression ofsexuality expressed locallyandacrosscultures Tolerance andrespect forthedifferent ways sexuality is identity People donotchoose theirsexual orientationor gender identity Respect forthedifferent sexual orientationsand gender 5.1 Sex, SexualityandtheSexualLifeCycle • • • • • • • • • • Key Ideas: Describe sexualityinrelation tothehumanlifecycle Learning Objectives forLevel II(9-12) • • • • Key Ideas: psychological, spiritual, ethicalandcultural components. De Learning Objectives forLevel IV(15-18)

ne sexualityinrelation toitsbiological, social, Importance oftalkingwithtrustedadultaboutsexuality behaviour Cultural andgenderrolestereotypes affectsexual identity, andsexual orientation De It isacceptabletotalkandaskquestionsaboutsexuality many questions Most youngpeopleare curiousaboutsexuality andhave relationships maystillmasturbate People inlong-term Masturbation doesnotcausephysical oremotionalharm Many boys andgirlsbegintomasturbateduringpuberty pleasure Masturbation isoftenaperson’s sexuality withthecapacityofenjoyingHuman beingsare their born People canremain sexually activeintooldage Interest insexuality maychange with age respectfully Sexuality canenhancewell-beingwhenexpressed The conceptofsexuality iscomplex andmulti-faceted I nitions ofsex, sexuality, gender, genderrole, gender I rst experience ofsexual • • • • Key Ideas: care andaffection Explain thatsexualactivityisamature way ofshowing Learning Objectives forLevel I(5-8) Children are notready forsexual contactwithotherpeople to feelgood with oneanothertoshow care, love, physical intimacy and People kiss, hug, touch, andengageinsexual behaviours ways, includingsometimesthroughsex Adults show love andcare forotherpeopleindifferent Bodies canfeelgoodwhentouched 5.2 Shared SexualBehaviours andSexualResponse • • • • • • • • • • • • • • • Key Ideas: Describe maleandfemaleresponse tosexualstimulation Learning Objectives forLevel II(9-12) Conference Ready Version problems ordisappointments Few, ifanypeople, have asexual lifethatiswithout Avoiding unwanted sexual attentionontheinternet formakingfriends Skills inusingtheinternet sexual relationshipsDangers offorming over theinternet obtainedfromtheinternet imagery Advantages anddisadvantages and ofsexual information ‘aphrodisiacs’ Concept, examples andpositivenegativeeffectsof De response cycle The componentsofthemaleandfemalehumansexual acting onthemandare abletocontrolthemwhenneeded People canhave sexual thoughtsandfeelingswithout response tosexual stimulation Understand thathumanbeingshave anatural physical maturity Sexual relationships require emotionalandphysical demonstrate love, care, andfeelingsofsexually attraction There are arange ofways inwhich couplescan Showing love involvesmore thanpenetrative sex responses tosexual attraction andstimulation During puberty, boys andgirlsbecomemore aware oftheir responses Sexual stimulation(physical ormental)producesphysical I nition andfunction of orgasm

49 Part 2 50 Part 2 Conference Ready Version Key Concept5 • • • • • • • • Key Ideas: Describe thekey elementsofthesexualresponse cycle Describe commonsexualbehaviours Learning Objectives forLevel III(12-15) • • • • • • – Sexual Behaviour In gender identity People differintheirsexual identityandorientation Common mythsaboutsex including orgasm stages ofmaleandfemalehumansexual response, De without penetration There are manyways togiveandreceive sexual pleasure enjoy theirsexuality withoutunintendedconsequences Contraceptives andcondomsgivepeopletheopportunityto behaviours withothers Abstinence meanschoosing nottoengageinsexual A personhastherighttorefuse unwanted sexual contact love andfeelings People giveandreceive sexual pleasure toexpress their with apartnerofthesameoroppositesex Both menandwomen cangiveandreceive sexual pleasure De sexual behaviour topressureIt isharmful anotherpersontoengageinany caressing, oral intercourse andpenetration Sexual behaviours includekissing, touching, talking, Personalising sexual risks J uences onsexual beliefsandpractice I I nition anddescription ofthephysical changes and ning andrefusing transactional sex 5.2 Shared SexualBehaviours and SexualResponse(contd.) • • • • • Key ideas: De Learning Objectives forLevel IV(15-18)

ne key elementsofsexualpleasure andresponsibility contact withothers Many adultshave periodsintheirliveswithoutsexual pregnancy andSTIsincludingHIV isresponsible forpreventing unintended Everyone and dislikes sexual tocommunicatetheirlikes pleasure andcanlearn isresponsible fortheirown andtheirpartner’sEveryone unintended pregnancy andSTIsincludingHIV Sexual behaviours canbepleasurable andwithoutriskof Good communicationcanenhanceasexual relationship Key Concept6 • • • Key Ideas: Recognise thatnotallcoupleshave children Learning Objectives forLevel I(5-8) – Sexual andReproductiveHealth it deserves race orsexual statuscanraise achild andgiveitthelove All peopleregardless oftheirhealthstatus, religion, origin, Some peopleare unabletocare forachild Children shouldbewanted, cared for, andloved 6.1 Pregnancy Prevention • • • • • • • • • • • • • • • • • • Key Ideas: Describe key features ofpregnancy andcontraception Learning Objectives forLevel II(9-12) Conference Ready Version Refusal skillstoavoid unwanted sex Steps forproperuseofcondoms Key characteristics ofcondoms Health risksofillegalandunsafeabortion medically trained personnelissafe understerileconditionsbyLegal abortionperformed Legal statusofabortionlocallyandglobally De pregnant Options available toteenagerswhoare unintentionally pregnancy Health andsocialconsequencesofearlyunintended condoms andcontraceptives Respective responsibilities ofmenandwomen touse Natural contraceptive methodsare onlysafeforadults Ways ofavoiding unintendedpregnancy Children shouldnothave penetrative sexual intercourse ways toprevent unintendedpregnancy Myths andfactsaboutcondoms, contraceptives andother unintended pregnancy, HIVandotherSTIs Correct andconsistentuseofcondomscanprevent pregnancy contraception) canbeusedtoprevent unintended Condoms andothercontraceptives (includingemergency contraception Not having sexual of intercourse isthemosteffectiveform Signs andsymptomsofpregnancy I nition ofabortion

51 Part 2 52 Part 2 Conference Ready Version Key Concept6 • • • • • • • • Key Ideas: pregnancy Explain theconceptofpersonalvulnerability tounintended pregnancy andtheirassociatedef Describe effective methodsofpreventing unintended Learning Objectives forLevel III(12-15) – Sexual andReproductiveHealth Access tosafeabortionandpost-abortioncare Role ofgenderinaccessingcondomsandcontraceptives Consistent andcorrect useofcondomsandcontraceptives Use andmisuseofemergency contraception Identify localsources ofcondomsandcontraceptives contraception Overcoming barrierstoobtainingandusingcondoms emergency contraception where legalandavailable) Obtaining andusingcondomscontraceptives (including condoms people have therighttoaccesscontraceptives and Regardless oftheirmaritalstatus, sexually activeyoung 6.1 Pregnancy Prevention (contd.)

cacy • • • Key Ideas: contraceptive methods Demonstrate con methods ofcontraception Describe personalbene Learning Objectives forLevel IV(15-18) • • • • • • • Side effectsandcontra-indications ofspeci including emergency contraception andcondoms Importance ofcorrect andconsistentuseofcontraception, contraceptive methods Difference betweenef methodofcontraception Sterilisation isapermanent Access tosafeabortionandpost-abortioncare Choosing themostappropriatemethodofcontraceptives planning Impact ofgenderexpectations ontheuseoffamily society Importance offamilyplanningforindividuals, familiesand community Obtaining condomsandcontraceptives inthelocal contraceptives andsexual risk-takingbehaviour ontheuseofcondomsand Impact ofpeernorms contraceptive methods

dence indiscussingandusingdifferent

ts andpossiblerisksofavailable I cacy andeffectivenessof I c • • • • • • • • • • • Key Ideas: Describe theconceptsof ‘health’ and ‘disease’ Learning Objective forLevel I(5-8) Knowing where toaskforhelpwhenweare sick We canhelpeach othermake healthy choices Impact ofHIVand AIDS onthecommunity on tootherpeople How someonewhohasHIVcanandnotpassthevirus You cannottellby lookingifapersonhasHIV People livingwithHIVneedlove, care andsupport How HIVandotherSTIsare spread HIV and AIDS andhow theyaffecttheimmunesystem diseases The immunesystemandhow itprotectsthebody from Staying healthy another How somediseasesare transmitted fromonepersonto and ReducingRiskofSTIsincludingHIV 6.2 Understanding, Recognising • • • • • • • • Key Ideas: safer sex Demonstrate communicationskillsastheyrelate to prevented Explain howSTIsandHIVare transmitted, treated and Learning Objectives forLevel II(9-12) • • • • • • Conference Ready Version Ways inwhich culture, genderandpeerscanin Risk reduction forSTIandHIV De Post Exposure Prophylaxis (PEP)forHIV Treatments forHIVand AIDS andtheirsideeffects Biology ofHIVandSTIinfection Myths andfactsaboutSTIsHIV AIDS avoiding penetrative sex to sexual intercourseSafe alternatives andreasons for Myths andfactsaboutpenetrative sexual intercourse including injectingdrugs Transmission ofHIVthroughunsterilizedequipment, Minimising theriskofmothertochild transmission ofHIV Transmission ofHIVfrommothertobaby Partner noti Young peoplelivingpositivelywithHIVand AIDS sexual behaviour I ne safersex I cation J uence

