International Guidelines on Sexuality Education: an Evidence Informed Approach to Effective Sex, Relationships and HIV/STI Education

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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, Scientiﬁ 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 Defi 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 Immunodefi 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, Scientifi 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 ReadyVersion people withage-appropriate, culturallyrelevant and Effective sexualityeducationcanprovide young HIV. particularly thosewithdisabilitiesandliving Some youngpeopleare more vulnerablethanothers, entitlement ofallyoungpeopletosexualityeducation. 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 ofopendiscussionsexual gender. Thisisoftenexacerbatedbyembarrassment, confl Many youngpeopleapproach adulthoodfacedwith 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? Access prevention andisalsocritical toachievingUniversal Effective sexualityeducation isacriticalpartofHIV lives. be abletomakeinformeddecisionsabouttheirsexual and values,topractisetheskillstheywillneed opportunities foryoungpeopletoexplore theirattitudes scientifi curriculum) withinwhichtodoso. as offering anappropriate structure (i.e.theformal education before theybecomesexuallyactive,aswell reach largenumbersofyoungpeoplewithsexuality School settingsprovide animportantopportunityto increase theuseofprotection againstpregnancy • reduce thenumberofsexualpartners;and • reduce thefrequency ofunprotected sexual • delaythedebutofsexualintercourse; • characteristics canhelpto: Research showsthatprogrammes sharingcertainkey increase communicationwithparents orother • improve perceptions aboutpeergroup norms; and • • increase clarifyandsolidifypositivevaluesattitudes; skills; • • increase knowledge; • reduce misinformation; can: Studies show(seesection4)thateffective programmes reduce someoftheserisks. properly designedandimplemented programmes pregnancy, andcoercive orabusivesexualactivity, eliminate theriskofHIVandotherSTIs,unintended support. Whilethere are noprogrammes thatcan and STIsduringsexualintercourse. activity; trusted adults. callyaccurateinformation.Itincludesstructured 1 targetsforprevention, treatment, care and can informed by practitioner experience and expert opinion. informed bypractitionerexperience andexpertopinion. studies, theInternationalGuidelines are alsodeliberately education isdrawnprimarilyfrom publishedresearch While sectionfourontheevidencebaseofsexuality conventional standards ofpublishedresearch studies. example, about‘promising approaches’; aswellthe education: practitionerexperienceandexpertopinion,for Different kindsofevidenceexistinrelation tosexuality include behaviourallydefi range oftopicsandconceptsthatmayornot best availableevidenceandencompassesabroad education combinesarights-basedapproach withthe behaviour. IntheseInternationalGuidelines,sexuality conceptual emphasiswouldbeonreducing sexualrisk safer behaviour. Forpublichealthprofessionals, the right, aswellbeingafi is valuedbothasaworthwhileoutcomeinitsown activity inwhichincreasing knowledge(e.g.aboutHIV) 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, theInternationalGuidelinescallforpoliticaland and well-beingofchildren andyoungpeople.Atanother parents, contributingtowards ensuringtheprotection classroom havearesponsibility toactintheplaceof institutions. Initssimplestinterpretation, teachersinthe duty ofcare ofeducation andhealthauthorities be life-threatening, sexuality educationispartofthe In acontextwhere ignorance andmisinformationcan topromote andsustainrisk-reducing behaviour. • todeveloporstrengthen skills;and • toexplainandclarifyfeelings,valuesattitudes; • toincrease knowledgeandunderstanding; • mutually reinforcing objectives: Sexuality educationprogrammes usuallyhaveseveral social relationships inaworld affected byHIVandAIDS. values tomakeresponsible choices abouttheirsexualand young peopleare equipped with theknowledge,skillsand The primarygoalofsexualityeducationisthatchildren and 1.2 Whatarethegoals of sexuality education? ned outcomes. ned rst steptowards adopting Provide guidanceonhowtodevelopresponsive, • • Build teacher preparedness andenhance Provide guidancetoeducationauthoritiesonhow • Provide aclearunderstandingofwhatsexuality • Promote anunderstandingoftheneedforsexuality • process. Theyare intendedto: and HIV/STIswithinastructured teaching/learning to children andyoungpeopleaboutsex,relationships offering guidedaccesstoinformationandknowledge The mayaffectturn, sexualbehaviour. and skillsthatare amenable tochangeandwhich,in designed, thataddress factors suchasbeliefs,values is placedontheneedforprogrammes thatare logically out ofschool,mayfi delivery andevaluationofsexualityeducation,in and teachers.However, anyoneinvolvedinthedesign, staff, includingcurriculumdevelopers, schoolprincipals relevance foreducationministers andtheirprofessional The sexuality education. set ofage-specifi materials. Itdoesthisprimarilybyrecommending a school-based sexualityeducationprogrammes and authorities inthedevelopmentandimplementationof primarily toassisteducation,healthandotherrelevant These 1.3 Conference ReadyVersion 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 Guidelinesare aframeworkfor International Guidelineswillhaveimmediate Whatarethepurposeand International Guidelineshavebeendeveloped International Guidelines? intended audienceofthe c standardobjectivesfor learning nd thisdocumentuseful.Emphasis

3 Part 1 4 Part 1 Conference ReadyVersion existing programmes. of newprogrammes orthereview andscalingupof those involvedinpolicy, advocacyandthedevelopment Thus, theInternationalGuidelinesprovide aplatformfor 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 Guidelinespresents aglobaltemplate of effective programmes. Thesecondpartofthe sexuality educationandpresents thekeycharacteristics of theavailableevidenceinrelation totheimpactof is andwhyitimportant.Itsetsoutaclearoverview parts. Thefi The 1.4 HIV andAIDSatthenationallevel. it isanessentialpartofacomprehensive response to part ofagoodcurriculumand,itcouldalsobeargued, In abroader context,sexuality educationisanessential acceptance. can bemadeinorder toincrease localrelevance and on thebasisofwhichregional andcountryadaptations Guidelines are thusintendedtobea globaltemplate, across awiderangeof settings. TheInternational the diverserealities andneeds ofyoungpeople’s lives and evidence-based.Theyare intendedtoaddress comprehensive, scientifi sensitive, respectful ofsexual andgenderdiversity, to sexualityeducationthatare rights-based,culturally The can befoundinAppendixVI. that already exist.Alistof recommended resources resources, curriculaandmaterialsfortrainingteachers The ‘howto’issuesare dealtwithinclassroom strategies tointroduce orstrengthen sexualityeducation. on the‘why’and‘what’issuesthatrequire attentionin This documentisnotacurriculum.Instead,itfocuses International Guidelinesare baseduponapproaches International Guidelinesare dividedintothree HowaretheInternational Guidelines structured? rst partexplainswhatsexualityeducation cally accurate,age-appropriate Curricula from 12countries wide rangeofresources. within theseInternationalGuidelinesare drawnfrom a objectives means exhaustive,thetopicsandlearning both in-schoolandoutofschool.Thus,whilebyno curricula across arangeofsettingsandaudiences, in somecasesrigorously evaluated,sexualityeducation The review yieldedadiversesampleofwidelyused,and databases, websitesandlistserves by keyinformantsandthrough searches ofrelevant existing curricula,guidelinesandstandards asidentifi was informedbyaspeciallycommissionedreview of The developmentofthetopicsandlearningobjectives review. were identifi times impactinguponbehaviour. Thesecharacteristics clarifying valuesandattitudes,increasing skillsandat found tobeeffective interms ofincreasing knowledge, education programmes were outlinedthathavebeen characteristics ofexistingandevaluatedsexuality other developedcountries.Furthermore, common countries, 47from theUnited Statesand11from around theworld;29studies were from developing behaviour. Thereview considered 87studiesfrom literature ontheimpactofsexuality educationonsexual a speciallycommissionedsystematicreview ofthe The developmentoftherationalewasinformedby 1.5 the as relying onprofessional guidancefrom expertsin inclusion withinpositivelyevaluatedcurricula,aswell Guidelines havebeenselectedonthebasisoftheir objectives intheseInternational 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, developedbytheSexualityInformationand In addition,theGuidelinesforComprehensiveSexuality identify commontopicsandrelatedobjectives. learning from educationalandbehaviourchangetheory, they fi eld. Thus,whiletheInternationalGuidelinesdraw International HowweretheInternational Guidelines developed? ed andveri fi 3 ed through independent were examinedinorder to 2 (seeAppendixV). ed to thiseffort. these communities considertobesensitive.Itishopedthat people inareas ofthecurriculumwhichparents and rights ofparents andtherightsofchildren andyoung and schoolmanagersare calledupontobalancethe an averageschoolsettingthisisimportant;teachers force normativeinstrument.Evenfor ofaninternational and non-bindingincharacterdonothavethe noted thattheInternationalGuidelinesare voluntary level.Atthesametime,itshouldbe at international highest qualitysafeguards, acceptabilityandownership recognised andlegitimateprotocol whichensures the engagement ofotherUNAIDSCosponsors.Thisisa fi contracting andconsultingwithleadingexpertsinthe In termsofprocess, they were developedby community.International Guidelinesintheinternational people willbesensitivetothelegalstandingofthese education andotherinstitutionsproviding foryoung withsettingpolicyin Decision-makers concerned this document. UNICEF, UNFPA andWHOhavealsoprovided inputfor gr The UnitedNationsPopulationFund(UNFPA) advisory February 2009 through aglobaltechnical consultation meetingheldin with recognised experts(see listinAppendixV),and were furtherdevelopedthrough keyinformantinterviews These available evidence. the world,andwillcontinuetobebasedonbest and willincorporatefeedbackfrom theirusersaround versions oftheInternationalGuidelineswillbeproduced are solidlyembeddedin practical experience.Future eld ofsexualityeducationandwiththesupport oup ofyoungpeopleandcolleaguesfrom UNESCO, International Guidelinesconstructivelycontribute International Guidelinesonsexualityeducation with expertsfrom 13different countries. future. and childbearingasexpectedpossibilitiesinthenear mobility, andthebeginningofadultlife,withmarriage For girls,pubertymaysignalanendtoschoolingand increased freedom, mobilityandsocialopportunities. and girls.Forboys,pubertycanbeagatewayto of socialaswellphysicalchangeforbothboys 2002), inmanycultures pubertyrepresents atime According totheWorld HealthOrganization(WHO, discomfort. because ofculturalnorms,theirownignoranceor to engageindiscussionofsexualmatterswithchildren and sexuality. Furthermore, parents are oftenreluctant orevenconfl with alternative teachers, mediaandpeers).Theseoftenpresent them sources ofinformationandvalues(e.g.from parents, communities, youngpeopleare exposedtoseveral includes valuesrelated togenderandsexuality. Inmany to thenextformsacriticalpartofsocialisation;it The transmissionofculturalvaluesfrom onegeneration within specifi 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 allplace substantialburdens on sense: HIVinfection,otherSTIs,(unsafe)abortionand health ofyoungpeoplemakessocialandeconomic young people.Ensuringthesexualandreproductive important contributorstotheburden ofdiseaseamong Sexual andreproductive ill-healthare amongthemost 2.1 2. Conference ReadyVersion Background Young people’s sexual and reproductive health c socio-economicandculturalcontexts. icting valuesaboutgender

5 Part 1 6 Part 1 Conference ReadyVersion behaviour in ourunderstandingofhumansexualityandsexual The pastfourdecadeshaveseendramaticchanges education. carefully inrelation totheevidencebaseforsexuality and programmatic interventions needtobeassessed 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 livingwith HIV, two-thirds ofwhom HIV/AIDS (UNAIDS,2008),more thantenmillionyoung According totheJointUnited NationsProgramme on acquire abetterunderstanding ofgenderandsexuality. which islargelysexuallytransmitted–weneededto rapidly understoodthat,inorder toaddress HIV– role inbringingaboutthis change,becauseitwas SRE%20fi Chapter 3, Section14.www.teachernet.gov.uk/_doc/13030/ Relationships Education(SRE) in Schools, Issues2008, Source: Fisher, J. andMcTaggart J. needs, evenindevelopedcountries’educationsystems. shows thescaleofchallenge inmeetingyoungpeople’s reviewing SREprovision yieldedimportantdata. The dataalso Involving astructure like the Youth Parliamentintheprocessof • • • only average. Otherkey fi or withafurther33percentdescribingitas ‘poor’ poor’ ‘very Relationships Education(SRE)theyhadreceived aseither says that40percentofyoungpeopledescribedtheSex and on questionnaire responses fromover 20,000youngpeople, A report published in2007by theUK Youth Parliament, based Box 1. Involving Young People their local sexual health service wastheir localsexuallocated. healthservice Just over halfofrespondents hadnotbeentoldwhere how touseacondom; 16-17 year oldfemalesreported nothaving beentaught 55 percentofthe12-15year oldsand57percentofthe taught anythingaboutrelationships; 43 percentofrespondents reported nothaving been nal.pdf orhttp://ukyouthparliament.org.uk/sre 4 . TheglobalHIVepidemichasplayeda 5 . ndings from the survey were that:ndings fromthesurvey Review ofSex and about HIVanditsprevention 15 to24hadaccurateandcomprehensive knowledge 40 percentofmalesand38femalesaged Survey datafrom sixty-fourcountriesindicatethatonly cite condomsasaneffective strategyforHIVprevention. protect againstHIV, only55percentofyoungwomen than 70percentofyoungmenknowthatcondomscan avoid exposure toHIV. WhileUNAIDSreports thatmore still lackaccurate,completeinformationonhowto men. According toUNAIDS (2006),manyyoungpeople countries, withwomengenerallylesswellinformedthan Knowledge aboutHIVtransmissionremains lowinmany status totheirpartners. not haveHIV. Manydidnotknowhowtodisclosetheir cent were inrelationships withasexualpartnerwhodid disclosed theirstatustosexualpartners;39per cent ofthoselivingwithHIVreported thattheyhadnot discouraged from becoming sexuallyactive.Sixtyper and reproductive healthservicesandare actively with HIVare oftendiscriminated againstbysexual 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 fi receive anyschool-basedHIVeducation.Furthermore, that atleasthalfofstudentsaround theworlddidnot maternal mortalitythanolder women. 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.Thisfi indicated thecoverageofHIVprevention inschoolswas v of ve fi fteen countriesreporting toUNAIDSin2006 6 reveals thatyoungpeople living gure fallswellshortofthe 7 . UNAIDS(2007)reported sustainable social backgrounds inways thatare replicable and reaching largenumbersof youngpeoplefrom diverse in school.Thus,schoolsprovide apracticalmeansof fi most countries,youngpeoplebetweentheagesof responsible choicesinour socialandsexuallives.In with theappropriate skills andknowledgetomake to adulthoodrequires beinginformedandequipped that governments guarantee the rights of young people guarantee therightsofyoungpeople that governments organizations,requirebodies andotherinternational human rightsstandards, asarticulatedbyUNgoverning for Reproductive Rights(2008)arguesthatinternational conventions (seeAppendixII).Forexample,theCenter as arightandarguethatthisissupportedbyspecifi now promote sexualandreproductive healtheducation health information(Biddlecom,2007).Someorganizations Young peoplewantandneedsexualreproductive 2.3 their adultroles andresponsibilities role toplayinpreparing children andyoungpeoplefor In thelargercontext,educationsectorhasacritical 2.2 and thebroader community. important issuesbetweenyoungpeople,trustedadults have thepotentialtopromote communicationabout other services(forexample,healthservices).Thus,they link children, parents, familiesandcommunitieswith also socialsupportcentres, trustedinstitutionsthatcan reproductive health.Inmanycommunities,schoolsare an opportunitytoprovide educationaboutsexualand school, makingthesettingevenmore importantas fi Moreover, inmanycountries,youngpeoplehavetheir contribute tomakingschoolshealthyforchildren point toacore setofcost-effective activitiesthatcan UNESCO, WHO,theUNICEFandWorld Bank and trustedsource ofinformation. Evidencefrom ve andthirteenspendrelatively largeamountsoftime rst sexualexperienceswhiletheyare stillattending Young people’s needs Theroleofschools sexuality education and entitlementto 9 . Teachers are likelytobethemostskilled 8 . Thetransition 10 . c age appropriate andrelevant. right balancebetweentheneedtoknowandwhatis process andgrowth, oflearning itiscrucialtostrikethe any teacherorparent in guiding andsupportingthe orientation. Giventhecomplexityoftaskfacing or stigmaanddiscriminationbecauseoftheirsexual is intheformofabusiverelationships, exposure toHIV their well-beingexistsinarangeofcontexts,whetherit a difference totheirlifechances.Thethreat tolifeand information andskillsonsexualityeducationthatmakes children andyoungpeople haveaspecifi education isinterpreted from thestandpointthat In theseInternationalGuidelinestheneedforsexuality secondary schools. and discriminationavailabletotheminprimary scientifi making comprehensive sexuality educationthatis to health,life,educationandnon-discrimination,by 2.4 imperatives shouldtakepriorityoverpersonalopinion. that goodscientifi Decision-makers withadutyofcare havetorecognise policy-makers andothersmaypersonallydisapprove. sexual lives:thisincludesthoseaspectsofwhich importance ofaddressing therealityofyoungpeople’s 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 fordesigningand of theirownsex.Theseare sensitiveandchallenging now orinthefuture, willbesexuallyactivewithmembers money, foodorshelter)coercion. Somestudents, this isthrough choice,necessity(e.g.inexchangefor people before theybecomesexuallyactive,whether The challengeforsexualityeducationistoreach young Conference ReadyVersion cally accurate,objectiveandfree from prejudice Addressing sensitive International Guidelinesemphasisethe issues c evidenceandpublichealth c needfor

7 Part 1 8 Part 1 Conference ReadyVersion Table 1. Commonconcernsabouttheprovision ofsexualityeducation thataresome typicalexamplesofconcerns expressed aboutintroducing orpromoting sexualityeducation). to address, orelsethere isnoclearguidanceaboutwhattoteachandhowit(seeTable 1,whichprovides to doso.Teachers’ personalorprofessional valuescouldalsobeinconfl 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,inmostcountriesthroughout 3. children oftheir ‘innocence’. Sexuality educationdeprives early sex. Sexuality educationleadsto Concerns 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 not foryoung children. good foryoung people, but Sexuality educationmay be taught inschools. sexuality educationbeing Parents will objectto about sexuality. educate ouryoung people and theextendedfamilyto It istherole ofparents religion. against ourculture or Sexuality educationis Buildingsupportforsexuality education Response Response Getting the right information thatisscientifi Getting therightinformation sexuality educationleadstolaterandmore responsible sexual behaviour. Research fromaround theworld clearlyindicatesthat, rather thanleadingtoearlysexual initiation, age anddevelopmentofachild. conceptssuch assafetyandconfi learning understanding principlesofhumanreproduction, exploring familyandinterpersonalrelationships and an earlyage. Sexuality educationlaysthefoundations–e.g. correct namesforpartsofthebody, learning their sexuality andtherefore need theskillstounderstandtheirbodies, relationships andfeelingsfrom sexual relationships. Children are aware ofandrecognise theserelationships longbefore theyacton objectives.Sexuality educationencompassesarange oflearning ofrelationships,grouping notonly andanemphasisonvalues. correct information peers, themediaorothersources. Goodqualitysexuality educationbalancesthisthroughtheprovision of children andyoungpeople willoftenreceive confl at anearlyage, issomethingtowhich allchildren andyoungpeopleare entitled.Intheabsenceofthis, are inextricably linked to universally accepted human rights. are inextricably linked touniversallyacceptedhumanrights. Guidelinesonsexuality educationsupportarights-basedapproachThese International inwhich values base inadynamic andrapidly changing fi presents anopportunitytoevaluate andstrengthen thecurriculum, teaching practice andtheevidence sexuality education. Whilst recognising thevalue oftheseefforts, Guidelines usingtheseInternational Ministries, schools andteachers inmanycountriesare already responding tothechallenge ofimproving professional developmentandsupport. the subjectinthecurriculum,education throughaddedemphasisonformalising aswellstronger ofsexuality educationintheclassroom. delivery Teachers shouldbeencouraged tospecialiseinsexuality sexuality education.Clearsectoral andschool policiesandcurriculahelptosupportteachers inthe Well-trained, supportedandmotivated ofgoodquality teachers are anessentialpartofthedelivery Guidelinesare builtupontheprincipleofage-appropriatenessreThese International qualifi andresponsible choicesinformed intheirsocialandsexual lives.Furthermore, teachers remain thebest institutions functionwell, youngpeopleare abletodevelopthevalues, skillsandknowledge tomake aboutsex,an appropriateenvironmentforyoungpeopletolearn relationships andHIV/STIs. When these Schools and educationinstitutionswhere 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 insome places, 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 Guidelinesare builtupontheprincipleofbeingculturallyThe International relevant aswellengaging ed and the most trusted providers of information andsupportformostchildrened andthemosttrustedproviders ofinformation andyoungpeople. eld. eld. cally accurate, non-judgemental, age-appropriateandcomplete, dence. These canthenbebuiltupongradually, inlinewiththe icting andsometimesdamagingmessagesfromtheir ict withtheissuestheyare beingasked fi dence andskills fl ected inthe are outofschool. content willbeequallyrelevant tothosechildren who focus specifi out ofschool.WhiletheseInternationalGuidelines is importantforallchildren andyoungpeople,in they refl youth-friendly, gender-sensitive, rights-based,andthat and designofprogrammes toensure thattheseare Young peopleneedtobeinvolvedinthedevelopment • Donors. Training institutionsforhealthprofessions; and • Media(localandnational); • NGOs,particularlythoseworkingonsexual and • 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 inbuildingconsensus ontheneedfor insurmountable. Ministriesofeducationhavetoplay Should oppositionoccur, itisbynomeans Opposition tosexualityeducationisnotinevitable. 3.1 understood. the voicesofyoungpeopleare rarely heard and many cases,especiallyaround suchsensitiveissues, considered asoneofthestrategies tobuildsupport.In especially betweenyoungpeopleandadults,couldbe Facilitating dialoguebetweendifferent stakeholders, reproductive healthwithyoungpeople; teachers, headteachersandtraininginstitutions; withtheneedsofyoungpeople; concerned them (includingyouthparliaments); Key stakeholders ect thereality oftheirlives.Sexualityeducation cally upon theschoolsetting,muchof and contraception. duration andconcurrency, aswelluseofcondoms number ofsexualpartners,agedifferences, coercion, sexual initiation,partnershipdynamicsincludingthe sex andgender-specifi Ideally, thiswillincludebothquantitativeandqualitative, factors associatedwithHIV/STIriskandvulnerability. be mostvulnerable,togetherwithstudiesonspecifi ofyoungpeople,includingthosethoughtto patterns other STIsandteenagepregnancy, sexualbehaviour assessments. ThisshouldincludelocaldataonHIV, evidence from thelocal/national situationandneeds education canbedevelopedonthebasisof A clearrationalefortheintroduction ofsexuality 3.2 Conference ReadyVersion 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 in theregion. andsecondary it acore area ofinstructionatbothprimary strengthening comprehensive sexuality educationandtomake education throughouttheregion. The declaration advocatesfor a mandatefornationalschool-based sexuality andHIV together inMexico Citytosignahistoricdeclaration affi ministers fromacrossLatin America andtheCaribbeancame and educationgoals.In August 2008, healthandeducation priority essentialtoachieving nationaldevelopment, health confi aroundtheworldA growingnumberofgovernments are Leading thecalltoaction Box 2. LatinAmerica: theircommitment tosexuality educationasa rming identities. aspects; respects diversityofsexual orientationsand 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 rming rming c

9 Part 1 10 Part 1 Conference ReadyVersion methods. and trainingintheuseofactive,participatorylearning sexuality educationwillusuallyalsoneeddesensitisation desensitisation. Teachers responsible forthedeliveryof health. Thisshouldincludevaluesclarifi 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 sexualharassmentandabuseamong and AIDS.Theseshouldclearlypromote confi the nationalstrategicplanandpolicyframeworkonHIV explicitly linkedtoeducationsectorplans,aswell national policyonsexualityeducationshouldbe and evaluation.Atthepolicylevel,awell-developed classroom deliverytogether withplansformonitoring 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,togenerate supportforprogrammes, by ministriesofeducationtoinformthedevelopment and/or Task Force Committeeshavebeenestablished In somecountries,NationalAdvisoryCouncils 3.3 Planning for implementation cto and cation dentiality Supporting pregnanttocontinuewiththeir learners • Procedures for responding toparental concerns; • • Parental Curriculumdeliverybytrainedteachers; involvement; • commitment to: education willclarifyandstrengthen theschool’s absence ofpre-existing guidance,apolicyonsexuality discrimination andgenderinequality. However, inthe AIDS payspecifi example, mostschool-basedpoliciesonHIVand defi It ispossiblethatsomeoftheseissuesmaybewell Protect andsupportteachersresponsible for • Setstandards ofappropriate behaviour;and • Setstandards onconfi • Anticipate and address sensitivitiesconcerning • Provide aninstitutionalframeworkfortheimple- • framework will: homophobia) hasanumberofadvantages.Apolicy (including sexualharassment)andbullying sexual andreproductive health,genderdiscrimination forexample, wide policiesorguidelinesconcerning, the frameworkofaclearsetrelevant school- Secondly, implementingsexualityeducationwithin programmatic interventions andthosethatfalter. teachers canmakethedifference betweensuccessful confl andgrowth.learning Inaclimateofuncertaintyor experience sexualityeducationthrough discovery, to taketheleadinhowchildren andyoungpeople a classroom, instructional leadership requires 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 attentiontoissuesofconfi dentiality; dentiality, teaching/learning process. teaching/learning each otherinimplementingaguidedandstructured possible scenario,teachersandparents 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 andthat 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 ofsexuality Many parents mayhavestrong viewsandconcerns 3.5 their skillsinparticipatoryandactivelearning. to buildtheircomfortandconfi service andrefresher trainingforclassroom teachers, pre-service trainingatteacher trainingcolleges,andin- curriculum. Furthermore, it shouldincludeplanningfor on theplaceofprogramme withinthebroader (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 • reproductive healthandotherservices. bullying; and stigma anddiscrimination,sexualharassmentor example, inthecaseofbreach ofcon for girlsandboys,othermeasures); (through provision ofclean,private,separatetoilets Parental involvement dence, andtodevelop fi dentiality, protect themfrom violence,exploitationandabuse. together withaccesstocommunityserviceshelp relevant informationandskills toprotect themselves, disabled, orphaned,orlivingwithHIV. Theyneed vulnerable. Theseincludethosewhoare displaced, groups ofchildren andyoungpeopleare particularly important intermsofchildprotection, sincesome link betweentheschoolandcommunityisparticularly abuse, gender-based violenceanddomestic crisis services forsexualandreproductive health,substance provide necessarylinksto otherresources, suchas Schools canbecometrustedcommunitycentres that 3.6 Conference ReadyVersion Schoolsascommunity resources 11 . This

11 Part 1 12 Part 1 4.1 Conference ReadyVersion on sexualbehaviours Table 2. Thenumberofsexualityeducationprogrammes withindicatedeffects behaviours suchashealth-seekingbehaviour, sexualharassment, sexualviolenceorunsafeabortion. that directly affect pregnancy andsexualtransmissionofHIVotherSTIs. Itdidnotreview impactonother than 30hoursoreven15hours.Thereview examinedtheimpactoftheseprogrammes onthosesexualbehaviours in schoolsandtheremainder were implementedincommunityorclinicsettings.Manywere verymodest,lastingless their righttoinformationaboutmanytopics.Allwere curriculum-basedprogrammes, 70percentwere implemented unintended pregnancy orSTIs, includingHIV; theywere notdesignedtoaddress thevariedneedsofyoungpeople or description ofthecriteriaforselectionevaluationstudies).Allprogrammes were designedtoreduce countries, 47from theUnited Statesand11from otherdevelopedcountries(pleaserefer toAppendixIVforadetailed The review considered 87studiesfrom around theworld(seeTable 2below);29studieswere from developing behaviour. Guidelines. ItwascommissionedbyUNESCOin2008aspart ofthedevelopmenttheseInternational This sectionpresents asummary ofthefi 4. • Frequency ofSex • • • Initiation ofSex • • • Number ofSexual Partners • • • Use ofCondoms • • • Sexual Risk-Taking • • • Use ofContraception • • Decreased frequency Had nosignifi Delayed initiation Had nosignifi Hastened initiation Icesd frequency Increased Dcesd number Decreased Had nosignifi Icesd number Increased Icesd use Increased Had nosignifi Dcesd use Decreased Rdcd risk Reduced use Decreased Had nosignifi use Increased Had nosignifi Icesd risk Increased Theevidencebaseforsexuality education 2008Reviewoftheimpactsexuality educationonsexual behaviour cant impact cant impact cant impact cant impact cant impact cant impact Countries (N=29) Developing 16 14 522 38% 23 2 15 4 0000 6 00115 5 00008 7 0000 1 010134181416 10013 ndings ofarecent review oftheimpactsexualityeducationonsexual United States (N=47) 17 15 11 12 14 17 15 6 9 Countries (N=11) Other developed 7 0 1 0 0 2 4 0 1 All Countries 762% 37 031% 10 166% 21 644% 16 056% 20 340% 23 560% 35 653% 16 343% 13 (N=87) 5 4 0 3 0 0 7 3 3 0 % % % % % % % % percentages ofresults in theundesired direction are none ledtoanincreased numberofpartners.Thesmall partners, 56percenthadnoimpactinthisregard, and of theprogrammes decreased thenumberofsexual the frequency ofsexualintercourse. Finally, 44percent 66 percenthadnoimpactand3increased intercourse (whichincludesreverting toabstinence),while programmes ledtoadecrease inthefrequency ofsexual of sexualintercourse. Notably, noneoftheprogrammes hastenedtheinitiation important sub-sample,while62percenthadnoimpact. intercourse amongeithertheentire sampleoran intercourse, 38percentdelayedtheinitiationofsexual education programmes upontheinitiationofsexual Of sixtystudiesthatmeasured theimpactofsexuality 4.2 behaviour oftenshared commoncharacteristics. the programmes thatwere effective atchangingsexual often thesameorsimilarresults were obtained;and4) when thesameprogramme wasstudiedmultipletimes, similar tothosewithweakerevaluationdesigns;3) very strong research designsandtheirresults were number ofstudies;2)somethestudiesemployed experimental orquasi-experimentaldesigns,isalarge from thesestudiesforseveralreasons: 1)87,allwith Despite theselimitations,there ismuchtobelearned counteract eachother. results are positive.Fortunately, someofthesebiases are more likelytoacceptarticlesforpublicationwhen support theirtheories.Also,programmes andjournals more likelytotrypublish articlesifpositiveresults that affect thepublication ofstudies:researchers are biological markers.Finally, there were inherent biases still measured impactonSTI orpregnancy rateswith impact uponeitherSTIorpregnancy ratesandfewer multiple testsofsignifi statistically underpowered. Mostdidnotadjustfor barely adequateevaluation designsandmanywere same-sex sexualbehaviour. Somestudieshadonly for gayorlesbianotheryoungpeopleengagingin respective programmes. Noneexaminedprogrammes studies suffered from aninadequatedescriptionoftheir were conductedindeveloping countries.Some by implication,tothereview. Too fewofthestudies There were anumberoflimitationstothestudiesand, Limitations andstrengthsofthereview Impactonsexual behaviour cance. Fewstudiesmeasured Similarly, 31percentofthe more thanathird decreased thenumberofsexual • aboutathird decreased thefrequency ofsexual • more thanathird delayedthe initiationofsexual • behaviour. Onthecontrary: condom andcontraceptiveusedonotincrease sexual intercourse asthesafestoption andthatalsodiscuss programmes thatemphasise nothavingsexual strong evidencethat,despite fearstothecontrary, Thus, takentogether, thesestudiesprovide very the positiveresults were probably theresult ofchance. that were examined.Alsoby thesameprinciple,afewof chance, giventhelargenumberoftestssignifi equal to,orlessthan,thatwhichwouldbeexpectedby 4.3 positive impactsuponbehaviour isquitestrong. experimental designs.Thus, theevidencefor studies are restricted tolargestudieswithrigorous sexual risk-taking,are essentiallythesamewhen activity, namelyoncondomandcontraceptiveuse 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 foundtoincrease it. decreased sexualrisk-taking;43percenthadnoimpact risk-taking’. Fifty-three percentoftheprogrammes used. Thesemeasures were grouped andlabelled‘sexual sexual partnerswithwhomcondomswere notalways sexual intercourse withoutcondomsorthenumberof For example,somestudiesmeasured thefrequency of as condomorcontraceptiveuseinthesamemeasure. that includedboththeamountofsexualactivityaswell contraceptive use.Somestudiesassessedmeasures impact, and7percent(asingleprogramme) reduced also increased contraceptiveuse;53percenthadno decreased condomuse.Fortypercentofprogrammes condom use,whilesixtypercenthadnoimpactandnone Forty percentofprogrammes were foundtoincrease Conference ReadyVersion important sub-samples. partners, eitheramongtheentire sampleorin intercourse; and intercourse; Impactoncondomand contraceptive use cance cance