53 Part 2 54 Part 2 Conference Ready Version Key Concept6 • • • • • • • • • • • • • • • Key Ideas: and refusing unsafesexualpractices Demonstrate skillsinnegotiatingsafersexualintercourse living withHIV Describe thephysical, emotional, andsocialimpactof making regarding sexualrelationships Explain howculture andgenderaffectpersonaldecision- condoms transmitting HIVandotherSTIsincludingthecorrect useof Identify speci Learning Objectives forLevel III(12-15) – Sexual andReproductiveHealth protection againstSTIs, HIVandunintended pregnancy Not having sexual intercourse isthemosteffective partner unprotected penetrative sexual intercourse withaninfected The vast majorityofHIVinfectionsare transmitted through Personalising sexual riskassessment PEP forHIV sexual intercourse aboutpenetrativePerceptions andsafer ofpeernorms Strengthening intentiontoconsistentlyusecondoms Negotiating safersexual practices Self-ef about sexual health Effects ofculture andgenderonpartnercommunication Partner noti Risks ofintergenerational relationships partnerships Risk associatedwithmultipleandconcurrent risk reduction Importance ofpositiveattitudestowards condomuseand counselling andtesting(VCT)centres, inthecommunity Visiting sexual healthservices, includingvoluntary Reasons fordelayingsexual intercourse and ReducingRiskofSTIsincludingHIV(contd.) I cacy andvulnerability

c ways ofreducing theriskofacquiringor I cation andSTIs, HIVand AIDS 6.2 Understanding, Recognising • Key Ideas: relation tosafersexualintercourse Demonstrate communicationanddecision-makingskillsin effectiveness andpersonalpreference Assess arange ofriskreduction strategies for Learning Objectives forLevel IV(15-18) • • • • • • • • • • Key Ideascontinued: Learning Objectives forLevel III(12-15) • • • • • Key factorsthatmake itdif STI/HIV prevention One’s roleandresponsibility toeducateone’s peersabout their familiesaboutHIVand AIDS Schools andcommunityresources toeducatestudentsand Stigma anddiscriminationtoward peoplelivingwithHIV sexual practices Importance ofexploring one’s own attitudeaboutsafer andsafer sexual practicesAlternative Protected sexual practices ‘Mutual monogamy’ Assessing personalrisksandperceived vulnerability risk behaviours Alcohol anddruguseincrease risksforengaginginhigh- STIs includingHIV Correct andconsistentuseofcondomscanreduce riskof Attitudes to Strategies foraddressing these Bene intercourse Possible consequencesofhaving penetrative sexual other STIs How genderrolestereotypes canincrease riskforHIVand sexual intercourse andways ofresponding tothese I ts ofdualprotection(condomsandcontraception) w ards peoplelivingwithHIV I cult forpeopletopractice safer 6.3 HIV and AIDS Stigma, Treatment, Care and Support

Learning Objectives for Level I (5-8) Learning Objectives for Level II (9-12)

Identify the basic needs of people living with HIV Describe the emotional, economic, physical and social challenges of living with HIV Key Ideas: Key Ideas: • All people need love and affection • Need for positive attitudes, care, and respect towards • People living with HIV can give love and affection and can people living with HIV contribute to their environment and society • HIV and AIDS affect family structure, family roles, and • People living with HIV have rights and deserve love, responsibilities respect, care and support • Key emotional, health, nutritional and physical needs of • There are medical treatments that help people live orphans and other vulnerable children positively with HIV • ART and side-effects on puberty • How HIV and AIDS affect individuals, families, and communities • The importance of getting tested for HIV

• Stigma, self-stigma and discrimination

Learning Objectives for Level III (12-15) Learning Objectives for Level IV (15-18)

Explain the importance and key elements of living positively Describe the concept and causes of stigma and discrimination with HIV in relation to people living with HIV

Key Ideas: Describe key social, economic, and health issues associated with living with HIV • Stigmatisation and discrimination against people living with HIV Key Ideas:

• Key aspects of HIV treatment • Effects of HIV-related stigma and discrimination on individuals and communities • Where and how to access voluntary HIV counselling and testing • Strategies for challenging stigma and discrimination

• The technicalities of disclosing one’s HIV status • ART

• People living with HIV have a right to sexuality education • Nutritional needs for people living with HIV and to express their love and feelings via sexuality • Care and support for people living with HIV • People living with HIV have the right to marry and start a family • Death, grief and loss • Advocacy for the rights of people living with HIV

Conference Ready Version 55 Endnotes

1. UNAIDS. 2006. Scaling up access to HIV 10. WHO and UNICEF. 2003. Skills for Health: Skills- prevention, treatment, care and support. The next based health education including life skills. Geneva: steps. Geneva: UNAIDS. WHO and UNICEF.

2. These included but were not limited to the following 11. UNESCO. 2008. School-centered HIV & AIDS Care sites: SIECUS; Johns Hopkins Bloomberg School and Support. Paris: UNESCO. of Public Health Center for Communications Program’s The Info Project; International HIV/AIDS 12. See appendix VIII: Hubbard, Giese and Rainey, 1998; Alliance; Family Health International; Institute of Jemmott, Jemmott, Braverman and Fong, 2005; Education, University of London; United Nations St. Lawrence, Crosby, Bras eld and O’Bannon, Educational, Scienti c and Cultural Organization 2002; St. Lawrence et al., 1995; Zimmerman et al., (UNESCO); UNESCO International Bureau of 2008; Zimmerman et al., forthcoming. Education (IBE); United Nations Population Fund (UNFPA); and International Planned Parenthood 13. See appendix VIII: Borawski, Trapl, Lovegreen, Federation (IPPF). Colabianchi and Block, 2005; Clark, Trenholm, Devaney, Wheeler and Quay, 2007; Denny and 3. Botswana, Ethiopia, Indonesia, Jamaica, Kenya, Young, 2006; Kirby, Korpi, Barth and Cagampang, Namibia, Nigeria, South Africa, Tanzania, Thailand, 1997; Rue and Weed, 2005; Trenholm et al., 2007; USA, Zambia. Weed et al., 1992; Weed et al., 2008.

4. WHO. 2002. De ning sexual health: report of a technical 14. Kirby et al. 2007. Tool to Assess the 17 Characteristics consultation on sexual health. Geneva: WHO of Effective Sex and STD/HIV Education Programmes. Washington, DC: Healthy Teen Network. 5. Stirling, M., Rees, H., Kasedde, S., Hankins, C. 2008. Addressing the vulnerability of young women 15. Kirby, D., Laris, B. and Rolleri, L. 2005. Impact of and girls to stop the HIV epidemic in southern Sex and HIV Curriculum-based Education Programs Africa. Geneva: UNAIDS. on Sexual Behaviors of Youth in Developing and Developed Countries. Washington DC: Family 6. Birungi, H., Mugisha, J.F. and Nyombi, J.K. 2007. Health International. Sexuality of young people perinatally infected with HIV: A neglected element in HIV/AIDS Programming 16. Baral, S., Trapence, G., Motimedi, F., Umar, E. et al. in Uganda. Exchange on HIV/AIDS, sexuality and 2008. HIV Prevalence, Risks for HIV Infection, and gender. Nairobi: Population Council. Human Rights among Men Who Have Sex with Men (MSM) in Malawi, Namibia, and Botswana. PLoS ONE 7. UNAIDS. 2008. 2008 Report on the Global AIDS 4(3): e4997. doi:10.1371/journal.pone.0004997 Epidemic. Geneva: UNAIDS. 17. WHO and UNAIDS. 2009. Operational guidance 8. Delors, J., Al Mufti, I., Amagi, I., Carneiro, R. et al. for scaling up male circumcision services for HIV 1998. Learning: the treasure within. Report to prevention. Geneva: WHO. UNESCO of the International Commission on Education for the Twenty- rst Century. Paris: 18. Abortion is illegal or severely restricted in some of UNESCO. UNESCO’s Member States.

9. Gordon, P. 2008. Review of Sex, Relationships and HIV Education in Schools. Paris: UNESCO.

Conference Ready Version 57 Part III: Appendices

Conference Ready Version 60 Part 3 Conference Ready Version onsex andsexualityGlossary terms Appendix I options. Abstinenceeducation promotes abstinence orientation, marriage,family structure, andpregnancy and maypromote biasesbasedongender, sexual sexuality, distortinformationabout condomsandSTIs, programmes often rely onnegativemessagesabout behaviour byinstillingfear, shameandguilt.These that are designedtocontrol young people’s sexual only andabstinence-only-until-marriageprogrammes activity. Fear-based programmes includeabstinence- marriage astheonlymorallycorrect contextforsexual emphasise failure rates.Inaddition,theyoftenpresent methods are discussed,theseprogrammes typically marriage. Ifcontraceptionordisease-prevention abstinence from allsexualbehavioursoutsideof Abstinence-only-until-marriage educationemphasises about contraceptionordiseaseprevention methods. These programmes donotincludeinformation that emphasiseabstinencefrom allsexualbehaviours. Abstinence-only-until-marriage): Theseare programmes Abstinence-only Education: to beabstinentatanytimeintheirlives. all ages,genders,andsexualorientationscanchoose body ‘lower-risk’ behaviourssuchassafersexwhere no it maymeannopenetration(oral,anal,vaginal)oronly For some,itmaymeannosexualcontact.others, people havedifferent de to avoidcertainsexualactivitiesorbehaviours.Different Abstinence: index.html). who.int/reproductive health/publications/sexualhealth/ consultation onsexualhealth WHO’s (see http://glossary.ippf.org/GlossaryBrowser.aspx) and Glossary of International siecus.org/_data/global/images/TalkAboutSex.pdf), the including been developedandmodi Many ofthede uidsare exchangedbetweenpartners.People of De Talk AboutSex Sexualabstinenceisaconsciousdecision ning SexualHealth:reportofatechnical Planned Parenthood Federation’s online Sexual andReproductive HealthTerms nitions usedinthisglossaryhave nitions ofsexualabstinence. (SIECUS,2005http://www. (e.g.Abstinence-only; ed from othersources (2006,seehttp://www.