13 Part 1 14 Part 1 Conference ReadyVersion 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 theyhadsuffi markers failedtodemonstratesignifi markers. However, otherstudiesemployingbiological positive results were demonstratedbybiological rates, agreater numberdid not.Atleasttwoofthe that hadasignifi While asmallnumberofstudiesdidevaluateprogrammes presented inTable 2. having adequatestatisticalpower, theseresults are not rates. Becausemanystudiespresent results without the impactofprogrammes uponSTIandpregnancy larger samplesare needed tomeasure adequately pregnancy orchildbearing require thatconsiderably use, thedistributionsofoutcomemeasures ofSTI, frequently thansexualactivity, condomorcontraceptive Because STI,pregnancy and childbearingoccurless 4.4 Magnitudeandduration ImpactonSTI, pregnancy of impact and birthrates cant reduction inSTIand/orpregnancy cient statistical power. 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 asignifi concert withmutuallyreinforcing community-basedelements well-designed, curriculum-basedprogrammeimplementedin Whatever theexplanation, thestudy isacautionthateven difference inrates ofpregnancy, STI andHIV. not have changed behaviours tosuch anextent as tomake a impact onpregnancy, STIsandHIV. Third, theprogrammemay have changed thespecifi programme mayhave changed riskbehaviours, butmaynot may nothave actuallychanged sexual behaviour. Second, the sexual behaviour mayhave been biasedandtheprogramme explanations forthis.First, study participants’reports of other STIorpregnancy rates. There are atleastthree possible However, theprogramme didnothave 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 c behaviours thathave thegreatest cant impactonpregnancy, STIor implemented inclassroom settings. evaluated incommunitysettings,butwere subsequently condom use,orwhentheywere designedforand when theyomittedactivitiesthatfocusedonincreasing effective whentheirduration wasshortenedconsiderably, positive results. Programmes were lesslikelytoremain the sameordifferent researchers, theyconsistentlyyielded in onestudywere replicated insimilarsettings,eitherby programmes foundtobeeffective atchangingbehaviour States programmes, allofwhichwere conductedintheUnited programs describedabove,elevenabstinence-only In additiontotheeffects ofthesexualityeducation 4.8 are encouraging Results from severalreplication studiesintheUnitedStates 4.7 studies, tworeported thattheevaluatedprogramme impact forshorterperiodsoftime.Ofthese weaker statisticalanalysisormeasured programme not alwayswell-matched.Somehadhighattritionrates, experimental designswithcomparisongroups thatwere were methodologicallyweaker. Theseemployedquasi- Studies oftheremaining abstinence-onlyprogrammes intercourse. of sexualpartners,orcondomuseduring abstinence intheprevious twelvemonths,number intercourse, ageofinitiationsexualintercourse, that thecurriculahadnoeffects oninitiationofsexual and usedstatisticalanalyses.Resultsdemonstrated experimental designs,measured long-termimpact, of thestudieswere particularlyrigorous: employed 13 Abstinence-only Resultsofreplication , mettheselectioncriteriaforreview. Six programmes studies 12 . These studies demonstrate that when . Thesestudiesdemonstratethatwhen fi ve weaker ve young womenandoldermales. amount ofunprotected sexualintercourse between to beimportantbothinitselfandasanindicatorofthe (Dupas, 2007).Thisbiologicalmarkerwasperceived the dangerofhavingsexualintercourse witholdermen likely tobeHIV-positive); andshowingavideoabout having sexualintercourse witholdermen(whoare more age andsex;emphasisingtheriskofyoungwomen men: providing HIVprevalence rates,disaggregated by the rateofpregnancy amongteenagegirlstoolder reported thatthefollowingallsignifi use condoms(Dufl from HIV, studentswere subsequentlymore likely to an essayaboutwaystheycouldprotect themselves should betaughthowtousecondomsandthenwrote people observedadebateonwhetherschoolchildren schools. Thefi programmes, integratedwithinmultiplecoursesin within larger, more comprehensive HIVprevention studies considered theimpactofparticularactivities activities withincurriculum-basedprogrammes. Two Few studieshavemeasured theimpactofspecifi 4.9 a signifi either condomorothercontraceptiveuse,nonefound quasi-experimental designsthatmeasured impacton people. Ofthestudieswitheitherexperimentalor number ofsexualpartnersamongparticipatingyoung found thatthecurriculumresulted inareduction inthe programme impactuponthe numberofsexualpartners of sexualintercourse. The singlestudythatmeasured reported thattheprogrammes reduced thefrequency who hadpreviously had sexualintercourse. Both frequency ofsexualintercourse amongyoungpeople Two ofthesemeasured programme impactonthe showed nosignifi delayed sexualinitiation.Thethree remaining studies Conference ReadyVersion cant effect. cant Specifi activities rst studyfoundthat,whenyoung cant effect uponsexualbehaviour. o c curriculum-based et al.,2006).Thesecondstudy cnl decreased cantly c

15 Part 1 16 Part 1 Conference ReadyVersion Curriculum-basedprogrammes implementedin • 4.11 sexual behaviour. factors, whichthenpositivelyaffected youngpeople’s actually changedbehaviourbyhavinganimpactonthese there isconsiderableevidencethateffective programmes an impactonadolescentsexualdecision-making.Thus, have studies havedemonstratedthatthesefactors,inturn, that particularprogrammes improved thesefactors.Other It shouldbeemphasisedthatsomestudiesdemonstrated • • • • • • • • contraceptive usetypicallyfocusedon: or reducing sexualactivity orincreasing condomor Those programmes thatwere effective ateitherdelaying strove tochangeotherfactors thataffect sexualbehaviour. to reduce sexualriskand employed alogicmodelalso primary role ofschools.Programmes thatwere designed This isimportant,becauseincreasing knowledgeisa aspects ofsexualityandriskpregnancy orHIV/STIs. been studiedincreased knowledge aboutdifferent Nearly allsexualityeducationprogrammes thathave 4.10 reducing HIV, STIorpregnancy rates. insuffi the community, theseprogrammes are sometimes However, isolatedfrom broader programmes in necessarily always)reduce sexualriskbehaviour. important componentthatcanoften(butnot schools orcommunitiesshouldbeviewedasan and potentiallywithsexualpartners. Communication e.g.withparents orotheradults restrict sexualactivityorpartners; Intention toabstainfrom sexualintercourse orto use condoms; Self-effi activity, condomsandcontraception; Perceptions ofpeernorms e.g.aboutsexual Attitudes aboutcondomsandcontraception; abstinence; Personal valuesaboutsexualintercourse and pregnancy; Perceptions ofriske.g.HIV, otherSTIsandof and pregnancy, includingmethodsofprevention; Knowledge e.g.ofsexualissues,HIV, otherSTIs Summary ofresults Summary Impactoncognitivefactors cient tohaveasignifi cacytorefuse sexualintercourse andto cant impactintermsof Thesexualityeducationprogrammes studiedhad • Evenifsexualityeducationprogrammes improve • Comparativeanalysisofeffective andineffective • More thanone-fourthofthestudiesimproved • 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 theirriskmay knowledge, skillsandintentionstoavoidsexual put youngpeopleatriskofSTIsandpregnancy. can beeffective atchangingthebehavioursthat programmes thatincorporatekeyrecommendations programmes provides strong evidencethat consistent results. research designsandreplication studieswith behavioural results include studieswithstrong people. Encouragingly, thesestudieswithpositive two ormore sexualbehaviours amongyoung important sub-sample. behaviour amongeithertheentire sampleoran thirds ofthemdemonstrate positiveresults on demonstrate increased knowledge andabouttwo- people. Rather, itcanbebothrealistic andeffective. who are sexuallyactiveis notconfusingtoyoung abstinence togetherwithuseofprotection forthose contraception. Inotherwords, adualemphasison increase theuseofcondoms orotherformsof programmes, todelaysexual intercourse andto also demonstratethatitispossible,withthesame hasten orincrease sexual behaviour. Thestudies have negativeeffects: in particular, theydidnot years. Whengivingyoung peopleclearmessages covered inanage-appropriate manneroverseveral To different maximiselearning, topicsneedtobe Include several years. 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 Implementprogrammesthatinclude atleast 2. who are more likelytobeinschool. numbers ofyoungpeople,especiallyyoungerchildren places, schoolsare theeasiestplacetoreach large that wasimplementedinschools.Moreover, inmany at leastincludedanimportantcurriculumcomponent on behaviourhavebeenimplementedinschools,or the programmes thathadlong-termpositiveeffects clinic andcommunitysettings.However, amajorityof Programmes havebeenfoundtobeeffective inschool, Implementprogrammesinschoolsandother 1. skills andimpactinguponbehaviour knowledge, clarifyingvaluesandattitudes,increasing have beenfoundtobeeffective intermsofincreasing of evaluatedsexualityeducationprogrammes that This sectionsetsoutthecommoncharacteristics 5. and verifi 3b). Thesecharacteristicsbuilduponthoseidentifi 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 fortwo orthree yearsandthen Thus, studentscouldbeexposedtothecurriculum or community-wideactivitiesoversubsequentyears. these programmes have also implementedschool- concepts overthecourseofseveralyears.Afew It alsomakesitpossibletoreinforce important provided thanmightotherwise havebeenpossible. or evenyears,later. Thisenablesmore sessionstobe followed upwith‘booster’sessionsdelivered months, sessions havebeenprovided duringthefi years, orelsetheyare programmes inwhichmost sequential sessionsoverthecourseoftwoorthree years follow-uphaveeitherinvolvedtheprovision of to haveenduringbehaviouraleffects attwoormore messages overtime.Mostoftheprogrammes found about behaviour, itisalsoimportanttoreinforce those attitudes andskillsrequired toavoidthem. before goingontoaddress thespecifi by emphasisingsusceptibilitytoandseverityofthese, motivation toavoidSTI/HIVinfectionandpregnancy effective curriculafocusfi Topics shouldbetaughtinalogicalsequence.Many 4. among those groups and emphasise the need for young among thosegroups andemphasisetheneedforyoung attention tothehighratesof HIV, otherSTIsorpregnancy specifi students. Someeffective curriculahavebeendesignedfor with thecommunity, culture, ageand sexualexperienceof To bemaximallyeffective, curriculamustbeconsistent Employactivities, instructionalmethodsand 6. re or community, followedbyaperiodofdiscussionor students inataskoractivity, conductedintheclassroom Typically thesepromote theactiveinvolvementof been usedintheimplementationofeffective curricula. A broad rangeofparticipatoryteachingmethodshave Employeducationallysoundmethodsthat 5. need tobematchedspecifi Conference ReadyVersion