reproductive health,including familyplanning.” supported policiesandprogrammes intheareaof the fundamentalbasisforgovernment- andcommunity- The promotionof…theserights forallpeopleshouldbe violence, asexpressedinhuman rightsdocuments... reproduction freeofdiscrimination,coercionand It alsoincludestheirrighttomakedecisionsconcerning the higheststandardofsexualandreproductivehealth. information andmeanstodoso,therightattain spacing andtimingoftheirchildrentohavethe individuals todecidefreelyandresponsiblythenumber, on therecognitionofbasicrightallcouplesand and Development,stated: agreed Conference attheInternational onPopulation Reproductive Rights: acceptable feminineormasculineroles andbehaviour. the prevalent culturalandsocialnormsabout whatis they are asmalesorfemales,whichisoften based on Gender Roles: should beaccorded equaltreatment. men are thesame,butthattheyhaveequalvalue and men. Genderequalitydoesnotimplythatwomenand Gender Equality: male orfemale. refer toaperson’s biological,social,orlegalstatusas in aparticularpointtime(WHO2001).Itmayalso cultural attributesassociatedwithbeingmaleorfemale Gender education programmes. option forsafersexaspartofcomprehensive sexuality should benotedthatabstinenceisoftentaughtasone in comprehensive sexualityeducationprogrammes. It reproductive healthissues,whichare typicallyincluded relating tocontraception,sexualityorsexualand type ofeducationoftendoesnotdiscussissues and unwantedpregnancies canbeprevented. This abstinence astheonlywayinwhichHIVinfections from allformsofsexualactivityuntilmarriage,and : Genderrefers totheeconomic,socialand Aperson’s outward expression ofwho Equalrepresentation ofwomenand Thede “Reproductive rights…rest nition ofreproductive rights de Sex*: and females. characteristics tendtodifferentiate humansasmales as there are individualswhopossessboth,butthese biological characteristicsare notmutuallyexclusive to sexuality;itisnotmerely theabsenceofdisease, emotional, mentalandsocial well-beinginrelation Sexual Health*: sexual andreproductive health. health care servicesthatpromote, maintain,andrestore All peoplehavearighttoinformation,education,and preventing andsolvingreproductive healthproblems. sexual andreproductive healthand well-beingthrough methods, techniquesandservicesthatcontributeto Sexual andReproductive HealthServices: community groups, andhealthcare professionals. children receive from theirfamilies,religious and complement andaugmentthesexualityeducation and beliefsrepresented inthecommunityandwill sexuality programme willrespect thediversityofvalues and reproductive healthandrights.Acomprehensive other topicsregarding humansexuality, andsexual sexually transmittedinfectionprevention; and many sexuality; relationships; sexabuse,pregnancy, HIVand through gainingknowledgeaboutthebody; healthy thinking, self-actualisation,andbehaviouralchange Comprehensive sexualityeducationpromotes critical and riskreduction skillsaboutallaspectsof sexuality. attitudes andtobuilddecision-making,communication provides opportunitiestoexplore one’s ownvaluesand information. Comprehensive sexualityeducation scienti education thatincludeprogrammes providing sensitive andcomprehensive approach tosexuality Sexuality Education: religious andspiritualfactors. social, economic,political,cultural,ethical,legal,historical, in them are alwaysexperiencedorexpressed. Sexualityis sexuality canincludeallofthesedimensions,not behaviours, practices,roles andrelationships. While in thoughts,fantasies,desires, beliefs,attitudes,values, and reproduction. Sexualityisexperiencedandexpressed and roles, sexualorientation,eroticism, pleasure, intimacy throughout lifeandencompassessex,genderidentities Sexuality*: health discussions,theabovede technical purposesinthecontextofsexualityandsexual term sexisoftenusedtomean‘sexualactivity’,butfor uenced bytheinteractionofbiological,psychological, ne humansasfemaleormale.Thesesetsof Sex refers tothebiologicalcharacteristicsthat cally accurate,realistic, non-judgmental Sexuality is a central aspect of being human Sexualityisacentralaspectofbeinghuman

In generaluseinmanylanguages,the Sexual healthisastateof physical, Anage-appropriate, culturally nition ispreferred. De nedasthe

Theseworkingde * attracted tootherwomenwouldbeidenti For example,amanwhobecomeswomanandis identify themselvesasasexual,andothersother. questioning andheterosexual. Someindividualsmay are homosexual,gay, lesbian,bisexual,transgender, The commontermsforthevarietyofsexualorientations and/or genderofanotherpersontowhicha Sexual orientation all personsrespect therightsofothers. The responsible exercise ofhumanrightsrequires that pursueasatisfying,safeandpleasurablesexual • decidewhetherornot,andwhen,tohavechildren; • • consensual consensualsexualrelations; marriage; • decidetobesexuallyactiveornot; • choosetheirpartner; • respect forbodilyintegrity; • • sexuality education; seek,receive andimpartinformationrelated to • thehighestattainablestandard ofsexualhealth, • of coercion, discriminationandviolence,to: statements. Theyincludetherightofallpersons,free human rightsdocumentsandotherconsensus are already recognised innationallaws,international Sexual Rights*: including oralsex,analsexandpenile-vaginalsex. Sexual Intercourse persons mustberespected, protected andful to beattainedandmaintained,thesexualrightsofall coercion, discriminationandviolence.Forsexualhealth pleasurable andsafesexualexperiences,free of sexual relationships, aswellthepossibilityofhaving positive andrespectful approach tosexualityand dysfunction orin nds themselvesemotionallyandsexuallyattracted. Conference Ready Version WHO. sexual health.Theydonotrepresent anof as acontributiontoadvancingunderstanding inthe Platform forAction.Theseworking de Development (ICPD)Programme ofActionandtheBeijing Conferencesuch astheInternational onPopulationand consensusdocuments concepts andbuildoninternational January 2002.Theyre with theWHOTechnical ConsultationonSexualHealthin consultative processexpertsbeginning withinternational life. and sexuality; care services; including accesstosexualandreproductive health Sexualrightsembracehumanthat : Sexualorientationrefers tothesex : Penetrativesexualbehaviours, rmity. Sexualhealthrequires a ( nitions were developedthrough a ) ect anevolvingunderstandingofthe ( nitions are offered ( cial positionof ed asa lled. ( eld of

61 Part 3 62 Part 3 Conference Ready Version as adifferent gender. Source: http://www.glaad.org/ transgender peoplemayornottakestepstolive transgender asasynonymfortranssexual,however, wide arrayofindividuals.Fewpeoplealsousetheword term transgenderisan“umbrella” term,asit covers a individuals. Thisisthemainreason whywe saythe cross-dressers andothergendernon-conforming inclined tocross genderlines,includingtranssexuals, identity. Thisincludesthegroup ofallpeoplewho are completely oradequatelyre any personwhofeelstheirassignedsexdoesnot Transgender: bisexual. Source: http://www.glaad.org/ not havehadasexualexperienceatalltoidentifyas attracted tomenandwomen.Bisexualpeopleneed Bisexual: www.glaad.org/ emotionally attractedtootherwomen.Source: http:// Lesbian: attracted toothermen.Source: http://www.glaad.org/ Gay: transbasics/faq/ lesbian. Adaptedfrom http://www.gaycenter.org/gip/ describesamanwhoissexuallyandemotionally describesawomanwhoissexuallyand isanindividualwhosexuallyandemotionally isabroad term,generallyusedtoinclude gender ect theirinternal experience atalltoidentifyasheterosexual. sex. Heterosexual peopleneednothavehadasexual emotionally attractedtoapersonoftheopposite Heterosexual: experience atalltoidentifyashomosexual. Homosexual peopleneednothavehadasexual emotionally attractedtoapersonofthesamesex. Homosexual: glaad.org/ of identifyingtheirsexualidentity. Source: http://www. Questioning: describespeoplewhoare intheprocess isanindividualwhosexuallyand isanindividualwhosexuallyand

the entitlementtosexuality education International conventionsoutlining Appendix II Centre forReproductive Rights.2008. 1 age-appropriate and relevant. right balancebetweentheneed toknowandwhatis process andgrowth, oflearning itiscrucialtostrikethe any teacherorparent inguidingandsupportingthe orientation. Giventhecomplexityoftaskfacing or stigmaanddiscriminationbecauseoftheirsexual is intheformofabusiverelationships, exposure toHIV their well-beingexistsinarangeofcontexts,whetherit a difference totheirlifechances. The threat tolifeand information andskillsonsexualityeducationthatmakes that children andyoungpeoplehaveaspeci sexuality educationisinterpreted from thestandpoint In these component ofhumanrights. sexual rights,andthatsexualityeducationisanintegral areargued thatgovernments obligatedtoguarantee Parenthood Federation’s (IPPF’s) declarationin2008 Planned education inschool.TheInternational arethat governments obligatedtoprovide sexuality organizationsalsosupporttheview Some international planning andcontraception. unsafe abortion,theprevention ofHIVandSTI, family must becomprehensive, coveringtopicsofpregnancy, support thatsexualityeducationprogrammes in schools on topicsthatshouldbeincluded,andunanimously Monitoring Committees,havealsosetstandards authorities,suchasUNTreatyA varietyofinternational sexuality educationinprimaryandsecondaryschools. lawforstatestoprovidethe obligationsininternational World Conference onWomen inBeijingunderscore Development (ICPD)inCairo andthe1995 Fourth Conference1994 International onPopulationand recognised PlatformsofActionsdevelopedatthe HIV andSTIamongyoungpeople.Theglobally pregnancies, unsafeabortion,andprevention of Sexuality educationiscriticaltoreducing unplanned Schools Human Right:SexualityEducation forAdolescentsin International Guidelines . NewYork: CenterforReproductive Rights. 1 theentitlementto An International c needfor TheJointUnitedNationsProgramme onHIV/AIDS • TheWorld Health Organization(WHO)concludesit • The1994ICPD • The CRRreport provides severalexamples: call onStatestoprovide sexualityeducationin schools. Action, Treaties, andglobalconsensusdocuments that succinctly outlinesthemandatesfrom Platforms of Right: SexualityEducationforAdolescentsinSchools Reproductive Rights(CRR), on sexualityeducation,areport bytheCenterfor withsettingpolicy For decision-makersconcerned 3 UNAIDS. 1997. 2 ICPD 4 UNAIDS. 2005. Conference Ready Version Geneva: UNAIDS. Sexual BehaviourofYoung People:AReviewUpdate at 33.Geneva:UNAIDS. activity. educating youngpeoplebefore theonsetofsexual approaches tosexualityeducationbegin with (UNAIDS) hasconcludedthatthemosteffective in the particularly indevelopingcountries,becausegirls is criticalthatsexualityeducationbestartedearly, school alsoreaches studentswhoare unableto and beginningsexualityeducationinprimary greatest riskoftheconsequencessexualactivity, effective. all levelsofformalandnon-formaleducationtobe must begininprimaryschoolandcontinuethrough that educationaboutsexualandreproductive health condom use. including correct andconsistentmalefemale accurate andexplicitinformationaboutsafersex, address gendernormsandrelations; andinclude and evidence-based;promote genderequality and programmes shouldbecomprehensive, highquality Programme ofAction 34 rst classesofsecondaryschoolfacethe UNAIDSrecommends thatHIVprevention 2

4 Intensifying HIVPrevention

Impact ofHIVandSexualHealth onthe Programme ofAction , supranote2,para.11.9. AnInternationalHuman , supra recognises note26, 27. ,