ﬂ ection inorder todrawoutspeciﬁ c racialorethnicgroups. Theseprogrammes 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 ReadyVersion gender inequalitiesandstereotypes. Forexample,they effective curriculaneedtoexamineandaddress these In order tobeeffective atreducing sexualriskbehaviour, peers tofulfi 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 comfortablywiththeir with relevant informationorelsehelpthemacquire Some programmes prepare parents byproviding them more sensitiveones. begin withrelatively safetopicsandprogress towards parents orothertrustedadults.Suchassignmentscan homework assignmentstodiscussselectedtopicswith communication aboutsexualityistoprovide student The mosteffective way to increase parent-to-child Include homeworkassignmentstoincrease 7. with-men develop specifi with-men, efforts are underwayinsomecountriesto higher ratesofHIVinfectionamongmen-who-have-sex- condom iftheyhavesexualintercourse). Giventhemuch intercourse whentheydonot wanttoandalwaysusinga and incontrol ofsexualsituations (i.e.bynothavingsexual women, emphasisingthatyoungwomencanbepowerful Other curriculahavebeendesignedspecifi being responsible forthemselves andtheircommunities. people toavoidunprotected sexualactivityasawayof the contentandteachingapproach. communication withparentsorotheradults. 16 . l malestereotypes. c curriculaforyoungmen-who-have-sex- cally foryoung entrenched genderinequality andstereotyping. also contributeinasmallwaytothereduction of intercourse inthosesituations. Suchactivitiesmight methods ofavoidingunwantedorunprotected sexual young women(ormen)andgenerateeffective need todiscussthespecialcircumstances facedby comply withexistingpolicyandpractice. sequencing, testingandotherrequirements inorder to review andapproval, teacheraccreditation, grade-level These programmes mayneedtoundergooffi 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 amatterof policies are inplace,demonstrating thatthedelivery sexuality educationmakesitimportantthatsupportive The sensitiveandsometimescontroversial nature of Ensurethatasupportivepolicy environmentis 9. in supportofsuchefforts is notyetavailable. need tobeaddressed, even ifarigorous evidencebase grammes, thefollowingkeycontextualfactorsalso In additiontothesecharacteristicsofeffective pro- to consider Important contextual factors in place. cial 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 re demonstrate positiveeffects onbehaviour. However, this adult-led (ascompared topeer-led) programmes education curricula.There isstronger evidencethat effi Debate continuesregarding therelative potential effectively delivered bybothgroups ofeducators. Studies havedemonstratedthatprogrammes canbe to community-basedreproductive healthservices. regularly updatedinformation;andtheycanbelinked participatory activities;theycanbeprovided with trained tocoverthissensitivetopicandimplement education educatorsinclude:theycanbespecially subjects. Theadvantagesofusingspecialistsexuality integrate sexualityeducationmessagesintodifferent established relationshipsandtheycan withlearners; and trustedbythecommunity;theyhavealready are partoftheschoolstructure; theymaybeknown general classroom teachers includethefollowing:they the relevant classesinthe schools.Theadvantagesof 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 a transparent process thatidentifi who delivercurriculashouldbeselectedthrough impact ontheeffectiveness ofthecurriculum.Those The qualitiesoftheeducatorscanhaveahuge Selectcapableandmotivated educatorsto 10. fl cacyofpeer-led versusadult-leddeliveryofsexuality ects thelargernumberofstudiesthathavefocused implement thecurriculum. es relevant and training shouldbesolicited. At theendoftraining,participants’feedbackon be taughtbyexperiencedandknowledgeabletrainers. health andHIVstatus,ifappropriate. Finally, itshould address abouttheirsexual teachers’ownconcerns and raisequestionsissues.Ifpossible,itshould and toallowparticipantstimepersonalisethetraining cover themostimportantknowledgecontentandskills of teachingtoexams.Itshouldlastlongenough communities e.g.verylargeclasssizesandpressures It shouldaddress challenges thatwilloccurinsome curriculum completelyandwithfi Itshouldencourageeducatorstoteachthe learners. their personalvaluesandthehealthneedsof The trainingshouldhelpeducatorsdistinguishbetween increase theconfi rehearse keylessonsinthe curriculum.Allofthiscan be implemented,andshouldprovide opportunitiesto and skills,shouldbebasedonthecurriculumthatisto should providecontent agoodbalance betweenlearning and providemethods, practiceinparticipatory learning should havecleargoalsandobjectives,teach and thusspecialisedtrainingisimportant.This methods involves bothnewconceptsandlearning For teachers,deliveringsexualityeducationoften qualitytrainingtoeducators. Provide 11. made totheschool’s programme. education sothatanynecessaryadaptationscanbe of importantdevelopmentsinthefi of theirwork.Supervisorsshouldalsokeepabreast and challengingsituationsastheseariseinthecourse teachers haveaccesstosupportinresponding tonew parts thatoftenmaybepartofexaminations),and all partsare fullyimplemented(notjustthebiological the curriculumisbeingimplementedasplanned,that involved indeliveringit.Supervisorsshouldmakesure encouragement, guidanceandsupporttoteachers in manyschools,schoolmanagersshouldprovide Because sexualityeducationisnotwellestablished on-goingmanagement, Provide and supervision 12. Conference ReadyVersion oversight. dence andcapabilityoftheeducators. delity, not selectively. not delity, eld ofsexuality

19 Part 1 20 Part 1 Conference ReadyVersion to reduce sexualriskbehaviour, thenthecurriculum curricula. Inaddition,ifprogrammes are designed be involvedindevelopingorselectingandadapting people familiarwiththisresearch andknowledgeshould an extensivebodyofresearch andknowledge.Thus, fi Just likemathematics,science,languagesandother Involvemultiplepeoplewithexpertise inhuman 14. completed toincrease effectiveness: maximum effectiveness. Thefollowingstepsshouldbe objectivesinthenextsectionwillnotensurethe learning Simply incorporatingtheprinciplesaboveandcovering curriculum canhavealargeimpactonitseffectiveness. The process ofdevelopingorselectingandadaptinga 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 separatestudents intosame-sexgroups, positive reinforcement ofstudentparticipation.Some promote participation,some curriculaalsoencourage of others;andmaintainingconfi 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 aconducive environment forsexuality activities, theyneedtofeelsafe.Itistherefore essential comfortable participatinginsexualityeducationgroup In order forstudentstobe able topayattentionandfeel Createasafeenvironmentforyouthto 13. elds, humansexualityisanestablishedfi sexual behaviour. sexuality, sexual healthandyoungpeople’s education. participate andlearn–linkwithquality dentiality. Inorder to eld basedon to address thosefactors. cognitive factorsaffect those behaviours,andhowbest at different ages,whatenvironmental andinternal behaviours youngpeopleare actuallyengagingin developers mustbeknowledgeableaboutwhatrisky or similarpopulations. well asreviews ofresearch datafrom thetargetgroup interviews withprofessionals whoworkwiththemas assessed through focusgroups withyoungpeopleand The needsandassetsofyoungpeoplecanbe address defi programmes shouldbuildontheseassetsaswell knowledge, positiveattitudesandskills.Thus,effective It isalsoimportanttobuilduponyoungpeople’s existing they mustbeidentifi programmes shouldstrivetoaddress thesereasons, intercourse. Becauseeffective sexualityeducation avoid unwanted,unintendedandunprotected sexual attitudes andskills,theirreasons forfailingto and agegroups intheirknowledge,beliefs, are alsomanydifferences across communities,settings people intermsoftheirneedsregarding sexuality, there While there isconsiderablecommonalityamongyoung Assessrelevant needsandassetsofthetarget 16. in allactivitiesduringpilot-testing. play scenariosmore realistic, andsuggestrefi activities thataddresshelpmakerole- such concerns, and commonlyheldbeliefsaboutsexuality, suggest they canidentifysomeoftheirparticularconcerns multiple roles thatyoungpeople canplay. Forexample, play arole indeveloping thecurriculum.There are to youngpeopleandmore effective ifyoungpeople Sexuality educationprogrammes canbemore attractive Involveyoungpeopleinthedevelopmentof 15. examples ofpeoplewhodeveloped curriculathatcould characteristic mayseemobvious, there are numerous This isanimportantstepforallprogrammes. Whilethis Designactivitiessensitivetocommunity 17. group. curriculum. supplies). (e.g. stafftime, staffskills, facility spaceand values and consistentwithavailable resources cits. ed. nements curriculum: 1)theyidentifi rates, usedaclearfour-step process for creating the especially thosethatreduced pregnancy orSTI effective programmes thatchangedbehaviour, and developers toplananddesignaprogramme. Most A logicmodelisaprocess ortoolusedbyprogramme Use alogicmodelapproachthatspecifi 1. achieving behaviourchange for Characteristics necessary rights. (see Table 3a).Characteristic19onlyaddresses human address humanrightsandleadtobehaviourchange Programme characteristics1-18outlinedabove acomprehensivearrayoftopicsthat Cover 19. 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 opportunitytofi 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 notfullyimplemented becausetheywere learning objectivesinPart II). address theneedsofyoungpeople(see programme ismeetingtheirneeds. feedback fromthelearnersabouthow to changethoseriskandprotectivefactors. affecting thosetypesofbehaviour, andactivities those goals, theriskandprotectivefactors health goals, thetypesofbehaviouraffecting ne-tune theprogramme aswell ed thehealthgoals(e.g. es the or basisfortheireffective programmes. to changeeachfactor. Thislogicmodelwasthetheory norms, skills,etc);and4)theycreated multipleactivities that affect thosebehaviours (e.g.knowledge,attitudes, identifi and HIV/STIratesthattheycouldchange;3) identifi reducing unintendedpregnancy orHIV/STIs);2)they that addressed similarcommunitiesandyoungpeople. programmes thatchangedbehaviour, especiallythose they needknowledgeaboutothersexualityeducation methods forchangingthosefactors.And,ofcourse, affecting sexualbehaviourandeffective teaching that theyare profi methods toaddress eachof thosefactors.Thisrequires curriculum developersmustuseeffective instructional the factorsprogramme willaddress. Then,the about thefactorsaffecting sexualbehaviourtoidentify curriculum developersmustusetheoryandresearch To create programmes thatreduce sexualriskbehaviour, Involvemultiplepeoplewithexpertise in 2. and unintendedpregnancy. curricula motivateyoungpeopletowantavoidSTIs occurrences. Intheprocess ofdoingthis,effective are negativeconsequencesassociatedwiththese pregnant (orofcausingapregnancy), andthatthere are potentiallyatriskofHIV, otherSTIsorofbecoming unprotected sexualintercourse onaregular basisthey messages aboutthesegoals:i.e.ifyoungpeoplehave of theseoccurrences. Effective curriculagiveclear STIs orpregnancy) andthenegativeconsequences young people’s susceptibility(forexample,toHIV, other relation tosexualityeducation,thismeansfocusingupon Effective curriculaare focusedcurricula.Specifi Focusonclear goalsindeterminingthe 3. Conference ReadyVersion 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 thespecifi cient intheory, psychosocialfactors c behavioursthataffected pregnancy cally in cally

21 Part 1 22 Part 1 Conference ReadyVersion they willbeconsistentwith themessage.Giventhat curriculum are designedtochangebehaviourssothat protective behaviours.Infact,mostactivitiesinthe ways, reinforce clearandconsistentmessagesabout effective programmes repeatedly, andinavarietyof characteristics ofeffective programmes. Nearlyall behaviours appearstobeoneofthemostimportant Providing clearmessagesaboutriskandprotective Giveclear messagesaboutbehaviours to 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,analor oral).Iftheydohavesexual young peopleneedtoavoidunprotected sexual To eliminatetheriskofacquiringHIVorotherSTIs, Focusnarrowlyonspecifi 4. testing, forexample. These havefacilitatedtheuseofcontraceptionandSTI close linkageswithnearbyreproductive healthservices. A feweffective programmes haveestablisheddirect and treatment forSTIs). cost andconfi specifi to obtainingorusingthese,forexample,identifying correctly. waysofovercoming Theyalsolearn barriers howtousecondomsorcontraceptives people learn and explored copingstrategies.Duringsessions,young lead tounwantedorunprotected sexualintercourse Curricula haveidentifi people andsuggestedwaysofresponding tothis. the pressures tohavesexualintercourse facingyoung contraceptive use.Forexample,theyhaveidentifi intercourse, havingfewerpartnersandcondomuse variety ofways.First,theytalkexplicitlyaboutsexual Effective curriculafocuson particularbehavioursina else useaneffective method ofcontraception. 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 specifi ed c sexual and c situationsthatcould ed consistent withthesevalues. specifi do appealtothesevalues,theymakeveryclearthe responsible’, or‘respect Whenprogrammes yourself’. to importantcommunityvaluese.g.‘beproud’, ‘be intercourse. Someprogrammes identifyandappeal should usecontraceptioneverytimetheyhavesexual prevention tendtoemphasise thatyoungpeople including HIV. Programmeswithpregnancy concerned programmes encouragetesting andtreatment forSTIs often implicitlyinreturnforsexualintercourse). Other of ‘sugardaddies’(oldermenwhooffer giftsortreats, Saharan Africancountriesalsoemphasisethedangers partners. Culturally-specifi being faithfulandavoidingmultipleorconcurrent sexual partner. Someeffective programmes alsoemphasise every timetheyhavesexualintercourse withevery either avoidsexualintercourse orelseuseacondom messages disseminatedare thatyoungpeopleshould to reduce HIVandother STIs,themostcommon the majorityofeffective programmes are designed 6. Address specifi access reproductive health services. cognitivefactors,buttheyalsodescribehowto internal especially thoseinschools,typicallyfocusprimarilyon support services.Curriculum-basedprogrammes, such asaccesstoadolescent-friendlyhealthandsocial factors, attitudes, skillsandintentions,aswellexternal such asknowledge,values,perception ofpeernorms, behaviour. cognitivefactors, Theseincludeinternal on youngpeople’s decision-makingaboutsexual Risk andprotective factorshaveanimportantimpact Focusonspecifi 7. impact ofdrugsandalcoholonsexualbehaviour. sexual intercourse, itisimportantalsotoaddress the where drugand/oralcoholuseleadstounprotected avoiding andgettingoutofthem.Inthosecommunities sexual intercourse andtorehearse strategiesfor young peopleare likelytobemostpressured tohave themselves, toidentifythespecifi It isimportant,ideallywiththeinputofyoungpeople attitudes, norms, skills). based programme(e.g. knowledge, values, that areamenabletochangebythecurriculum- that affectparticularsexual behavioursand them. and howtoavoidthesegetoutof unwanted orunprotectedsexual intercourse c sexualandprotective behavioursthatare c situationsthatmightleadto c riskandprotectivefactors c messagesinsomesub- c situationsinwhich parents. homework assignments,includingcommunicationwith have beenexplored through surveys,role playsand mutually faithfulsexualrelationships. Thesevalues demonstrating affection; andbeinginlong-term,loving, following values:abstinence;non-sexualwaysof behaviour. Effective programmes havepromoted the Personal valueshavesignifi Addresspersonalvalues abouthavingsexual 11. concepts ofsusceptibilityandseverity. statistical andotherfactualinformationinexploringthe playing haveallbeenfoundtobeusefuladjuncts pregnancy. Personaltestimony, simulations androle and theseverityofHIV, otherSTIsandunintended Effective curriculafocusonboththesusceptibilityto Addressperceptionsofrisk(especially 10. of condomsorotherformscontraception. exaggerating norunderstatingtherisksoreffectiveness based, scientifi Information withinacurriculumshouldbeevidence- 9. Provide scientifi unwanted sexualintercourse. intercourse orpossiblesituations thatmightleadto self-effi risk orprotective factors e.g. role playingtoincrease strategies thatare designed tochangetheassociated In addition,theactivitiesneedtoincludeinstructional usually lastforatleasttwelvetotwentysessions. needed. Thisisonereason why successfulprogrammes each riskandprotective factor; thus,manyactivitiesare Multiple activitiesare usually necessarytoaddress Implementmultiple, educationally sound 8. partners. about havingsexual intercourseandmultiple and perceptionoffamily andpeernorms intercourse and/orhavingmultiplepartners susceptibility). targeted riskandprotectivefactors. activities designedtochangeeachofthe methods ofprotection. intercourse andtheeffectivenessofdifferent about therisksofhavingunprotectedsexual cacy andskillstorefuse unwantedsexual cally accurateandbalanced,neither cally accurateinformation cant impactonsexual change (seeTable 3b). Programme characteristics1–13allleadtobehaviour available. demonstration andvisitstoplaceswhere theyare and acquisitionskillsare typicallyacquired through in progressively complexscenarios.Condomuse with elementsofeachskillidentifi situations, iscommonlyusedtoteachtheseskills partner. Roleplaying,representing arangeoftypical correctly. Thefi contraception; andtheabilitytoobtainusethese intercourse; theabilitytoinsistonusingcondomsor to refuse unwanted,unintended orunprotected sexual intercourse, youngpeople need thefollowing:ability In order toavoidunwanted orunprotected sexual Addressbothskillsandself-effi 13. these barriers condom andthendiscussedmethodsofovercoming to useacondom,oranydiffi possible embarrassmentwhenaskingone’s partner use e.g.diffi contraception andidentifi to explore theirattitudes towards condomsand their effectiveness. They have alsohelpedstudents these, togetherwithaccurateinformationabout programmes havepresented clearmessagesabout condom andcontraceptiveuse.Thus,effective Similarly, personalvaluesandattitudesalsoaffect Addressindividualattitudesandpeernorms 12. Conference ReadyVersion those skills. towards condomsandcontraception. culties obtaining andcarryingcondoms, rst two require communicationwitha ed perceived barrierstotheir culties actuallyusinga ed before rehearsal cacy touse

23 Part 1 24 Part 1 Conference ReadyVersion behaviour change that address human rightsandleadto Table 3a. Summaryofcharacteristics Pilot-testtheprogrammeandobtainon-going feedback 18. Designactivitiesconsistentwithcommunityvalues and 17. Assessrelevant needsandassetsofthetarget group. 16. Involveyoungpeopleinthedevelopmentof 15. Involvemultiplepeoplewithexpertise inhumansexuality, 14. Create asafeenvironmentforyouthtoparticipateand 13. Provide on-goingmanagement, andoversight supervision 12. Provide qualitytraining toeducators. 11. Selectcapableandmotivated educatorstoimplement 10. Assure asupportivepolicy environmentisinplacefor 9. Wheneverappropriate, address genderissuesand 8. Includehomework assignmentstoincrease 7. Employ activities, instructionalmethodsandbehavioural 6. Employ educationallysoundmethodsthatactivelyinvolve 5. Cover topicsinalogicalsequence. 4. Includesequentialsessionsover several years. 3. Implementprogrammesthatincludeatleasttwelveor 2. Implementprogrammesinschools andotheryouth- 1. Characteristics their needs. abouthow theprogrammeismeeting from thelearners space andsupplies). available resources (e.g. stafftime, staffskills, facility curriculum. sexual health andyoungpeople’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 Address bothskillsandself-effi 13. toward Address individualattitudesandpeernorms 12. Address personalvalues abouthaving sexual intercourse 11. Address perceptions ofrisk(especiallysusceptibility). 10. 9. Provide scientifi Implementmultiple, educationallysoundactivities 8. Focusonspecifi 7. 6. Address specifi Giveclearmessagesaboutthesebehaviours toreduce 5. Focusnarrowly onspecifi 4. thecurriculum Focusoncleargoalsindetermining 3. about Involvemultiplepeoplewithexpertise intheory 2. Usealogicmodelapproach thatspecifi 1. Characteristics condoms andcontraception. partners. abouthaving sexualnorms intercourse andmultiple or multiplepartnersandperception offamilyandpeer sexual intercourse orusingprotection. of having sexual intercourse and methodsofavoiding protective factors. designed tochange each ofthetargeted riskand knowledge, values, attitudes, norms, skills). to change by thecurriculum-based programme(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, c situationsthatmightleadtounwanted cally accurate information abouttherisks cally accurate information c riskandprotectivefactorsthataffect c sexual andprotective cacy tousethoseskills. es thehealth Part 2: Topics and learning objectives

Conference Ready Version 26 Part 2 Conference ReadyVersion because ofpersonaldiscomfort orperceived opposition. of course,beadjusted.However, thisshouldbedoneinresponse totheavailabledataandevidenceratherthan objectives whendevelopingcurricula,materialsandprogrammes.objectivescan, of particularlearning Learning debut, varyconsiderablywithinandacross regions.islikelytoaffect This,inturn, theperceived appropriateness The sexualandreproductive ofchildren healthneedsandconcerns youngpeople,aswelltheageofsexual disabilities. would beinkeepingwiththeircognitiveabilitiesastoinclude children andyoung peoplewithintellectual/learning with more matureintertiaryinstitutions.Allinformationdiscussedwiththe above-mentionedagegroups learners objectivescanalsobeused inthesecondarylevel maybeolderthan18andthatthetopicslearning learners who mightbeinthesameclass.Level4addresses from learners ages15to 18+ toacknowledgethatsome There isadeliberateoverlapbetweenlevels3and4inorder toaccommodatethebroad agerangeoflearners ages15to18+(Level4). 4. ages12to15(Level3) 3. ages9to12(Level2) 2. ages5to8(Level1) 1. objectivesaddressThe topicsandlearning fouragegroups andcorresponding levels: debut andsexualexploitationabuse. those whomaybemarginalisedforavarietyofreasons, andparticularlyvulnerabletoanearly, unprepared sexual It isequallyimportanttoprovide sexualityeducationtochildren andyoungpeopleoutofschool,especiallyfor training andcurriculumdevelopmentorsimplyasachecklisttoreview existingcurriculaandprogrammes. relationships, objectivesmayprove andbesexuallyactive.Inaddition,thetopicslearning usefulforteacher be especiallycritical,giventhatmanystudentswilllivingawayfrom homeforthefi also benefi many peoplehavenotreceivedintertiaryinstitutionsmay anysexualityeducationatthoselevelsandsolearners The 1. issues, remove socialand attitudinal barriersandincrease knowledge. objectiveswillattempttochangesocialnorms,facilitatecommunicationofsexual sexual behaviourmostlearning and education.However, objectivesare whileonlysomeoftheselearning specifi 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 sexuality educationprogramme.objectivesare Thegoalsofthetopicsandlearning to: This sectionoftheInternationalGuidelinespresentsobjectives the‘basicminimum package’oftopicsandlearning rights ofothers. sexual andsocialrelationships; they haveaneedtoknow; topics andlearningobjectivesare intendedforyoungpeopleatprimaryandsecondaryschoollevels.However, Age range t from theseInternationalGuidelines.Indeed,theneedforsexualityeducationattertiarylevelmay cally designedtoreduce risky rst time,maydevelop within existingsubjectssuchassocialscience,biology orguidanceandcounselling. it maybemore practicaltobuilduponandimprove whatteachersare already teaching,andlooktointegrateit response mightacknowledgethat,whileitwouldbeidealtointroduce sexualityeducationasaseparatesubject, communitysupportforsexualityeducationprogrammesneeds oflearners, andtimetablingissues.Apragmatic supportive schooladministration,trainedteachersandmaterials),competingprioritiesinthecurriculum, the Decisions willbeinfl 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:sexualityeducationencouragesstudentstoassumeresponsibility fortheirownbehaviour Interpersonalandrelationship skills:sexualityeducationpromotes theacquisitionofskillsinrelation to: 3. Values, attitudesandsocialnorms:sexualityeducationoffers students opportunitiestoexplore values, 2. 1. Information:sexualityeducationprovides accurateinformationabouthumansexuality, including:growth process: objectivescoverfourcomponentsofthelearning The topicsandlearning 2. condoms andcontraceptives. resisting early, unwantedorcoerced sex;andpractisingsafersex,includingthecorrect andconsistentuseof and empathyforallpeopleregardless oftheirhealthstatusorsexualorientation;insistingongenderequality; as welltheirbehaviourtowards otherpeoplethrough 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)in relation tosexualbehaviour, health,risk-taking 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 Points ofEntry Componentsoflearning uenced bygeneraleducationalpolicies,theavailabilityofresources (includingtheavailabilityof Conference ReadyVersion

27 Part 2 28 Part 2 Conference ReadyVersion early andcomprehensively aspossible,andhaveaneedtoreceive thisimportantinformation. most expertsbelievethatchildren andyoungpeoplewantneedsexuality sexualhealthinformationas objectives couldbeadjustedtoincludedwithinearlierorlateragelevels.However,the contentsoflearning needs andcountry/region-specifi objectivesfromwith olderstudents,itmaybenecessarytocovertopicsandlearning earlieragelevels.Based on should befi are objectives theintendedoutcomesofworkingonparticulartopics.Learning de Each topicislinkedtospecifi Sexualandreproductive health 6. 5. Sexual behaviour 4. Human development Culture, societyandlaw 3. Values, attitudesandskills 2. 1. Relationships concepts: The overarchingobjectiveshavebeendefi topicsunderwhichlearning 4. curricular content. approachesThe strategyandpeersupportreinforced alsomakes useofparticipatory by aparallel parental programme. In Viet Nam, extra-curricular component, ofHealthisintheprocessdevelopingacompulsory theMinistry which willcomplementintra- Viet Nam Tanzanian caseproves thatsexuality educationdoesnotneedtobemadeanentirely separate subjectinorder tobeexaminable. In theUnitedRepublicof Tanzania, sexuality educationisintegratedwithincarriersubjectssuch asascienceandcivicseducation.The United RepublicofTanzania school. secondary fact thatsexuality ispartofmanyaspectslife. Sexuality (aged15-18 educationmaybecomeaseparate subjectforlearners In Mexico, sexuality educationisintegrated withinvarious partsofthecurriculumsuch asscienceandcivicseducation, inrecognition ofthe Mexico teachers usingspecifi In Malawi, school sexualityonwards. educationisastand-aloneandexaminable subjectfromprimary Sexuality educationistaughtby trained Malawi being taughtatall. and familyliving. The strategy ofteaching sexuality educationasastand-alonesubjectensures thatcompetingprioritiesdonot prevent itfrom In Jamaica, sexuality educationistaughtasastand-alonesubjectby arange ofteachers includingthoseresponsible forbiology, health, home Jamaica Box 4. Sexualityeducation–Points ofentryexperiencesinfi Structure rst introduced, buttheyneedtobereinforced across different agelevels.Whenaprogramme begins cally designedmaterials. c learning objectives,groupedc learning accordingobjectives tothefouragelevels.Thelearning c characteristics, suchassocialandculturalnormsepidemiologicalcontext, ned are organizedaround sixkey ve countries fi ned atthelevelwhenthey years) in upper years) inupper 6. curriculum development. upon experiencesinthefi behaviour-changebase concerning objectivesbased curricula,butgobeyondthistoincludetopicsandlearning The tablesbelowrefl 5. 4.5 Body Rights 4.4 Body Image 4.3 Puberty 4.2 Reproduction Sexual4.1 andReproductive Topics: Human Development Key Concept4: 1.4 Long-term Commitment, Tolerance1.3 andRespect Friendship,1.2 Love and 1.1 Families Topics: Relationships Key Concept1: Anatomy andPhysiology Marriage, andParenting Romantic Relationships Overview ofkeyconceptsandtopics Overview Presentation ect abroad, rights-basedapproach tosexualityeducation.Theydrawfrom theevidence eld, togetherwithexpertopinion,inorder toprovide acomprehensive ‘menu’for Shared5.2 Sexual Behaviour and Sex,5.1 Sexuality andtheSexual Topics: Sexual Behaviour Key Concept5: Finding HelpandSupport 2.5 Communication,2.4 Refusaland 2.3 Decision-making andPeerInfl Norms 2.2 Values,2.1 Attitudes andSources Topics: Attitudes andSkills Key Concept2:Values, Sexual Response Life Cycle Negotiation Skills Sexual Behaviour of Sexual Learning Conference ReadyVersion uence on 3.4 Gender-Based Violence, The SocialConstructionof 3.3 Sexuality3.2 andtheMedia Sexuality,3.1 Culture andLaw Topics: Culture, SocietyandLaw Key Concept3: HIV and 6.3 AIDS Stigma, Care, 6.2 Understanding, Recognising 6.1 Pregnancy Prevention Topics: and Reproductive Health Key Concept6:Sexual Traditional Practices Sexual Abuse andHarmful Gender Treatment andSupport including HIV and ReducingtheRiskofSTIs

29 Part 2 30 Part 2 Conference ReadyVersion Key Concept1 • • • Key Ideas: kinds offamilystructures Defi Learning Objectives forLevel I(5-8) • • • • • • • • Key Ideas: they mature Describe howresponsibilities offamilymemberschangeas Learning Objectives forLevel III(12-15) – Relationships ne theconceptof ‘family’ withexamplesofdifferent Gender inequalityisoftenre fl 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, genderequalityandmutualrespect usually resolvable withmutual respect children are common, especiallyduringpuberty, and Confl increasing responsibility forselfandothers Increasing independenceisusuallyaccompaniedby respect and genderequality Family relationships shouldbebasedonmutualcaring, ict andmisunderstandingsbetweenparents and 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 supportsystemsthatfamilymemberscanturn or comesoutasbeinggay Families helpchildren toacquire values andinfl 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 criseswhentheysupportoneanother Families cansurvive 18 , refuses anarranged marriage uence their • • • • • • • Key Ideas: Differentiate between different kindsofrelationships Learning Objectives forLevel III(12-15) • • • • Key Ideas: Defi Learning Objectives forLevel I(5-8) ne a ‘friend’ abuse andviolence Links betweengenderrolestereotypes andrelationship relationships Gender stereotypes, genderrolesandromantic relationships Characteristics andqualitiesofhealthy andunhealthy Friends caninfl attraction Differences betweenlove, friendship, infatuationandsexual Sometimes closerelationships canbecomesexual Benefi Key characteristics of different kindsofrelationships Different kindsoflove anddifferent ways ofexpressing it Feelings, trust, sharing, empathy andsolidarity friends, boyfriends, girlfriends) Different kindsoffriends(e.g. goodfriendsversusbad ts offriendship uence oneanotherpositivelyandnegatively 1.2 Friendship, Love andRelationships • • • • • Key Ideas: Identify relevant laws concerningabusive relationships Learning Objectives forLevel IV(15-18) • • • • • • • Key Ideas: Identify skillsneededformanagingrelationships Learning Objectives forLevel II(9-12) Conference ReadyVersion Know where tofi Recognising andreporting abuse relationships A person’s rightsandresponsibilities regarding abusive Concept ofempowerment Legal sanctionsagainstabuse Different kinds ofrelationship 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 nd support

31 Part 2 32 Part 2 Conference ReadyVersion Key Concept1 • • • • Key Ideas: Explain whydiscriminationandbullyingare harmful Learning Objectives forLevel III(12-15) • • • • Key Ideas: Defi Learning Objectives forLevel I(5-8) – Relationships ne ‘respect’ Knowing where tofi Speaking outagainstbiasandintolerance self-stigma Consequences ofstigmaanddiscrimination, including orientation because ofdisability, HIVstatus, genderidentityorsexual tostigmatiseordiscriminateagainstpeople It isharmful Making funofpeopleisharmful respect humanbeingdeserves Every and peoplelivingwithHIV relationship andby givinglove, includingdisabledpeople contribute tosocietyby beingafriend, beingina humanbeingisuniqueandvaluable andcan Every Concepts oftolerance, acceptanceandrespect nd helpwhenpeopleare beingharmed 1.3 Tolerance andRespect • • Key Idea: against thoseperceived to be «different» Explain whyitisimportanttochallengediscrimination Learning Objectives forLevel IV(15-18) • • • Key Ideas: harassment, rejection andbullying Defi 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 and copingwithitseffects parenting Diffi parents Impact ofculture andgenderrolestereotypes onrolesof Roles andresponsibilities ofparents/guardians child marriage andteenageparenting Negative socialandhealthconsequencesofearlymarriage, 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 ReadyVersion fertility technologies andsurrogateparenting unintended pregnancy, adoption, fostering, useofassisted Adults canbecomeparents inseveral ways: intendedand Responsibilities ofparenting basic humanrights Child marriageandforced marriageare inconsistentwith parent includingdisabledpeopleandlivingwithHIV personhastherighttodecidewhetherbecomea Every children Legal restrictions ontherighttomarriageandhave Coping withdiffi commitments Challenges oflong-term Qualities neededforsuccessfulloving relationships Reasons tohave children (or not) culties inrelationships