63 Part 3 64 Part 3 EDUCAIDS,aUNAIDSinitiativeforcomprehensive • TheCommitteeontheRightsofChild(e.g., • Conference Ready Version 6 WHO. 2001. 5 WHO. 2004. TheCommitteeontheEliminationofDiscrimination • UNOHCHR.2003.ConventionontherightsofChild, 9 UNOHCHR.2003.ConventionontherightsofChild, 8 7 UNESCO. 2008. attend secondaryschool. epidemic”. inequality andotherstructuraldriversofthe and “address stigmaanddiscrimination,gender protective behavioursandreduce vulnerability”, sexual activity”,“buildknowledgeandskillstoadopt curricula inschools“beginearly, before theonsetof led byUNESCO,recommends thatHIVandAIDS education sectorresponse toHIVandAIDSthatis others astheybegintoexpress theirsexuality. the knowledgeandskillstoprotect themselves and must ensure thatchildren havetheabilitytoacquire and sexualhealthinformation”,thatparties adequate, appropriate andtimelyHIVAIDS, information require statestoprovide children with (CRC), concludesthat“therightstohealthand the 1989ConventiononRightsofChild The Children’s RightCommittee), in monitoring curricula andiscomprehensive. reproduction isincludedinallsecondaryschool States toensure thateducationonsexualityand WHO RegionalOf and practisehealthybehaviours”. on howtoprotect theirhealthanddevelopment not denied,accurateandappropriate information both inandoutofschool,are provided with,and must ensure that“alladolescentgirlsandboys, their healthanddevelopment”,thatStates right toaccessadequateinformationessentialfor Committee alsostatesthatadolescents“havethe curricula forprimaryandsecondaryschool. parties makesexualityeducationpartofthe healthy lifestyle”,andrecommends thatstates provision ofinformationnecessarytodevelop a “recognises thattherighttoeducationrequires parties eliminateallformsofgenderstereotyping in vocational schools.CEDAWalsorequires thatstates to provide itsystematicallyinschools,including to makesexualityeducationcompulsory, and Against Women (CEDAW)urgesstatesparties General Comment4 OHCHR. General Comment3,supra Reproductive Health for Europe. Adolescent PregnancyReport 7

WHO RegionalStrategyonSexualand EDUCAIDS Overviews , para.26.Geneva:UNOHCHR. . Copenhagen:WHO,RegionalOf ce forEurope callonMember note23,para.16.Geneva:UN 5 Guidelinesfrom the 6

. Paris:UNESCO. . Geneva:WHO. 9 Itfurther 8 The cial ( ce TheProgramme ofActionadopted attheFourth • Sweden alsohighlightedthefollowing: and SouthernAfrica Adolescent SexualandReproductiveHealthinEast Sexual andReproductiveHealth, The report, 12 Pillay, Y. andFlisher, A., 11 10 CEDAW, PlatformsofActioncontinuallycall International • by revising textbooksandschoolprogrammes. sex educationprogrammes andcurricula,including Ibid. Press, CapeTown, 2008. Southern Africa Adolescent SexualandReproductive HealthinEastand Adolescent SexualandReproductive Health, programmes. of parents mustbeaddressed inadolescenthealth recognises thattherightsofchild,andduties are oftenconsequencesofsexualviolence; and gender relations; acknowledgesthatSTIsand HIV to promote mutuallyrespectful andequitable information andservices;encouragescountries comprehensive sexualandreproductive health developing countrieshavelimitedaccessto mothers); recognises thatadolescentsinmany (particularly pregnant adolescentsandyoung need toremove barrierstoeducationforwomen on Women PlatformofActionemphasisesthe CRC documents.TheFourthWorld Conference reproductive (ASRH)issuesasintheICPDand addresses manyofthesameadolescentsexualand World Conference onWomen (Beijing,1995) young peopletheyserve. that enhancethesexualandreproductive ofthe develop andimplementpoliciesprogrammes Organizations (NGOs)mustworktogetherto multi-national agencies,andNon-Governmental The UnitedNations,withotherbi-lateraland in thedevelopmentofyouthfriendlyprogrammes. services; andgreater involvementofyoungpeople reproductive healthinformation,programmes and upon youngpeople’s accesstosexualand health andrights;removal ofbarriersthatimpinge for improved adolescentsexualandreproductive PublicPolicy:ATool toPromoteAdolescent supra note39,atart.10(c). 11 , Nordiska Afrikainstitutet, Sweden,HSRC , bytheNordiska Afrikainstitutetin Public Policy:ATool toPromote 12

in in Promoting Promoting 10

Interview scheduleandmethodology Interview Appendix III D) Respondentswere contacted,questions were C) Arrangementswere madetocalltherespondents at B) Oncetheyagreed toparticipate,andgave their A) Keyinformantswere initiallycontactedby phone In general, included. existing inEurope andNorthAmericahasalso been about developingparticularlyinnovativeapproaches particularly insub-SaharanAfrica.However, information programmes andcurriculaindevelopingcountries, implementing formalschool-basedsexualityeducation to documentbestpracticewithdevelopingand The consultantinterviewedkeystakeholders/informants Education draft ofthe information fordevelopmentoftheworking recorded, transcribedandcompiledasbackground to-face interview, andtheirresponses were then asked duringasemi-structured phoneor face- an agreed upondateandtime, responses. prepare inadvance,orchoosetotypeuptheir structured interviewguidesothattheycould informed consent,theywere emailedasemi- and/or email,andinterviewswere requested. . International GuidelinesonSexuality compiled withtheotherkeyinformantinterviews. scope; thus,theirresponses were nottranscribedand helpful, informationprovided wasmore limitedin (FHI).Although Fazekas ofFamilyHealthInternational Independent ARSHConsultant;BillFingerandKarah Novia Condell,UNICEFJamaica;ShirleyOliver-Miller, and/or experiencethatmightbehelpful.Theyincluded: because theywere thoughttohaveparticular insight with informantsnotontheKeyInformantcontactlist In addition,fourmore informalinterviewswere conducted from onehalfhourtotwoandahours. interviews. Thephoneinterviewsrangedinduration responses assupplementalinformationtotheir phone interview, andtwoinformantssubmittedwritten preferred writingtheirresponses insteadofthephone one byaface-to-faceinterview. Two oftheinformants Eight oftheinterviewswere completedbyphone, and feedback andresponse. on theirarea ofspecialisation(s),whileeliciting their Informants were looselystructured toencouragefree designed tobeopen-ended,andinterviewswithKey the semi-structured questionnaire were intentionally programmes andcurricula.Interviewquestionson implementing formalschool-basedsexualityeducation to helpdocumentbestpracticewithdevelopingand structured interviewguide.Thetoolwasdeveloped with asetofpre-determined questionsusingasemi- A totalof11in-depthinterviewswere conducted ow ofinformationandideas,tomaximisefocus Conference Ready Version

65 Part 3 66 Part 3 Conference Ready Version questionnaire schedule Semi- structuredinterview 6. How canwemoveschoolsandcommunities 5. WhatisthebestwayforMinistriesofEducation Whatare4. themostimportantelementsofquality Whathasbeensuccessful;whatworked? 3. Whathaspresented challenges? 2. 1. Whathasbeenyourexperiencewithdeveloping abstinence-only-until-marriage approaches? towards comprehensive sexualityeducationverses approaches? implement comprehensive sexualityeducation to workwithschoolsgetthempromote and sexuality educationprogrammes? in schoolsortheformaleducationsector? and implementingsexualityeducationprogrammes 10. What is important to include in an international 10. Whatisimportanttoincludeinaninternational 9. What isthebestprocess (ormostpromising How shouldtheprogramme betaught(whatare8. 7. What is(are) thebestschool-basedsexuality programmes? makers thatwillhelpthemimplementquality guidelines documentforministersandpolicy education programmes inschools? when developingandimplementingasexuality practises) forministriesofeducationtoundertake throughout thecurriculum)? subject, alongwithacarrierorintegrated the entrypoints)inschools(e.g.,asaseparate education programme(s) youknowabout? evaluation studies Criteria forselectionof Appendix IV . Theresearch methodshadto: 2. Theevaluatedprogramme hadto: 1. meet thefollowingcriteria: HIV/STI educationprogrammes, eachstudyhadto To beincludedinthisreview ofsex,relationships and (d) measure impactonthosebehavioursthat measure programme impactononeormore of (c) haveasamplesizeofatleast100. (b) includeareasonably strong experimentalor (a) beimplementedanywhere intheworld. (d) focusonadolescentsupthrough age24outside (c) focusprimarilyonsexualbehaviour(asopposed (b) (a) be acurriculum- andgroup-based sex, behaviours oroutcomesthat changeless at least3monthsormeasure impactonthose use ofcontraception,orsexual risktaking)for number ofsexualpartners, use ofcondoms, can changequickly(i.e.,frequency ofsex, pregnancy rates,andbirthrates. (e.g., frequency ofunprotected sex), STIrates, generally, compositemeasures ofsexualrisk use ofcondoms,contraceptionmore frequency ofsex,numbersexualpartners, the followingsexualbehaviours:initiationofsex, pretest andpost-testdatacollection. intervention andcomparisongroups andboth quasi-experimental designwithwell-matched of theUSorupthrough age18intheUS to sexualbehaviour). drug use,alcoholandviolenceinaddition to coveringavarietyofriskbehaviourssuchas or mediaawareness activities). interaction, oronlybroad school,community, spontaneous discussion,onlyone-on-one (as opposedtoaninterventioninvolvingonly relationship, orSTI/HIVeducationprogramme . Thestudyhadtobecompletedorpublishedin 3. . Reviewedtheresults ofprevious ETRsearches for 2. Reviewed multiplecomputeriseddatabasesfor 1. over twotothree years.More speci were completed,severalofthemonanongoing basis throughout theentire worldaspossible,severaltask In order toidentifyandretrieve asmanyofthestudies Review methods and summarisedinTable 1andthetextabove. multiple articles).Allofthese were obtained,coded evaluated 85programmes (someprogrammes had 109 studiesmeetingthecriteriaabove.These This comprehensive combinationofmethodsidenti inwhichrelevant Scannedeachissueof12journals 6. Attendedprofessional meetings,scanned abstracts, 5. Contacted32researchers whohaveconducted 4. Reviewed the studies already 3. summarisedin Conference Ready Version had beenpublishedinpeer-reviewed journals. as possible,thecriteriadidnotrequire thatstudies 1990 orthereafter. Inaneffort tobeasinclusive criteria speci studies andidenti CHID, andBiologicAbstracts). Abstracts, Bireme, DissertationAbstracts, ERIC, Popline, SociologicalAbstracts,Psychological studies meetingthecriteria(i.e.,PubMed,PsychInfo, studies mightappear. possible. spoke withauthors,andobtainedstudieswhenever any newstudies. studies previously foundandtosuggestprovide research inthis previous reviews completedbyothers. or STIrates)foratleast6months. quickly (i.e.,initiationofsex,pregnancy rates, ed above. ed eld askedthemtoreview allthe ed thosestudiesmeetingthe cally,we: ed