33 Part 2 34 Part 2 Conference ReadyVersion Key Concept2 • • • Key Ideas: Defi Learning Objectives forLevel I(5-8) • • Key Idea: own decisionsandbehaviour Provide clearexamplesofhow personalvalues affecttheir sexuality andreproductive healthissues Describe theirownpersonalvalues inrelation toarange of Learning Objectives forLevel III(12-15) – Values, AttitudesandSkills ne values andidentifythree 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 to standupforthem The needtoknow one’s own values, beliefsandattitudes 2.1 Values andAttitudesSources ofSexual Learning • • Key Ideas: questions aboutbasicsexualmatters Demonstrate confi Identify sources of values, 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 infl Values regarding gender, relationships, intimacy, love, that theirchildren mightfromdifferent values able torefl Parents teach andmodeltheirvalues totheirchildren, are values Relationships benefi ect onthisinteraction andcanrespect thefact dence indiscussingandasking t whenpeoplerespect each other’s uence personalbehaviour • • • Key Ideas: Defi Learning Objectives forLevel I(5-8) • Key Ideas: sexual decisionsandbehaviour Explain howpeerinfl Learning Objectives forLevel III(12-15) • • • ne peerpressure Resisting infl Examples ofdifferent kindsofpeerpressure The righttoself-determination Ways andpeerinfl inwhich socialnorms peer pressure ofbullyingandnegative consequencesofallforms Harmful Sticking to one’s own decisionsaboutsexual activity and ‘no’ Saying ‘yes’ behaviourindividual andgroup 2.2 NormsandPeer Infl uence ofnegativepeerpressure uence andsocialnormsinfl uence canaffect uence uence onSexualBehaviour • • • Key Ideas: Describe socialnormsandtheirinfl Learning Objectives forLevel II(9-12) • • Key Ideas: Demonstrate skillsinresisting peerpressure Learning Objectives forLevel IV(15-18) • Conference ReadyVersion pressure Resisting theinfl Assertive behaviour sexual values andbehaviour infl Social norms People canresist negativepeerinfl People canmake rational decisionsaboutsexual activity People canstandupfortheirrighttoself-determination making uence of negative social norms andpeer uence ofnegativesocialnorms uence values andbehaviour, including uence onbehaviour uence intheirdecision-

35 Part 2 36 Part 2 Conference ReadyVersion Key Concept2 • • • • • Key Ideas: or reproductive healthconcerns Apply thedecision-makingprocess toaddress sexualand/ different decisions Evaluate advantages, disadvantages andconsequencesof Learning Objectives forLevel III(12-15) • • • • Key Ideas: consequences Identify examplesofgoodandbaddecisionstheir Learning Objectives forLevel I(5-8) – Values, AttitudesandSkills Role ofemotionsindecision-making Effects ofalcoholanddrugsondecision-making Decisions canaffectpeople’s health, future, andlifeplans making decisions how toreLearning fl Barriers todecisions decisions Children mayneedhelpfromadultstomake certain Decision-making skills People have therighttomake theirown decisions Decisions andtheirconsequences ect ontheconsequencesbefore 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 tofi stereotypes, peersandmedia) Infl Choosing actionswiththebestoutcome Anticipating consequences Steps inthedecision-makingprocess People have different ways ofmakingdecisions uences ondecisions(e.g. friends, culture, genderrole nd helpwithdecision-making • • • • Key Ideas: skills Demonstrate confi Learning Objectives forLevel III(12-15) • • • • • Key Ideas: communication Demonstrate understanding ofdifferent 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: and sexuallimits Demonstrate effective communication ofpersonalneeds Leaning Objectives forLevel IV(15-18) • • • • • • • Key Ideas: communication Demonstrate examples ofeffective andineffective Learning Objectives forLevel II(9-12) Conference ReadyVersion to practice safersex resist unwanted sexual pressure orreinforce theintention Assertiveness andnegotiationskillscansometimeshelpto romantic, school andwork relationships Good communicationisessentialtopersonal, family, 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

37 Part 2 38 Part 2 Conference ReadyVersion Key Concept2 • • • • Key Ideas: Identify specifi 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 Specifi help/support Right toprivacy, respect andconfi orhelpwithaproblem obtain information Potential usesanddangersofusingmedia(e.g. to internet) Ways toseekadditionalhelp, resources, orinformation Shame/guilt shouldnotbeabarriertoseekinghelp Trusted adultswhomightbeabletoprovide help c stepsinvolvedinbeingtestedforHIVandSTIs c ways inwhichpeoplecanhelpeachother 2.5 FindingHelpandSupport dentiality whenseeking • • • Key Ideas: Identify specifi Learning Objectives forLevel II(9-12) • • Key Ideas: Demonstrate appropriate help-seekingbehaviour Learning Objectives forLevel IV(15-18) contraception, includingemergency contraception Specifi Sources ofsupportintheschool andcommunity Some problemscanbeaddressed withoutsidehelp confi Stand upfortherighttoaffordable, respectful and help/support Right toprivacy, respect andconfi dential help c stepsinvolvedinobtainingandusingcondoms c problems andrelevant sources ofhelp dentiality whenseeking Key Concept3 • • • • • • Key Ideas: relating tosexuality Identify key cultural normsandsources ofmessages Learning Objectives forLevel III(12-15) • Key idea: Identify sources of ourinformationaboutsexandgender Learning Objectives forLevel I(5-8) – Culture, Societyand Law 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 Specifi Sources of messagesaboutsexuality from theircultures andreligions People receive messagesaboutsex, genderandsexuality c messagespeoplereceive aboutsexuality from 3.1 Sexuality, Culture andLaw • • • • • • • • Key Ideas: sexual andreproductive rights Identify specifi Explain theconceptofsexualandreproductive rights Learning Objectives forLevel IV(15-18) • • • Key Idea: regarding sexuality Demonstrate willingness tolistentheopinionsofothers messages aboutsexuality Identify key cultural, religious andlegalnorms Learning Objectives forLevel II(9-12) Conference ReadyVersion Gender equalityasahumanright services, etc.) abortion, sexual orientation, rightsofyoungpeopletoSRH marriage, femalegenitalcutting(FGC), ageof consent, 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 Identify ritesofpassagetoadulthood gender andhow theyhave changed over time Defi infl Recognise theimportanceofculture, societyandlawin uencing people’s well-being ne cultural norms andtaboosrelatedne cultural tosexuality norms and c legislationaffectingtheimplementationof

39 Part 2 40 Part 2 Conference ReadyVersion Key Concept3 • • • • Key Ideas: stereotyping Describe theimpactoftheseimagesongender sexual relationships, sexualityandreproduction Identify unrealistic imagesinthemassmediaconcerning Learning Objectives forLevel III(12-15) • Key Idea: (e.g. television, internet) Distinguish between examplesfrom reality andfi Identify different forms ofmedia Learning Objectives forLevel I(5-8) – Culture, Societyand Law Gender stereotyping inpornography women Self-esteem andhow themassmediaportrays menand stereotypes Mass mediarepresentations ofbeautyandgender Infl representation ofpeople Different massmediaare positiveandnegativeintheir uence ofmassmediaonvalues andattitudes 3.2 SexualityandtheMedia ction • • Key Ideas: gender equality positive contribution topromoting safersexualactivityand Identify ways inwhichthemassmediacouldmake a behaviour andrisk-taking messages aboutsex, genderandsexualityonsexual Critically assessthepotentialinfl 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 mediainfl uences on social norms concerning gender, concerning uences onsocialnorms uence ofmassmedia • • • • • Key Ideas: bias anddiscrimination Explain themeaningofandprovide examplesofgender Learning Objectives forLevel III(12-15) • • • Key Ideas: Defi Learning Objectives forLevel I(5-8) 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 specifi Learning Objectives forLevel II(9-12) Conference ReadyVersion gender bias Strategies forpromotinggenderequalityandreducing and familyplanning Equal decision-makinginmattersrelated tosexual activity Personal values aboutgenderrolesandequality the riskofsexual coercion, abuseandviolence Rigid genderrolescanreinforce behaviour thatincreases Factors thatinfl Gender rolesimilaritiesanddifferences Examples ofgenderinequality messages aboutgender Families, schools, friends, mediaandsocietyassources of Gender rights Overcoming genderbiasandinequality c ways inwhichgenderinequalityaffects uence genderroles

41 Part 2 42 Part 2 Conference ReadyVersion 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 specifi Learning Objectives forLevel III(12-15) – Culture, Societyand Law sex Difference betweenconsensualsexual activityandforced Concepts ofbody rightsandsexual abuse Male/son preference andculture Defi Gender roles, stereotypes andgender-based violence well-being cultural/traditionalHow harmful practices affecthealthand know where tofi Recognising andresponding togender-based violenceand marriage, forced marriage, etc traditional practicesEliminating harmful such asFGC, child nition ofgenderinequality c strategies forreducing gender-based 3.4 Gender-Based Violence, SexualAbuse, nd help and HarmfulTraditional Practices • • • • • • Key Ideas: discrimination andsexualharm (e.g. assertiveness, refusal) inresisting gender Demonstrate relevant communicationskills and itsprevention Defi 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 topromotetherightandaccesssafe traditional practices andgender-based violence social injusticessuch asgenderinequality, harmful Personal responsibility tostandupandspeakoutagainst Advocacy topromoteequalityandhumanrights 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 and impactofsocialandcultural beliefsaboutsex circumcision andFGC sex, gender, pubertyandreproduction (includingmale Cultural, traditional andreligious practices relating to systems Differences betweenthesexual response andreproductive reproductive andsexual functioning ingrowth,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: and femalesover thelifecycle Describe thesexualandreproductive capacity ofmales Learning Objectives forLevel IV(15-18) • • • Key Ideas: reproductive organs Describe thestructure andfunctionofthesexual Learning Objectives forLevel II(9-12) Conference ReadyVersion sexual pleasure throughoutlife Men andwomen canexperience givingandreceiving functioning acrossthelifecycle Changes inhormones, reproductive capacityandsexual Describe commongenitalproblems Both menandwomen cangiveandreceive sexual pleasure and erection, wetdreams andejaculation physiology, includingthemenstrualcycle, spermatogenesis Basic principlesofsexual andreproductive anatomyand

43 Part 2 44 Part 2 Conference ReadyVersion Key Concept4 • • Key Ideas: Describe where babies comefrom Learning Objectives forLevel 1(5-8) • • • • Key Ideas: pregnancy methods ofcontraception inpreventing unintended Describe thecorrect andconsistentuseofdifferent development andchildbirth Describe thesignsofpregnancy, andthestagesoffoetal Learning Objectives forLevel III(12-15) – HumanDevelopment pregnancy Basic processesoffertilisation, conception, and delivery Reproduction requires andanegg asperm abortion, andwithillegalunsafeabortion Health risksassociatedrespectively withsafeandlegal Defi contraception Effectiveness rates ofthedifferent methodsof Health risksofearlypregnancy 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 andsexualfunction 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 Specifi Relationship betweenvaginal intercourse andpregnancy Infertility andfertilitytreatment options function Menopause andmaleclimactericinrelation toreproductive transmitted infection)needstobeconsidered beforehand Prevention (ofunintendedpregnancy andsexually consent Sexual activity shouldonlyoccurwhenthere ismutual Sexual activity canprovide pleasure c meansofpreventing unintendedpregnancy • • • Key Ideas: Distinguish between pubertyandadolescence changes associatedwithpuberty and boys inrelation tothephysical, emotional, andsocial Describe thesimilaritiesanddifferences between girls Learning Objectives forLevel III(12-15) • Key Idea: Describe thekey features ofpuberty Describe howbodieschangeaspeoplegrow Learning Objectives forLevel I(5-8) without actinguponthem Pleasurable sexual feelingsandthoughtscanbeenjoyed pubertal development Pleasurable sexual thoughtsandfeelingsare partof teens Some peopledonotreach fullpubertyuntilthemidorlate happens aschildren growandmature Puberty isatimeofphysical andemotionalchange that 4.3 Puberty • • • • Key Ideas: puberty thatoccurasaresult ofhormonalchanges Describe thekey emotionalandphysicalchangesin Learning Objectives forLevel IV(15-18) • • • • • Key Ideas: sexual andreproductive system Describe theprocess ofpubertyandthematuration ofthe Learning Objectives forLevel II(9-12) Conference ReadyVersion Dealing withphysical andemotionalchanges inspermatogenesis Role ofhormones involvedinovulation andthemenstrualcycleHormones emotional andphysical changes Specifi Wet dreams How pubertyrelates toreproductive capability menstrual aids padsandother Access andproperuseofsanitary washing thegenitals, menstrualhygiene, etc.) Importance ofgoodhygiene asthebody matures (e.g. with puberty Range ofsocial, emotionalandphysical changes associated c role and function of male and female hormones on c roleandfunctionofmalefemalehormones

45 Part 2 46 Part 2 Conference ReadyVersion 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 ofbeauty 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 image canaffectself-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 that sexual 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 Deﬁ 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 ReadyVersion ne unwanted sexualattention coercion Avoiding andresponding tosexual harassment and rape Deﬁ 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 ning sexual harassment andcoercive sex, including

47 Part 2 48 Part 2 Conference ReadyVersion Key Concept5 • • • • • • Key Ideas: life cycle Explain ways inwhichsexualityisexpressed across the Learning Objectives forLevel III(12-15) • • • • • • Key Ideas: Explain theconceptofprivate partsofthebody Learning Objectives forLevel I(5-8) – Sexual Behaviour needed fantasies andfeelingsare abletocontrolthemwhen People donothave toactupontheirsexual 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 orientationorgender identity Respect forthedifferent sexual orientationsandgender Masturbation isnotharmful, butshouldbedoneinprivate Some peoplemasturbateandsomedonot Touching andrubbingone’s genitalsiscalledmasturbation Bodies canfeelgoodwhentouched It isnatural toexplore andtouch partsofone’s own body Most children are curiousabouttheirbodies 5.1 Sex, SexualityandtheSexualLifeCycle • • • • Key Ideas: psychological, spiritual, ethicalandcultural components. Defi Learning Objectives forLevel IV(15-18) • • • • • • • • • • Key Ideas: Describe sexualityinrelation tothehumanlifecycle Learning Objectives forLevel II(9-12) ne sexualityinrelation toitsbiological, social, People canremain sexually activeintooldage Interest insexuality maychange withage respectfully Sexuality can enhancewell-beingwhenexpressed The conceptofsexuality iscomplex andmulti-faceted Importance oftalkingwithtrustedadultaboutsexuality behaviour Cultural and genderrolestereotypes affectsexual identity, andsexual orientation Defi It isacceptabletotalkandaskquestionsaboutsexuality many questions Most youngpeopleare curiousaboutsexuality andhave relationships maystillmasturbate People inlong-term Masturbation doesnotcausephysical oremotionalharm Many boys andgirlsbegintomasturbateduringpuberty pleasure Masturbation isoftenaperson’s fi sexuality withthecapacityofenjoyingHuman beingsare their born nitions ofsex, sexuality, gender, genderrole, gender 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 and care forotherpeopleindifferent Bodies canfeelgoodwhentouched 5.2 Shared SexualBehaviours andSexualResponse • • • • • • • • • • • • • • • Key Ideas: Describe maleandfemaleresponse tosexualstimulation Learning Objectives forLevel II(9-12) Conference ReadyVersion 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 Defi response cycle The componentsofthemaleandfemalehumansexual acting onthemandare abletocontrolthemwhenneeded People canhave sexual thoughtsandfeelingswithout response to sexual stimulation Understand thathumanbeingshave anatural physical maturity Sexual relationships require emotionalandphysical demonstrate love, care, andfeelingsofsexually attraction There are arange ofways inwhich couplescan Showing love involves more thanpenetrative sex responses tosexual attraction andstimulation During puberty, boys andgirlsbecomemore aware oftheir responses Sexual stimulation(physical ormental)producesphysical nition andfunctionoforgasm