67 Part 3 68 Part 3 Conference Ready Version People contactedandkeyinformantdetails Appendix V University CollegeLondon Frances Cowan World Association forSexual Health Mexican Association for Sex Educationand Esther Corona University of Windsor Eleanor Matika-Tyndale UNICEF Doug Webb UNESCO ChairinEducation University ofthe West Indies David Plummer Medical Research CouncilUK Daniel Wight Population CouncilUSA Cynthia Lloyd ofEducation Jamaica Ministry Christopher Graham WHO Bruce Dick, JaneFerguson Family HealthInternational Bill Finger, Karah Fazekas UNESCO’s Global Group Advisory Human SciencesResearch Council Bhana Arvin University ofCalifornia, SanFrancisco Antonia Biggs, Claire Brindis The Alan Guttmacher Institute Anne Biddlecom Ford Foundation Ana LuisaLiguori UNESCO’s Global Group Advisory Global Coalitionfor Women on AIDS, Alice Welbourn University ofCape Town Alan Flisher UNFPA Akinyele Dairo Name, Title andAf V lainCutyRgo Area(s) ofExpertise Country/Region liation otenArc Research Implementationandadvocacy Africa Southern Research Coordination and technical support Mexico andLatin America Canada andEastern Africa Sub-Saharan Africa Research research Operations Coordination, research &technical Southern Africa andtheCaribbean Research Technical support Implementationandadvocacy UK, Caribbeanandsub-Saharan Africa Sub-Saharan Africa Research Jamaica andtheCaribbean Global Research Global Research Fundingandtechnical support Africa Southern US andLatin America Advocacy andtechnical support Research Sub-Saharan Africa Latin America Implementationandtechnical support Sub-Saharan Africa Africa Southern Sub-Saharan Africa support UNICEF Tajudeen Oyewale Columbia University Susan Philliber Counselling andResearch Programme Manager, Centre forEducation, Sanja Cesar Medical Research Council, South Africa Rachel Jewkes UNESCO’s Global Group Advisory Institute ofEducation, London Peter Aggleton,Strange Vicki Executive Director, Action Health, Inc. (AHI) Nike Esiet SIECUS Nanette Ecker University ofPretoria Crewe Mary Independent Consultant Maria Bakaroudis Clearinghouse UNESCO HIVand AIDS Education Lynne Sergeant Health (PATH) for AppropriateTechnologyProgramme in Lisa Mueller Population CouncilBrazil Juan Diaz University ofPennsylvania John Jemmott World PopulationFund(WPF) Joanne Leerlooijer, JoReinders Tanzania National InstituteforMedicalResearch Liverpool School of Tropical Medicine, Jenny Renju Medicine London School ofHygiene& Tropical David Ross Isolde Birdthistle, JamesHargreaves, University ofMaastricht Schaalma Herman Professor ofEducation, EgertonUniversity Helen Mondoh Population CouncilKenya Harriet Birungi Centre for Adolescent Health The Royal Children’s HospitalMelbourne, George Patton Name, Title andAf V lainCutyRgo Area(s) ofExpertise Country/Region liation iei Research andimplementation Research Implementationandadvocacy Research Nigeria North America Research Implementationandadvocacy Technical support Croatia Africa Southern Research andtechnical support Research UK andglobal Technical support Nigeria Global Sub-Saharan Africa Malawi Operations research Global Research Republic of Tanzania Botswana, China, GhanaandUnited Brazil andLatin America US andSouth Africa Thailand, Uganda, Viet Nam Implementationandadvocacy India, Indonesia, Kenya, The Netherlands, Research Implementationandresearch Research United Republicof Tanzania research Operations Sub-Saharan Africa Research The Netherlands Kenya Africa Eastern Australia Conference Ready Version Implementation andtechnical support Implementation andtechnical support

69 Part 3 70 Part 3 nigerian_guidelines.pdf SIECUS. http://www.siecus.org/_data/global/images/ Education inNigeria. States). 1996. Information andEducation Council oftheUnited unesco.org/ Clearinghouse websitehttp://hivaidsclearinghouse. be foundontheUNESCOHIVandAIDSEducation Updated versionsofthispracticalresource listcan • Available inEnglish,French, Spanishor Targeted oreducators,particularlyat tolearners • Recentlypublished(1998-2009)withaccurate,up- • Evaluatedorrecommended byexperts • Contributestowards comprehensive sexuality • consultation inFebruary2009: based oncriteriaestablishedattheexperttechnical principals andteachers.Theresources were selected curriculum developers,programme planners, school bibliography isintendedtoserveasapracticaltoolfor teacher trainingmanualsfrom around theworld.The sexuality educationcurricula,curriculumguidesand Education to accompanythe This bibliographyof Conference Ready Version Bibliography ofusefulresources Appendix VI Guidelines andguidingprinciples Action HealthIncorporatedandSIECUS(Sexuality Portuguese including thetertiarylevel the primaryandsecondaryschoollevel,butalso art” knowledge to-date informationre training manuals education curricula,curriculumguidesorteachers . Itiscomposedofexisting,highquality Guidelines forComprehensive Sexuality International GuidelinesonSexuality Lagos, ActionHealthIncorporated, how-to ecting latest“state-of-the- materialswasdeveloped 1998. PUB_0.asp?productCode=F2027.27 (abstract) Cancer Society. https://www.cancer.org/docroot/PUB/ Second Edition,AchievingExcellence Standards. 2007. 1E1876C24928/0/Sexuality.pdf org/NR/rdonlyres/CE7711F7-C0F0-4AF5-A2D5- Sexuality Education. (IPPF). 2006. RightFromTheStart.pdf United States).www.siecus.org/_data/global/images/ (Sexuality InformationandEducationCouncilofthe Issues, BirthtoFiveYears global/images/guidelines.pdf United States).http://www.nomoremoney.org/_data/ (Sexuality InformationandEducationCouncilofthe through 12thGrade for ComprehensiveSexualityEducation:Kindergarten Principles_for_working_on_sexuality/ (abstract) Mono/The_common_ground_about_sexuality_ http://www.cihp.org/Desktop.aspx/Publications/ (Talking AboutReproductive andSexualHealthIssues). Principles forWorking onSexuality Health Issues).2001. wiyoc37uxyxg/sexedstandards.pdf yk55wi5lwnnwkgko3touyp3a33aiczutoyb6zhxcn fhi.org/NR/rdonlyres/ea6ev5ygicx2nukyntbvjui35 YouthNet.(Family HealthInternational), http://www. HIV EducationProgrammes for Curriculum-BasedReproductiveHealthand Early ChildhoodSexualityEducationTask Force. National GuidelinesTask Force. 2004. Joint CommitteeonNationalHealthEducation PlannedParenthoodInternational Federation Senderowitz, J.andKirby, D.2006. TARSHI (Talking AboutReproductive andSexual Right FromtheStart:GuidelinesforSexuality IPPFFrameworkforComprehensive National HealthEducationStandards, , 3rd Edition.NewYork, NY, SIECUS London, IPPF. http://www.ippf.

Common GroundSexuality: . NewYork, NY, SIECUS . Arlington,VA, FHI . NewDelhi,TARSHI . Atlanta,American Guidelines Standards New York (Mexico). Forthcomingin2009. Women’sInternational HealthCoalition,andMEXFAM Hemisphere Region(LatinAmericaandCaribbean), Planned Parenthood Federation(IPPF),IPPF Western (India), GirlsPowerInitiative(Nigeria);International main.aspx?PageID=137 (abstract) Strategies forHopeTrust. http://www.actionaid.org/ Communications andRelationshipsSkills Stepping Stones:ATraining PackageinHIV/AIDS, org/index.php?id=192&L=1 pdf French, Russian,Arabic: unesdoc.unesco.org/images/0014/001463/146355e. School Curricula 2006. SCSweden_TellMeMore.pdf savethechildren.net/alliance/resources/hiv_aids/2007_ Education), SavetheChildren Sweden.http://www. Stockholm, RFSU(SwedishAssociationforSexuality Rights andSexualityintheContextofHIV/AIDSAfrica Guidelines.pdf www.siecus.org/_data/global/images/Jamaica%20 and EducationCounciloftheUnitedStates).http:// Ann, FAMPLAN Jamaica,SIECUS(SexualityInformation Guidelines forComprehensiveSexualityEducation Comprehensive SexualityEducation.2008. publications/Our_Future_Grades_4-5.pdf Alliance. http://ovcsupport.net/graphics/secretariat/ People: grades4-5 Future: SexualityandLifeSkillsEducationforYoung International curricula publications/Our_Future_Grades_6-7.pdf Alliance. http://ovcsupport.net/graphics/secretariat/ People: grades6-7 Future: SexualityandLifeSkillsEducationforYoung People: grades8-9 Future: SexualityandLifeSkills EducationforYoung Creating Resources forEmpowermentinAction andWelbourn,A.1999. ActionAid International UNESCO/International BureauUNESCO/International ofEducation(IBE). Thomsen, S.C.2007. The JamaicanTask Force Committee for International HIV/AIDS Alliance.2006. International International HIV/AIDS Alliance.2006. International International HIV/AIDSAlliance.2006. International ManualforIntegratingHIVandAIDSEducationin , Population Council. . Geneva,UNESCOIBE.English:http:// . Brighton, International HIV/AIDS . Brighton,International . Brighton, International HIV/AIDS . Brighton,International . Brighton, International HIV/AIDS . Brighton,International

Tell MeMore!Children’s

http://www.ibe.unesco. It’s AllOneCurriculum. . Oxford, Jamaican Our Our Our . St . education programme) based, comprehensive andrights-basedsexuality Youth inIndonesia. 2008. pdf wpf.org/documenten/20080729_IMToolkit_July2008. Education Programmes Mapping (IM)ToolkitIntervention forPlanningSexuality programme) comprehensive andrights-basedsexualityeducation Indonesia. YPI. 2006. sexuality educationprogramme) computer-based, comprehensive andrights-based Disadvantaged Youth inKenya”. Schoolsand World Me.ForSecondary StartsWith for StudyofAdolescence)andNairobits. 2006. “ education programme) based, comprehensive andrights-based sexuality SNU. http://www.theworldstarts.org (WPF’s computer- SchoolsinUganda.” For Secondary (SchoolNet Uganda).2003.“ program) comprehensive andrights-basedsexualityeducation wpf.org/publication/745. (WPF’s computer-based, world startswithme! publicacoes/MANUAL%20M.pdf www.promundo.org.br/materiais%20de%20apoio/ and Health Working Young With Women: Empowerment,Rights Instituto PAPAI andWorld Education.2008. http://www.promundo.org.br/396?locale=pt_BR www.promundo.org.br/396?locale=es Portuguese: promundo.org.br/396?locale=en_US Spanish:http:// Janeiro, InstitutoPromundo. English:http://www. Project H:Working Young With MenSeries. publications/Our_Future_Grades_8-9.pdf Alliance. http://ovcsupport.net/graphics/secretariat/ Conference Ready Version WPF (World Population Foundation)Indonesia,YPI. WPF (World PopulationFoundation).2008. WPF (World PopulationFoundation)Indonesia, WPF (World PopulationFoundation),CSA(Centre WPF (World PopulationFoundation)and SNU WPF (World PopulationFoundation).2003. Instituto Promundo, SaludyGénero, ECOS, Instituto Promundo, PAHO andWHO.2002. MAJU!ForSpecialEducation SchoolsforDeaf . RiodeJaneiro, InstitutoPromundo. http:// Indonesia, WPF. DAKU! For Secondary Schoolsin DAKU! ForSecondary Indonesia,WPF. (WPF’s computer- Utrecht: WPFhttp://www. . Utrecht, WPF. http://www.

The World Me. StartsWith (WPF’s computer-based, Kenya, WPF. (WPF’s Uganda, WPFand Project M: Riode The The

71 Part 3 72 Part 3 Power Initiative). an EmpoweredWomanhood Gender-Based ApproachonHumanSexualitytowards Sexuality, SexualandReproductiveHealthRights: Incorporated. Federal MinistryofEducationandActionHealth Teachers LearningforanHIVFreeGeneration Curricular ActivitiesonHIVandAIDS–Students Incorporated. 2007. (abstract) www.actionhealthinc.org/publications/guides.htm Handbook Schools,Students’ HIV EducationforJuniorSecondary actionhealthinc.org/publications/guides.htm (abstract) Guide Schools,Teachers’HIV EducationforJuniorSecondary org/publications/guides.htm (abstract) Action HealthIncorporated.http://www.actionhealthinc. Sexuality Education,Trainers’ ResourceManual based sexualityeducationprogramme) (WPF’s computer-based, comprehensive andrights- Education For theTeacher EducationatDanangUniversityof University ofDanang.2009. programme) comprehensive andrights-basedsexualityeducation in Indonesia. Pastiku! the MinistryofSpecialEducation,YPI.2008. sexuality educationprogramme) computer-based, comprehensive andrights-based WPF, theMinistryofSpecialEducation, YPI.(WPF’s Juvenile CorrectionInstitutesinIndonesia Ministry ofSpecialEducation,YPI.2008. Conference Ready Version Curricula -Sub-SaharanAfrica GPI (Girls’PowerInitiative).2004. Federal MinistryofEducationandActionHealth Action HealthIncorporated.2007. Action HealthIncorporated.2007. Action HealthIncorporated.2003. WPF (World Nam, PopulationFoundation)Viet WPF (World PopulationFoundation)Indonesia, WPF (World PopulationFoundation)Indonesia,the . Ibadan,SpectrumBooksLimited.http://www.

For SpecialEducationSchoolsforBlindYouth . Viet Nam,WPF,. Viet UniversityofDanang. . Ibadan,SpectrumBooksLimited.http:// Indonesia, WPF. (WPF’s computer-based, Facilitating School-BasedCo- Journey toAdulthood . Calabar, GPI(Girls’ Comprehensive Family Lifeand Family Lifeand SERU!For . Indonesia, Adolescent Langhka . Nigeria . Lagos, . 2005. A., Sikenyi,V., Changeiywo,J.M (abstract) www.phoenixpublishers.co.ke/display.php?catID=1 Festival: Chela3 Sikenyi, V., Changeiywo,J.M.2006. (abstract) www.phoenixpublishers.co.ke/display.php?catID=1 Wedding: Chela2 V., Changeiywo,J.M.2006. (abstract) www.phoenixpublishers.co.ke/display.php?catID=1 visit: Chela1 Sikenyi, V., Changeiywo,J.M.2006. (abstract) http://www.questafrica.org/ItemDetail.aspx?itemId=70 SchoolinKenya Primary of GrowingUpandSexualMaturation:theRole Omar, N.O.2006. Prevention Education ApproachtoHIV/STDsandPregnancy Us ProtectOurFuture:AComprehensiveSexuality org/legacy/countries/ethiopia/PLETH180.pdf ethiopia/PLETH179.pdf Oromifa: http://www.jhuccp. Amharic: http://www.jhuccp.org/legacy/countries/ http://db.jhuccp.org/mmc/media/PLETH178.PDF AIDS Relief),SavetheChildren USA,USAID.English: PEPFAR (UnitedStatesPresident’s EmergencyPlanfor HCP (HealthCommunicationPartnership)Ethiopia, org/publications/downloads/jnrcurriculum.pdf and DevelopmentCouncil).http://www.actionhealthinc. Nigeria Schoolin HIV EducationCurriculumforJuniorSecondary Development Council).2003. (abstract) www.phoenixpublishers.co.ke/display.php?catID=1 Experience: Chela4 HCP (HealthCommunicationPartnership)Ethiopia. Mondoh, H.,McOnyango,O.,Othuon,L. Mondoh, H.,McOnyango,O.,Othuon,L.A., Mondoh, H.,McOnyango,O.,Othuon,L.A.,Sikenyi, Mondoh, H.,McOnyango,O.,Othuon,L.A., Mondoh, H.O.,Chiuri,L.W., Changeiywo,J,M., Jemmott, LS;J.,Gueits,L.2008. NERDC (NigerianEducationalResearch and . Abuja,NERDC(NigerianEducational Research Activity book:Beaconschools . NewYork, NY, SelectMedia. . Nairobi, PhoenixPublishers.http:// . Nairobi, PhoenixPublishers.http:// . Nairobi, PhoenixPublishers.http:// . Nairobi, PhoenixPublishers.http:// The Contemporary Management The Contemporary . Nairobi, PhoenixPublishersLt. National FamilyLifeand Journey toCheptoo’s . 2006 . AddisAbaba, Grandmother’s The Drama Naomi’s Let

UNICEF. Educational Research andDevelopmentCouncil) Basic ScienceandTechnology Family LifeandHIVEducation–Teachers’ Guidein Development Council)andUNICEF. 2006. Development Council). Abuja, NERDC(NigerianEducationalResearch and Schools. HIV EducationCurriculum–UpperPrimary Development Council).2004. School ofHygieneandTropical Medicine).http:// and Research Foundation) andLSHTM(London Institute forMedicalResearch), AMREF(AfricanMedical of HealthandEducation,NIMR (Tanzania National Teacher’s GuideforStandard7. Schools. Reproductive HealthEducationforPrimary and Ross,D.A.2004. Mmassy, G.,Makohka,M.,Plummer, M.L.,Kudrati, English.pdf memakwavijana.org/pdfs/Teachers-Guide-Std-6- School ofHygieneandTropical Medicine).http://www. and Research Foundation)andLSHTM(London Institute forMedicalResearch), AMREF(AfricanMedical of HealthandEducation,NIMR(Tanzania National Teacher’s GuideforStandard6. Schools. Reproductive HealthEducationforPrimary and Ross,D.A.2004. Mmassy, G.,Makohka,M.,Plummer, M.L.,Kudrati, English.pdf memakwavijana.org/pdfs/Teachers-Guide-Std-5- School ofHygieneandTropical Medicine).http://www. and Research Foundation)andLSHTM (London Institute forMedicalResearch), AMREF(African Medical of HealthandEducation,NIMR(Tanzania National Teacher’s GuideforStandard5. Schools. Reproductive HealthEducationforPrimary and Ross,D.A.2004. Mmassy, G.,Makohka,M.,Plummer, M.L.,Kudrati, Educational Research andDevelopmentCouncil). Action HealthIncorporatedandNERDC(Nigerian Nigeria, Version 1.1 about Living.TheElectronicVersion ofFLHE.North Research andDevelopmentCouncil).2009. Incorporated andNERDC(NigerianEducational OneWorld UK,Butter NERDC (NigerianEducationalResearch and NERDC (NigerianEducationalResearch and Obasi, A.I.N.,Chima,K.,Cleophas-Frisch,B., Obasi, A.I.N.,Chima,K.,Cleophas-Frisch,B., Obasi, A.I.N.,Chima,K.,Cleophas-Frisch,B., . OneWorld UK,Butter Good ThingsforYoung People: Good ThingsforYoung People: Good ThingsforYoung People: y Works, ActionHealth . Abuja,NERDC(Nigerian National FamilyLifeand Tanzanian Ministries Tanzanian Ministries Tanzanian Ministries y Works, y Learning National lifeskills/ Republic ofNamibia,UNICEF. http://www.unicef.org/ Health andDevelopmentProgramme, of Government Future IsMyChoiceFacilitators for theTrainers ofTrainers My FutureisChoiceFacilitatorTraining: AGuide ofRepublicNamibia,UNICEF.Government 2001. pdf www.unicef.org/lifeskills/ ofRepublicNamibia,UNICEF.Government http:// The Youth HealthandDevelopmentProgramme, Protecting OurPeersfromHIVInfection Training ManualforAdolescents13to18Years ofAge. My FutureIsChoice:ExtracurricularLifeSkills ofRepublicNamibia,UNICEF.Government 1999. org/publications/details.php?i=1590 (abstract) Appropriate Technology inHealth).http://www.path. Workbook. Young PeopleinAfrica,BotswanaVersion. Participant’s Health). 2003. org/publications/details.php?i=1590 (abstract) Appropriate Technology inHealth).http://www.path. Manual. Young PeopleinAfrica,BotswanaVersion. Facilitator’s Health). 2003. questafrica.org/ItemDetail.aspx?itemId=71 (abstract) Education Among theLuoofKenya:RemovingBarrierstoQuality Ayieko, M.2006. pdf memakwavijana.org/pdfs/Teachers-Resource-Book. of HygieneandTropical Medicine).http://www. Research Foundation)andLSHTM(LondonSchool for MedicalResearch), AMREF(AfricanMedicaland Health andEducation,NIMR(Tanzania NationalInstitute Teacher’s ResourceBook. Schools. Reproductive HealthEducationforPrimary and Ross,D.A.2004. Mmassy, G.Makohka,M.,Plummer, M.L.,Kudrati, 7-English.pdf www.memakwavijana.org/pdfs/Teachers-Guide-Std- Conference Ready Version The Youth HealthandDevelopmentProgramme, The Youth HealthandDevelopmentProgramme, PATH (Program forAppropriate Technology in PATH (Program forAppropriate Technology in Othuon, L.A.,Mconyango,O.,An’gawa,F., Obasi, A.I.N.,Chima,K.,Cleophas-Frisch,B., Washington D.C.,PATH (Program for les/mfmc_tot_manual.pdf . Nairobi, PhoenixPublishersLtd.http://www. Washington D.C.,PATH (Program for Life PlanningSkills:ACurriculumfor Life PlanningSkills:ACurriculumfor Growing UpandSexualMaturation Good ThingsforYoung People: les/mfmc_facilitator_manual. . For theTraining ofNewMy Tanzanian Ministriesof . Windhoek, TheYouth. Windhoek, . Windhoek, . Windhoek,