49 Part 2 50 Part 2 Conference ReadyVersion Key Concept5 • • • • • • • • • • • • • • Key Ideas: Describe thekey elements ofthesexualresponse cycle Describe commonsexualbehaviours Learning Objectives forLevel III(12-15) – Sexual Behaviour with apartnerofthesameoroppositesex Both menandwomen cangiveandreceive sexual pleasure Defi sexual behaviour topressureIt isharmful anotherpersontoengageinany caressing, oral intercourse andpenetration Sexual behaviours includekissing, touching, talking, Personalising sexual risks Infl gender identity People differintheirsexual identityandorientation Common mythsaboutsex including orgasm stages ofmaleandfemalehumansexual response, Defi without penetration There are manyways togiveandreceive sexual pleasure enjoy their sexuality withoutunintendedconsequences Contraceptives andcondomsgivepeopletheopportunityto behaviours withothers Abstinence meanschoosing nottoengageinsexual A personhastherighttorefuse unwanted sexual contact love andfeelings People giveandreceive sexual pleasure toexpress their uences onsexual beliefsandpractice ning andrefusing transactional sex nition anddescriptionofthephysical changes and 5.2 Shared SexualBehaviours and SexualResponse(contd.) • • • • • Key ideas: Defi 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 and canlearn isresponsible fortheirown andtheirpartner’sEveryone unintended pregnancy andSTIsincludingHIV Sexual behaviours can bepleasurable andwithoutriskof Good communicationcanenhanceasexual relationship Key Concept6 • • • Key Ideas: Recognise thatnotallcoupleshave children Learning Objectives forLevel I(5-8) – Sexual andReproductiveHealth it deserves race orsexual status canraise 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 ReadyVersion Refusal skillstoavoid unwanted sex Steps forproperuseofcondoms Key characteristics ofcondoms Health risksofillegalandunsafeabortion medically trained personnelissafe understerileconditionsbyLegal abortionperformed Legal statusofabortionlocallyandglobally Defi pregnant Options available toteenagers whoare unintentionally pregnancy Health andsocialconsequencesofearlyunintended condoms andcontraceptives Respective responsibilities ofmenandwomen touse Natural contraceptive methodsare onlysafeforadults Ways ofavoiding unintendedpregnancy Children should nothave 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 nition ofabortion

51 Part 2 52 Part 2 Conference ReadyVersion Key Concept6 • • • • • • • • Key Ideas: pregnancy Explain theconceptofpersonalvulnerability tounintended pregnancy andtheirassociatedeffi 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 confi methods ofcontraception Describe personalbenefi Learning Objectives forLevel IV(15-18) • • • • • • • Side effectsandcontra-indications ofspecifi including emergency contraception andcondoms Importance ofcorrect andconsistentuseofcontraception, contraceptive methods Difference betweeneffi 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 cacy andeffectivenessof 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 someone whohasHIVcanandnotpassthevirus You cannottellby lookingifapersonhasHIV People livingwithHIVneedlove, care andsupport How HIVand otherSTIsare 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 communication skillsastheyrelate to prevented Explain howSTIsandHIVare transmitted, treated and Learning Objectives forLevel II(9-12) • • • • • • Conference ReadyVersion Ways inwhich culture, genderand peerscaninfl Risk reduction forSTIandHIV Defi Post Exposure Prophylaxis (PEP)forHIV Treatments forHIVand AIDS andtheirsideeffects Biology ofHIVandSTIinfection Myths andfactsaboutSTIsHIV AIDS avoiding penetrative sex tosexual intercourseSafe alternatives andreasons for Myths andfactsaboutpenetrative sexual intercourse including injectingdrugs Transmission ofHIVthroughunsterilizedequipment, Minimising theriskofmothertochild transmission ofHIV Transmission ofHIVfrommothertobaby Partner notifi Young peoplelivingpositivelywithHIVand AIDS sexual behaviour ne safersex cation uence

53 Part 2 54 Part 2 Conference ReadyVersion Key Concept6 • • • • • • • • • • • • • • • Key Ideas: and refusing unsafe sexualpractices Demonstrate skills innegotiatingsafersexualintercourse living withHIV Describe thephysical, emotional, andsocialimpactof making regarding sexualrelationships Explain howculture andgenderaffectpersonaldecision- condoms transmitting HIVand otherSTIsincludingthecorrect useof Identify specifi Learning Objectives forLevel III(12-15) – Sexual andReproductiveHealth protection againstSTIs, HIV andunintendedpregnancy 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-effi about sexual health Effects ofculture andgenderonpartnercommunication Partner notifi 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.) cacy andvulnerability c ways ofreducing theriskofacquiringor 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) Attitudes to Strategies foraddressing these Benefi intercourse Possible consequencesofhaving penetrative sexual other STIs How genderrolestereotypes canincrease riskforHIVand sexual intercourse andways ofresponding tothese Key factorsthatmake itdiffi STI/HIV prevention One’s roleandresponsibility toeducateone’s peersabout their familiesaboutHIVand AIDS Schools and communityresources toeducatestudentsand Stigma anddiscriminationtoward peoplelivingwithHIV sexual practices Importance ofexploring one’s own attitudeaboutsafer andsafersexual practicesAlternative Protected sexual practices ‘Mutual monogamy’ Assessing personalrisksandperceived vulnerability risk behaviours Alcohol anddruguseincrease risksforengaginginhigh- STIs includingHIV Correct andconsistentuseofcondomscanreduce riskof ts ofdualprotection(condomsandcontraception) w ards peoplelivingwithHIV 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, Brasﬁ eld and O’Bannon, Educational, Scientiﬁ 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. Deﬁ 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-ﬁ 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 ReadyVersion onsex and sexualityGlossary terms Appendix I options. Abstinenceeducation promotes abstinence orientation, marriage,family structure, andpregnancy and maypromote biasesbasedongender, sexual sexuality, distortinformationaboutcondomsandSTIs, programmes oftenrely onnegativemessagesabout behaviour byinstillingfear, shameandguilt.These that are designedtocontrol youngpeople’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:(e.g.Abstinence-only; to beabstinentatanytimeintheirlives. all ages,genders,andsexualorientationscanchoose body ‘lower-risk’ behaviourssuchassafersexwhere no it maymeannopenetration(oral,anal,vaginal)oronly For some,itmaymeannosexualcontact.others, people havedifferent defi to avoidcertainsexualactivitiesorbehaviours.Different Abstinence: Sexualabstinenceisaconsciousdecision index.html). who.int/reproductive health/publications/sexualhealth/ consultation onsexualhealth(2006,seehttp://www. WHO’s (see http://glossary.ippf.org/GlossaryBrowser.aspx) and Glossary ofSexualandReproductive HealthTerms International siecus.org/_data/global/images/TalkAboutSex.pdf), the including been developedandmodifi Many ofthedefi fl uidsare exchangedbetweenpartners.Peopleof Defi Talk AboutSex(SIECUS,2005http://www. ning SexualHealth:reportofatechnical Planned Parenthood Federation’s online nitions usedinthisglossaryhave nitions ofsexualabstinence. ed from othersources

reproductive health,including familyplanning.” supported policiesandprogrammes intheareaof the fundamentalbasisforgovernment-andcommunity- The promotionof…theserightsforallpeopleshouldbe violence, asexpressedinhumanrightsdocuments... reproduction freeofdiscrimination,coercionand It alsoincludestheirrighttomakedecisionsconcerning the higheststandardofsexualandreproductivehealth. information andmeanstodoso,therightattain spacing andtimingoftheirchildrentohavethe individuals todecidefreelyandresponsiblythenumber, on therecognitionofbasicrightallcouplesand and Development,stated:“Reproductiverights…rest agreed Conference attheInternational onPopulation Reproductive Rights:Thedefi acceptable feminineormasculineroles andbehaviour. the prevalent culturalandsocialnormsaboutwhatis they are asmalesorfemales,whichisoftenbasedon Gender Roles:Aperson’s outward expression ofwho should beaccorded equaltreatment. men are thesame,butthattheyhaveequalvalueand men. Genderequalitydoesnotimplythatwomenand Gender Equality:Equalrepresentation ofwomenand male orfemale. refer toaperson’s biological,social,orlegalstatusas in aparticularpointtime(WHO2001).Itmayalso cultural attributesassociatedwithbeingmaleorfemale Gender: refers totheeconomic,socialand education programmes. option forsafersexaspartofcomprehensive sexuality should benotedthatabstinenceisoftentaughtasone in comprehensive sexuality educationprogrammes. It reproductive healthissues,whichare typicallyincluded relating tocontraception, sexualityorsexualand type ofeducationoftendoesnotdiscussissues and unwantedpregnancies canbeprevented. This abstinence astheonlywayinwhichHIVinfections from allformsofsexual activity untilmarriage,and nition ofreproductive rights and females. characteristics tendtodifferentiate humansasmales as there are individualswhopossessboth,butthese biological characteristicsare notmutuallyexclusive defi Sex*: to sexuality;itisnotmerely theabsenceofdisease, emotional, mentalandsocial well-beinginrelation Sexual Health*:healthisastateofphysical, sexual andreproductive health. health care servicesthatpromote, maintain,andrestore All peoplehavearighttoinformation,education,and preventing andsolvingreproductive healthproblems. sexual andreproductive healthandwell-beingthrough methods, techniquesandservicesthatcontributeto Sexual andReproductive HealthServices:Defi 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; andmany sexuality; relationships; sexabuse,pregnancy, HIVand through gainingknowledgeaboutthebody;healthy thinking, self-actualisation,andbehaviouralchange Comprehensive sexualityeducationpromotes critical and riskreduction skillsaboutallaspectsofsexuality. attitudes andtobuilddecision-making,communication provides opportunitiestoexplore one’s ownvaluesand information. Comprehensive sexualityeducation scientifi education thatincludeprogrammes providing sensitive andcomprehensive approach tosexuality Sexuality Education:Anage-appropriate, culturally religious andspiritualfactors. social, economic,political,cultural,ethical,legal,historical, infl them are alwaysexperienced orexpressed. 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 lifeandencompasses sex,genderidentities Sexuality*: Sexualityisacentralaspectofbeinghuman health discussions,theabovedefi technical purposesinthecontextofsexualityandsexual term sexisoftenusedtomean‘sexualactivity’,butfor uenced bytheinteractionofbiological,psychological, ne humansasfemaleormale.Thesesetsof Sex refers tothebiological characteristicsthat cally accurate,realistic, non-judgmental

In generaluseinmanylanguages,the nition is preferred. nedasthe

These workingdefi * attracted tootherwomenwouldbeidenti For example,amanwhobecomeswomanandis identify themselvesasasexual,andothersother. questioning andheterosexual. Someindividualsmay are homosexual,gay, lesbian,bisexual,transgender, The commontermsforthevarietyofsexualorientations fi and/or genderofanotherpersontowhicha Sexual orientation:refers tothesex all personsrespect therightsofothers. The responsible exercise ofhumanrightsrequires that pursueasatisfying, safeandpleasurablesexual • decide whetherornot,andwhen,tohavechildren; • • consensual consensualsexualrelations; marriage; • decidetobesexuallyactiveornot; • choosetheirpartner; • respect forbodilyintegrity; • • sexuality education; seek,receive andimpartinformationrelated to • thehighestattainablestandard ofsexualhealth, • of coercion, discrimination andviolence,to: statements. Theyincludetherightofallpersons,free human rightsdocumentsandotherconsensus are already recognised innationallaws,international Sexual Rights*:rightsembracehumanthat including oralsex,analsexandpenile-vaginalsex. Sexual Intercourse: Penetrativesexualbehaviours, persons mustberespected, protected andfulfi to beattainedandmaintained,thesexualrightsofall coercion, discriminationand violence.Forsexualhealth pleasurable andsafesexualexperiences,free of sexual relationships, aswell asthepossibilityofhaving positive andrespectful approach tosexualityand dysfunction orinfi nds themselvesemotionallyandsexuallyattracted. Conference ReadyVersion WHO. sexual health.Theydonotrepresent anoffi as acontributiontoadvancingunderstanding inthe Platform forAction.Theseworkingdefi Development (ICPD)Programme ofActionandtheBeijing Conferencesuch astheInternational onPopulationand consensus documents concepts andbuildoninternational January 2002.Theyrefl with theWHOTechnical ConsultationonSexualHealthin consultative processexpertsbeginning withinternational life. and sexuality; care services; including accesstosexualandreproductive health rmity. Sexualhealthrequires a nitions were developedthrough a ect anevolvingunderstandingof the nitions are offered cial position of fi ed asa lled. fi eld of

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

Centre forReproductive Rights.2008.AnInternational 1 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 that children andyoungpeoplehaveaspeciﬁ sexuality educationisinterpreted from thestandpoint In theseInternationalGuidelinestheentitlementto 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 inschools on topicsthatshouldbeincluded,andunanimously Monitoring Committees,havealsosetstandards authorities,suchasUNTreatyA varietyofinternational sexuality educationinprimaryandsecondaryschools. lawforstatestoprovidethe obligationsininternational World Conference onWomen inBeijingunderscore Development (ICPD)inCairo andthe1995Fourth Conference1994 International onPopulationand recognised Platformsof Actions developedatthe HIV andSTIamongyoungpeople.Theglobally pregnancies, unsafeabortion, andprevention of Sexuality educationiscriticaltoreducing unplanned the entitlementtosexuality education International conventionsoutlining Appendix II Schools. NewYork: CenterforReproductive Rights. Human Right:SexualityEducation forAdolescentsin 1 c needfor TheJointUnitedNationsProgramme onHIV/AIDS • TheWorld HealthOrganization(WHO) concludesit • The1994ICPDProgramme ofActionrecognises • The CRRreport provides severalexamples: call onStatestoprovide sexuality educationinschools. Action, Treaties, andglobalconsensusdocumentsthat succinctly outlinesthemandatesfrom Platformsof Right: SexualityEducationforAdolescentsinSchools, Reproductive Rights(CRR), AnInternationalHuman on sexualityeducation,areport bytheCenterfor withsettingpolicy For decision-makersconcerned 4 UNAIDS. 2005. 3 UNAIDS. 1997. 2 ICPD Conference ReadyVersion at 33.Geneva:UNAIDS. Geneva: UNAIDS. Sexual BehaviourofYoung People:AReviewUpdate27. activity. educating youngpeoplebefore theonsetofsexual approaches tosexualityeducationbeginwith (UNAIDS) hasconcludedthatthemosteffective school alsoreaches studentswhoare unableto and beginningsexualityeducationinprimary greatest riskoftheconsequencessexualactivity, in theﬁ particularly indevelopingcountries,becausegirls is criticalthatsexualityeducationbestartedearly, effective. all levelsofformalandnon-formaleducationtobe must begininprimaryschoolandcontinuethrough that educationaboutsexualandreproductive health condom use. including correct andconsistentmalefemale accurate andexplicitinformationaboutsafersex, address gendernormsandrelations; andinclude and evidence-based;promote genderequalityand programmes shouldbecomprehensive, highquality Programme ofAction,supranote2,para.11.9. 34 rst classesofsecondaryschoolfacethe UNAIDSrecommends thatHIVprevention 2