73 Part 3 74 Part 3 Framework_Merged.pdf hhd.org/sites/hhd.org/ Kingston, EDC,UNICEFandCARICOM.http://www. Regional CurriculumFrameworkForAges9-14 and CARICOM.2008. Grade 7-9. Family LifeEducation,Re Grade 1-6 Family LifeEducation,Re lifeskills/ Republic ofNamibia,UNICEF. http://www.unicef.org/ Health andDevelopmentProgramme,of Government Skills Training forYoung People Information forParentsonMyFutureisChoiceLife ofRepublicNamibia,UNICEF.Government 2001. club_manual.pdf UNICEF. http://www.unicef.org/lifeskills/ Programme, ofRepublicNamibia, Government TheYouthWindhoek, HealthandDevelopment ActivitiesforClubs. A HandbookforAIDSAwareness ofRepublicNamibia,UNICEF.Government 2001. Health Issues).2006. downloads/blue-book.pdf and SexualHealthIssues). http://www.tarshi.net/ years Book: WhatYou Want toKnowAboutYourself, 15+ Health Issues).2005(1999ReprintEdition). downloads/red-book.pdf and SexualHealthIssues).http://www.tarshi.net/ years Book: WhatYou Want toKnowAboutYourself, 10-14 Health Issues).1999(2005ReprintEdition). Conference Ready Version Curricula -AsiaandthePaci the Caribbean Curricula –LatinAmericaand EDC (EducationDevelopmentCenter, Inc.),UNICEF Caribbean ConsultingGroup. 2007 Caribbean ConsultingGroup. 2007 The Youth HealthandDevelopmentProgramme, The Youth HealthandDevelopmentProgramme, TARSHI (Talking AboutReproductive andSexual TARSHI (Talking About Reproductive andSexual TARSHI (Talking AboutReproductive andSexual . NewDelhi,TARSHI, (Talking AboutReproductive . NewDelhi,TARSHI, (Talking AboutReproductive les/mfmc_club_manual.pdf . Brooklyn, CaribbeanConsultingGroup. Brooklyn, CaribbeanConsultingGroup. Health andFamilyLifeEducation. Basics andBeyond:Integrating les/HFLE%20Curriculum%20 ned ScopeandSequence, ned ScopeandSequence, .

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Reproductive andSexualHealthIssues). A GuideforParents. Why, WhatandHowtoTalk To Your KidsAboutSexuality, Health Issues).Forthcomingin2009. Sexual HealthIssues). New Delhi,TARSHI, (Talking AboutReproductive and Didn’t KnowWhotoAsk,ABookforYoung Couples. All You Want toKnowAboutSexualRelationshipsand Health Issues).Forthcomingin2009. (abstract) www.tarshi.net/publications/publications_training.asp About Reproductive andSexualHealthIssues).http:// - AManualForTrainers. Sexuality, SexualAndReproductiveHealthRights a86f2b1b04 www.bzga.de/pdf.php?id=ae90c181d0cd3dbed43f78 Bundeszentrale fürgesundheitliche Aufklärung.http:// planning: Teenage pregnancies internationally Aufklärung). 2007. hp?id=39fc40c228a5226f48ab13b7a7e7fd8b gesundheitliche Aufklärung.http://www.bzga.de/pdf.p planning: Migration Aufklärung). 2006. hp?id=44f5170caadcbb182d188a626ead956b gesundheitliche Aufklärung.http://www.bzga.de/pdf.p planning: International Aufklärung). 2006. d7afc68ec56243700d3250312 Aufklärung. http://www.bzga.de/pdf.php?id=d8edee7 Cologne, Bundeszentralefürgesundheitliche planning: youngpregnantwomenandmothers Aufklärung). 2001. 9bbd496faa0ebfc5a894a58dc Aufklärung. http://www.bzga.de/pdf.php?id=d2de062 Cologne, Bundeszentralefürgesundheitliche Sex education,contraceptionandfamilyplanning Aufklärung). 1999 Curricula -Europe TARSHI (Talking AboutReproductive andSexual TARSHI (Talking AboutReproductive andSexual BZgA (Bundeszentralefürgesundheitliche BZgA (Bundeszentralefürgesundheitliche BZgA (Bundeszentralefürgesundheitliche BZgA (Bundeszentralefürgesundheitliche BZgA (Bundeszentralefürgesundheitliche . Conceptsexeducationforyouths: FORUM Sexeducationand family FORUM Sexeducationandfamily FORUM Sexeducationandfamily FORUM Sexeducationandfamily NewDelhi,TARSHI, (Talking About . Cologne,Bundeszentralefür . Cologne,Bundeszentralefür NewDelhi,TARSHI, (Talking The GreenBook: The WhiteBook: . Cologne, . .

draw_pr.pdf (overview) http://www.thenationalcampaign.org/EA2007/desc/ Pregnancy. Grade7 Respect theLine:SettingLimits toPreventHIV, STDand andETRAssociates.2003. California /draw_pr.pdf (overview) http://www.thenationalcampaign.org/EA2007/desc Pregnancy. Grade6 Respect theLine:SettingLimitstoPreventHIV, STD and and ETRAssociates.2003. California productdetails.cfm?PC=721 (product details) of Congregations). http://www.uuabookstore.org/ 12. Whole Lives:SexualityEducationforGrades10- productdetails.cfm?PC=719 (product details) of Congregations). http://www.uuabookstore.org/ Boston, UUA(UnitarianUniversalistAssociation Whole Lives:SexualityEducationforGrades4-6 Associates. HIV. StudentWorkbook Risk: BuildingSkillstoPreventPregnancy, STDand traininginstit/rtr.htm (overview) Scotts Valley, CA,ETRAssociates.http://www.etr.org/ Building SkillstoPreventPregnancy, STDandHIV upload/PDF-Material/atlas_sexuel_des_ecoles.pdf ) sexatlas%20engelska.pdf French: http://www.rfsu.org/ English: http://www.rfsu.org/upload/PDF-Material/ RFSU (SwedishAssociationforSexualityEducation). Education). 2005. PDF-Material/YMEPguidebookapril08.pdf for SexualityEducation).http://www.rfsu.org/upload/ Equal Partners Association forSexualityEducation). as aCulturalPhenomena Curricula -NorthAmerica Boston,UUA(UnitarianUniversalistAssociation Center forAIDSPrevention Studies/Universityof Center forAIDSPrevention Studies/Universityof Casparian, E.M.andGoldfarb,E.S.2000. Casparian, E.M.andGoldfarb,E.S.2000. Barth, R.P.2004 (4thedition). Barth, R.P.2004 (4thedition). Olsson, H.RFSU(SwedishAssociationforSexuality Centerwall, E.andLaack,S.2008. Centerwell, E.2008. . Stockholm,RFSU(SwedishAssociation A SexatlasforSchools. . ScottsValley, CA,ETRAssociates. . ScottsValley, CA,ETR Associates. Sexualities: ExploringSexuality . Stockholm,RFSU(Swedish . ScottsValley, CA,ETR ReducingtheRisk: DrawtheLine, DrawtheLine, Reducingthe Young Menas Stockholm, Our Our . . draw_pr.pdf (overview) http://www.thenationalcampaign.org/EA2007/desc/ Pregnancy. Grade8 Respect theLine:SettingLimitstoPreventHIV, STDand andETRAssociates.2003. California Associates. Peer LeaderWorkbook. Level2 Choices: PreventingHIV, OtherSTDandPregnancy. Associates. Peer LeaderWorkbook. Level1 Choices: PreventingHIV, OtherSTDandPregnancy. Associates. Peer LeaderTraining Guide Choices: PreventingHIV, OtherSTDandPregnancy. Associates. Level 2.StudentWorkbook Choices: PreventingHIV, OtherSTDandPregnancy. Associates. Level 1.StudentWorkbook Choices: PreventingHIV, OtherSTDandPregnancy. Level 2. Choices: PreventingHIV, OtherSTDandPregnancy. Level 1. Choices: PreventingHIV, OtherSTDandPregnancy. (overview ofthewhole thenationalcampaign.org/EA2007/desc/safer_pr.pdf Manual Preventing HIV, OtherSTDandPregnancy. Implementation to HIV/STDsandTeen Pregnancy Prevention 2004. Focus onKids Valley, CA,ETRAssociates. (Previously publishedas Prevention ProgramforAfrican-AmericanYouth Conference Ready Version ETR Associates.2007(RevisedEdition). ETR Associates.2007(RevisedEdition). ETR Associates.2007(RevisedEdition). ETR Associates.2007(RevisedEdition). Center forAIDSPrevention Studies/Universityof ETR Associates.2009. ETR Associates.2007(RevisedEdition). ETR Associates.2007(RevisedEdition). ETR Associates.2007(RevisedEdition). ETR Associates.2007(RevisedEdition). Jemmott, L.S.,J., andMcCaffree, K. Making ProudChoices:ASafer-Sex Approach . ScottsValley, CA,ETRAssociates.http://www. Scotts Valley, CA,ETRAssociates. Scotts Valley, CA,ETRAssociates. ) http://www.etr.org/foy/ (overview) . ScottsValley, CA,ETRAssociates. Safer Choices FocusonYouth: AnHIV . ScottsValley, CA,ETR . ScottsValley, CA,ETR . ScottsValley, CA,ETR . ScottsValley, CA,ETR . ScottsValley, CA,ETR Curricula) Curricula) DrawtheLine, Safer Choices: Safer Choices: . Scotts . New Safer Safer Safer Safer Safer Safer Safer

75 Part 3 76 Part 3 Conference Ready Version (product details) www.uuabookstore.org/productdetails.cfm?PC=720 Universalist AssociationofCongregations). http:// education forgrades7-9 (product details) www.uuabookstore.org/productdetails.cfm?PC=772 Universalist AssociationofCongregations). http:// Young Adults,Ages18-35. S. 2008. bart.htm (overview) CA, ETRAssociates.http://www.etr.org/traininginstit/ Reduction ProgrammeforAdolescents Becoming aResponsibleTeen (BART): anHIVRisk- (product details) www.uuabookstore.org/productdetails.cfm?PC=718 Universalist AssociationofCongregations). http:// Education forGradesK-1 dtopics/stds/stded.pdf Teen Network.www.health.state.mn.us/divs/idepc/ HIV EducationPrograms Assess theCharacteristicsofEffectiveSexandSTD/ org/curriculum.asp?curid=3 (product details) York, NY, SelectMedia,Inc.http://www.selectmedia. Wilson, P.Wilson, M.1999. M.J.,Stuart,L.A.andGibbMillspaugh, Tino, St.Lawrence, J.S.2005(RevisedEdition). Sprung, B.1999. Kirby, M.M.2007. D.,Rolleri,L.A.,Wilson, OurWholeLives:SexualityEducationfor Our WholeLives:Sexuality . Washington, DC,Healthy Our wholelives:sexuality . Boston,UUA(Unitarian . Boston,UUA(Unitarian Boston, UUA(Unitarian . ScottsValley, Tool to http://www.tarshi.net/ http://www.c4urself.org.uk/speakeasy.php http://www.sexedlibrary.org showFeature&CategoryID=34&FeatureID=1154 http://www.siecus.org/index.cfm?fuseaction=Feature. Across theWorld http://www.learningaboutliving.com/south FLHE (FamilyLifeandHIV/AIDSEducation) Websites TARSHI websiteandhelpline Speakeasy forParents SIECUS’ SexEdLibrary PromisingSIECUS GlobalVision: Resources From aboutLiving:TheElectronicLearning Version of San Francisco, USA relationships andHIV/STIeducation, 18-19February 2009, from theUNESCO/UNFPA globaltechnicalconsultationonsex, List ofparticipants Appendix VII: http://www.worldsexology.org/ [email protected] 14600 D.F., Mexico Col Valle Escondido,DelegaciónTlalpanMéxico Av delasTorres 27B301 Association forSexualHealth(WAS) Mexican AssociationforSexEducation/World Esther Corona http://www.actionaid.org/main.aspx?PageID=167 Johannesburg, SouthAfrica Private bagX31Saxonwold2132 Post Netsuite#248 Action AidInternational Dhianaraj Chetty http://www.unesco.org/aids 7, placedeFontenoy75352Paris,France Education Division fortheCoordination ofUNPrioritiesin Section onHIVandAIDS UNESCO Chris Castle http://www.hsrc.ac.za/CYFSD.phtml Dalbridge, 4014,SouthAfrica Private BagX07 Human SciencesResearch Council(HSRC) Child, Youth, Family&SocialDevelopment Arvin Bhana http://www.unfpa.org/adolescents/ New York, NewYork 10017,USA 220 East42ndStreet Technical SupportDivision Reproductive HealthBranch UNFPA Prateek Awasthi http://www.popcouncil.org/ New York, NY10017,USA One DagHammarskjoldPlaza Population CouncilUSA Nicole Haberland Kingston 5,Jamaica Road 37 Arnold Unit, MinistryofEducation HIV andAIDSEducationGuidanceCounseling Christopher Graham London NW17AU,UnitedKingdom 27a GloucesterAvenue Basement Flat Peter Gordon http://www.actionhealthinc.org/ Jibowu, Lagos,Nigeria 17 LawalStreet Action Health,Inc.(AHI) Nike Esiet http://www.siecus.org/ USA Hewlett Harbor, N.Y. 11557 164 SchenckCircle Nanette Ecker http://www.unesco.org/santiago Santiago, Chile Providencia Enrique Delpiano2058 UNESCO Santiago Mary GuinnDelaney Conference Ready Version

77 Part 3 78 Part 3 Conference Ready Version http://www.tarshi.net/ New Delhi110014,India 11, MathuraRoad,1stFloor, JangpuraB (TARSHI) Talking AboutReproductive andSexualHealthIssues Prabha Nagaraja Egerton-20115, Kenya P.O BOX536 Egerton University Helen OmondiMondoh Walnut Creek, CA94596,USA 1743 CarmelDrive#26 Health StrategiesInternational Elliot Marseille Beijing, 100875,China #19, Xinjiekouwaidajie Beijing NormalUniversity Research CenterforScienceEducation Wenli Liu http://www.etrassociates.org/ Scotts Valley, CA95066,USA 4 Carbonero Way, ETR Associates Doug Kirby http://www.popcouncil.org/africa/kenya.html P.O. Box17643-00500,Nairobi, Kenya General AccidentHouse,2ndFloor Ralph BuncheRoad Population CouncilKenya Sam Kalibala http://www.unesco.org/aids 7, placedeFontenoy75352Paris,France Education Division fortheCoordination ofUNPrioritiesin Section onHIVandAIDS UNESCO Ekua Yankah http://www.hewlett.org/Programs/Population/ Menlo Park,CA94025,USA 2121 SandHillRoad andFloraHewlettFoundation The William Population Program Sara Seims http://www.wpf.org/ 3512 ABUtrecht, Holland 2A Vinkenburgstraat World PopulationFoundation Jo Reinders http://www.gpinigeria.org/ P.O.Box 7400,BeninCity, Nigeria Upper EkenwanRoad,Ugbiyoko, 67 NewRoad,Off AmadasunStreet, Girls’ PowerInitiative(GPI)EdoState Grace Osakue http://www.rfsu.se/ Stockholm, Sweden Box 4331,10267 The SwedishAssociationforSexualityEducation Hans Olsson Reference Materialforthe Appendix VIII 6. Du Cowan,F. M.,Pascoe,S.J.S.,Langhaug,L.F., 5. P., Cabezon,C.,Vigil, Rojas,I.,Leiva,M.,Riquelme, 4. Baker, S.,Rumakom,P., Sartsara,S.,Guest,P., 3. Antunes,M.,Stall,R.,Paiva,V., Peres, C.,Paul, 2. Agha,S.,&Van Rossem,R.2004.Impactofa 1. behaviour inDevelopingCountries impact ofprogrammesonsexual References forstudiesmeasuring from arandomizedevaluation inWestern Kenya Education andHIV/AIDSprevention: Evidence International Health,13 design andbaselineresults. intervention forruralyouthinZimbabwe–study multi-component community-basedHIVprevention controlled trialtodeterminetheeffectiveness ofa Regai DziveShiriProject: aclusterrandomised Dirawo, J.,Chidiya,S.,Jaffar, S., 69. school. controlled interventioninaChileanpublic high prevention: Anabstinence-centered randomized R., &Aranda,W. 2005.Adolescentpregnancy Thailand. of anHIV/AIDSprogrammeforcollegestudentsin McCauley, A.,&Rewthong,U.2003. 11 in publicnightschoolsSàoPaulo,Brazil. sexual riskreduction programme foryoungadults J., Hudes,M., Adolescent Health,34 behaviour ofZambianadolescents. normative beliefs,riskperceptions, andsexual school-based peersexualhealthinterventionon (Supplement 1),S121-S127. o, E.,Dupas,P., Kremer, M.,&Sinei,S.2006. Journal ofAdolescentHealth,36 Washington, D.C.:PopulationCouncil. et al. 1997.EvaluatinganAIDS (5), 441-452. (10), 1235-1244. Tropical Medicineand et al. 2008.The Journal of Evaluation (1), 64- AIDS, . . Eggleston,E.,Jackson,J.,Rountree, W., &Pan, 8. Dupas,P. 2006. 7. 10. Fawole, I.,Asuzu,M.,Oduntan,S.,&Brieger, W. Erulkar, A.,Ettyang,L.,Onoka,C.,Nyagah,F., & 9. 11. Fitzgerald, A.,Stanton,B.,Terreri,11. N.,Shipena,H., 13. Jewkes, R.,Nduna,M.,Levin,J.,Jama,N.,Dunkle, 13. 12. James, S.,Reddy, P., Ruiter, R.,McCauley, A.,& Conference Ready Version International Guidelines American JournalofPublicHealth,7 Revista PanamericanadeSaludPública/Pan programme foryoungadolescentsinJamaica. Z. 2000.Evaluationofasexualityeducation Hanover: DartmouthCollege. sex: Teenagers, sugardaddiesandHIVinKenya Action Lab. Boston: DepartmentofEconomicsandPoverty of effectiveness. for secondaryschoolstudentsinNigeria:Areview 1999. Aschool-basedAIDSeducationprogramme Planning Perspectives,30 programme foryoungKenyans. of aculturallyconsistentreproductive health Muyonga, A.2004.Behaviourchangeevaluation Adolescent Health,23 adolescents inanAfricansetting. based HIVrisk-reduction interventionstargeting Li, X.,Kahihuata,J., 675-683. Stones onincidenceofHIVand HSV-2 andsexual K., Puren, A., Education andPrevention,18 students inKwaZulu-Natal,SouthAfrica, AIDS lifeskillsprogramme onsecondaryschool B.2006.TheimpactofanHIVand van denBorne, et al. Health EducationResearch,14 Relative risksandthemarketfor et al. 2008.ImpactofStepping (1), 52-61. (2), 58-67. 1999.Useofwestern- (4), 281-294. International Family (2), 102-112. Journal of AIDS (5), .

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