4 Intensifying HIVPrevention,

Impact ofHIVandSexualHealthonthe supra note26,

63 Part 3 64 Part 3 EDUCAIDS, aUNAIDSinitiativeforcomprehensive • TheCommitteeontheRightsofChild(e.g., • Conference ReadyVersion 6 WHO. 2001. 5 WHO. 2004. TheCommitteeonthe EliminationofDiscrimination • UNOHCHR.2003.Convention ontherightsofChild, 9 UNOHCHR.2003.ConventionontherightsofChild, 8 7 UNESCO. 2008. epidemic”. inequality andotherstructuraldriversofthe and “address stigmaand discrimination,gender protective behavioursand reduce vulnerability”, sexual activity”,“buildknowledgeandskillstoadopt curricula inschools“beginearly, before theonsetof led byUNESCO,recommends thatHIVandAIDS education sectorresponse toHIVandAIDSthatis attend secondaryschool. others astheybegintoexpress theirsexuality. the knowledgeandskillstoprotect themselvesand must ensure thatchildren havetheabilitytoacquire and sexualhealthinformation”,thatparties adequate, appropriate and timelyHIVandAIDS, information require statestoprovide children with (CRC), concludesthat“therightstohealthand the 1989ConventiononRightsofChild The Children’s RightCommittee),inmonitoring curricula andiscomprehensive. reproduction isincludedinallsecondaryschool States toensure thateducation onsexualityand WHO RegionalOfﬁ 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 parties eliminateallformsofgenderstereotyping in vocational schools.CEDAWalsorequires thatstates to provide itsystematicallyinschools,including to makesexualityeducationcompulsory, and Against Women (CEDAW)urgesstatesparties curricula forprimaryandsecondaryschool. parties makesexualityeducationpartofthe healthy lifestyle”,andrecommends thatstates provision ofinformationnecessarytodevelopa “recognises thattherighttoeducationrequires General Comment4,para.26.Geneva:UNOHCHR. OHCHR. General Comment3,supranote23,para.16.Geneva:UN for Europe. Reproductive Health.Copenhagen:WHO,RegionalOfﬁ Adolescent PregnancyReport.Geneva:WHO. 7

WHO RegionalStrategyonSexualand . Paris:UNESCO. EDUCAIDS Overviews ce forEurope callonMember 5 Guidelinesfrom the 6

9 Itfurther 8 The ﬁ cial ce TheProgramme ofActionadoptedattheFourth • Sweden alsohighlightedthefollowing: and SouthernAfrica,bytheNordiska Afrikainstitutet in Adolescent SexualandReproductiveHealthinEast Sexual andReproductiveHealth,inPromoting The report, PublicPolicy:ATool toPromoteAdolescent 12 Pillay, Y. andFlisher, A.,PublicPolicy:ATool toPromote 11 10 CEDAW, PlatformsofActioncontinuallycall International • by revising textbooksand school programmes. sex educationprogrammes andcurricula,including programmes. of parents mustbeaddressed inadolescenthealth recognises thattherightsofchild,andduties are oftenconsequencesofsexualviolence;and gender relations; acknowledges thatSTIsandHIV to promote mutuallyrespectful andequitable information andservices;encouragescountries comprehensive sexualand reproductive health developing countrieshavelimitedaccessto mothers); recognises that adolescentsinmany (particularly pregnant adolescents andyoung need toremove barriersto educationforwomen on Women Platformof Action emphasisesthe CRC documents.TheFourthWorld Conference reproductive (ASRH)issuesasintheICPDand addresses manyofthesame adolescentsexualand World Conference onWomen (Beijing,1995) Ibid. Press, CapeTown, 2008. Southern Africa,Nordiska Afrikainstitutet,Sweden,HSRC Adolescent SexualandReproductiveHealthinEast Adolescent SexualandReproductiveHealth,inPromoting 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 supra note39,atart.10(c). 11 12

Interview schedule andmethodology Interview Appendix III D) Respondentswere contacted,questionswere C) Arrangementswere madetocalltherespondents at B) Oncetheyagreed toparticipate,andgavetheir A) Keyinformantswere initiallycontactedbyphone In general, included. existing inEurope andNorth Americahasalsobeen about developingparticularlyinnovativeapproaches particularly insub-SaharanAfrica.However, information programmes andcurricula indevelopingcountries, implementing formalschool-basedsexualityeducation to documentbestpracticewithdevelopingand The consultantinterviewedkeystakeholders/informants Education. draft oftheInternationalGuidelinesonSexuality information fordevelopmentoftheworking recorded, transcribedandcompiledasbackground to-face interview, andtheirresponses were then asked duringasemi-structured phoneorface- an agreed upondateandtime, responses. prepare inadvance,orchoosetotypeuptheir structured interviewguidesothattheycould informed consent,theywere emailedasemi- and/or email,andinterviewswere requested. 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 thoughttohaveparticularinsight with informantsnotontheKeyInformantcontactlist In addition,fourmore informalinterviewswere conducted from onehalfhourtotwoandahours. interviews. Thephoneinterviewsrangedinduration responses assupplementalinformationtotheirphone interview, andtwoinformantssubmittedwritten preferred writingtheirresponses insteadofthephone one byaface-to-faceinterview. Two oftheinformants Eight oftheinterviewswere completedbyphone,and feedback andresponse. on theirarea ofspecialisation(s), whileelicitingtheir ﬂ 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 ReadyVersion

65 Part 3 66 Part 3 Conference ReadyVersion questionnaire schedule Semi- structuredinterview 6. How can wemoveschoolsandcommunities 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 Howshouldtheprogramme betaught(whatare8. 7. What is(are) thebestschool-basedsexuality programmes? makers thatwillhelpthemimplementquality guidelines documentforministersandpolicy education programmes in schools? when developingandimplementingasexuality practises) forministriesofeducationtoundertake throughout thecurriculum)? subject, alongwithacarrierorintegrated the entrypoints)inschools(e.g.,asaseparate education programme(s) you knowabout? . Theresearch methodshadto: 2. Theevaluatedprogramme hadto: 1. meet thefollowingcriteria: HIV/STI educationprogrammes, eachstudyhadto To beincludedinthisreview ofsex,relationships and evaluation studies Criteria forselectionof Appendix IV (d) measure impactonthosebehavioursthat measure programme impactononeormore of (c) haveasamplesizeofatleast100. (b) includeareasonably strong experimentalor (a) beimplementedanywhere intheworld. (d) focus onadolescentsupthrough age24outside (c) focusprimarilyonsexualbehaviour(asopposed (b) (a) be acurriculum-andgroup-based sex, behaviours oroutcomes that changeless at least3monthsormeasure impactonthose use ofcontraception,orsexualrisktaking)for number ofsexualpartners,usecondoms, can changequickly(i.e.,frequency ofsex, pregnancy rates,andbirthrates. (e.g., frequency ofunprotected sex),STIrates, generally, compositemeasures of sexualrisk 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/HIVeducation programme . Thestudyhadtobecompletedorpublishedin 3. and summarisedinTable 1andthetextabove. multiple articles).Allofthesewere obtained,coded evaluated 85programmes (someprogrammes had 109 studiesmeetingthecriteriaabove.These This comprehensive combinationofmethodsidentifi inwhichrelevant Scannedeachissueof12journals 6. Attendedprofessional meetings,scannedabstracts, 5. Contacted32researchers whohaveconducted 4. Reviewed thestudiesalready 3. summarisedin Reviewedtheresults ofprevious ETRsearches for 2. Reviewed multiplecomputeriseddatabases for 1. over twotothree years.More specifi were completed,severalofthemonanongoingbasis throughout theentire worldaspossible,severaltask In order toidentifyandretrieve asmanyofthestudies Review methods Conference ReadyVersion had beenpublishedinpeer-reviewed journals. as possible,thecriteriadidnotrequire thatstudies 1990 orthereafter. Inaneffort tobeasinclusive studies mightappear. possible. spoke withauthors,andobtainedstudieswhenever any newstudies. studies previously foundandtosuggestprovide research inthisfi previous reviews completedbyothers. criteria specifi studies andidentifi CHID, andBiologicAbstracts). Abstracts, Bireme, DissertationAbstracts,ERIC, Popline, SociologicalAbstracts,Psychological studies meetingthecriteria(i.e.,PubMed,PsychInfo, 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 ReadyVersion People contactedandkeyinformantdetails Appendix V University CollegeLondon Frances Cowan World Association forSexual Health Mexican Association forSex 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 andAfﬁ lainCutyRgo Area(s) ofExpertise Country/Region liation Southern Africa Southern Mexico andLatin America Canada andEastern Africa Sub-Saharan Africa Research Southern Africa andtheCaribbean Research UK, Caribbeanandsub-Saharan Africa Sub-Saharan Africa Jamaica andtheCaribbean Global Global Africa Southern US andLatin America Sub-Saharan Africa Latin America Sub-Saharan Africa Africa Southern Sub-Saharan Africa Research Implementation andadvocacy Research Coordination andtechnical support research Operations Implementation andadvocacy support Coordination, research &technical Technical support Research Research Research Funding andtechnical support Advocacy andtechnical support Research Implementation andtechnical 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 andAfﬁ lainCutyRgo Area(s) ofExpertise Country/Region liation Nigeria North America Croatia Africa Southern UK andglobal Nigeria Global Sub-Saharan Africa Malawi Global Republic of Tanzania Botswana, China, GhanaandUnited Brazil and Latin America US andSouth Africa Thailand, Uganda, Viet Nam India, Indonesia, Kenya, The Netherlands, United Republicof Tanzania Sub-Saharan Africa The Netherlands Kenya Africa Eastern Australia Conference ReadyVersion Research andimplementation Research Implementation andadvocacy Research Research Implementation andadvocacy Technical support Research Research andtechnical support Technical support Implementation andtechnical support Operations research Research Implementation andtechnical support Implementation andadvocacy Research Research Implementation andresearch research Operations Research

69 Part 3 70 Part 3 nigerian_guidelines.pdf SIECUS. http://www.siecus.org/_data/global/images/ Education inNigeria.Lagos,ActionHealthIncorporated, States). 1996.GuidelinesforComprehensiveSexuality Information andEducationCounciloftheUnited 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. Itiscomposedofexisting,highquality to accompanytheInternationalGuidelinesonSexuality This bibliographyofhow-tomaterialswasdeveloped Conference ReadyVersion Bibliography ofusefulresources Appendix VI Guidelines andguidingprinciples Action HealthIncorporatedandSIECUS(Sexuality Portuguese including thetertiarylevel the primaryandsecondaryschoollevel,butalso art” knowledge to-date informationreﬂ training manuals education curricula,curriculumguidesorteachers ecting latest“state-of-the- 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.NewDelhi,TARSHI Health Issues).2001.CommonGroundSexuality: wiyoc37uxyxg/sexedstandards.pdf yk55wi5lwnnwkgko3touyp3a33aiczutoyb6zhxcn fhi.org/NR/rdonlyres/ea6ev5ygicx2nukyntbvjui35 YouthNet.(Family HealthInternational), http://www. HIV EducationProgrammes.Arlington,VA, FHI for Curriculum-BasedReproductiveHealthand global/images/guidelines.pdf United States).http://www.nomoremoney.org/_data/ (Sexuality InformationandEducationCouncilofthe through 12thGrade,3rd Edition.NewYork, NY, SIECUS for ComprehensiveSexualityEducation:Kindergarten PUB_0.asp?productCode=F2027.27 (abstract) Cancer Society. https://www.cancer.org/docroot/PUB/ Second Edition,AchievingExcellence.Atlanta,American Standards. 2007.NationalHealthEducationStandards, 1E1876C24928/0/Sexuality.pdf org/NR/rdonlyres/CE7711F7-C0F0-4AF5-A2D5- Sexuality Education.London,IPPF. http://www.ippf. (IPPF). 2006.IPPFFrameworkforComprehensive RightFromTheStart.pdf United States).www.siecus.org/_data/global/images/ (Sexuality InformationandEducationCouncilofthe Issues, BirthtoFiveYears. NewYork, NY, SIECUS 1998. TARSHI (Talking About Reproductive andSexual Senderowitz, J.andKirby, D.2006.Standards National GuidelinesTask Force. 2004.Guidelines Joint CommitteeonNationalHealthEducation PlannedParenthoodInternational Federation Early ChildhoodSexualityEducationTask Force. Right FromtheStart:GuidelinesforSexuality . Brighton, International HIV/AIDS People: grades8-9.Brighton,International Future: SexualityandLife Skills EducationforYoung publications/Our_Future_Grades_6-7.pdf Alliance. http://ovcsupport.net/graphics/secretariat/ HIV/AIDS People: grades6-7.Brighton,International Future: SexualityandLifeSkillsEducationforYoung publications/Our_Future_Grades_4-5.pdf Alliance. http://ovcsupport.net/graphics/secretariat/ HIV/AIDS People: grades4-5.Brighton,International Future: SexualityandLifeSkillsEducationforYoung New York, PopulationCouncil. (Mexico). Forthcomingin2009.It’s AllOneCurriculum. Women’sInternational HealthCoalition,andMEXFAM Hemisphere Region(LatinAmericaandCaribbean), Planned Parenthood Federation(IPPF),IPPFWestern (India), GirlsPowerInitiative(Nigeria);International main.aspx?PageID=137 (abstract) Strategies forHopeTrust. http://www.actionaid.org/ Communications andRelationshipsSkills.Oxford, 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.Geneva,UNESCOIBE.English:http:// 2006. ManualforIntegratingHIVandAIDSEducationin 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.St Comprehensive Sexuality Education. 2008.Jamaican International curricula International HIV/AIDSAlliance. 2006.Our International HIV/AIDSAlliance. 2006.Our International HIV/AIDSAlliance.2006.Our International Creating Resources forEmpowermentinAction andWelbourn,A.1999. ActionAid International UNESCO/International BureauUNESCO/International ofEducation(IBE). Thomsen, S.C.2007.Tell MeMore!Children’s The JamaicanTask Force Committeefor http://www.ibe.unesco. education programme) based, comprehensive andrights-basedsexuality Youth inIndonesia.Indonesia,WPF. (WPF’s computer- 2008. MAJU!ForSpecialEducationSchoolsforDeaf pdf wpf.org/documenten/20080729_IMToolkit_July2008. Education Programmes.Utrecht, WPF. http://www. Mapping(IM)ToolkitIntervention forPlanningSexuality programme) comprehensive andrights-basedsexualityeducation Indonesia. Schoolsin YPI. 2006.DAKU!ForSecondary sexuality educationprogramme) computer-based, comprehensive andrights-based Disadvantaged Youth inKenya”.Kenya,WPF. (WPF’s Schoolsand World Me.ForSecondary StartsWith for StudyofAdolescence)andNairobits. 2006.“The education programme) based, comprehensive andrights-basedsexuality SNU. http://www.theworldstarts.org (WPF’s computer- SchoolsinUganda.”Uganda,WPFand For Secondary (SchoolNet Uganda).2003.“TheWorld Me. StartsWith program) comprehensive andrights-based sexualityeducation wpf.org/publication/745. (WPF’s computer-based, world startswithme!Utrecht: WPFhttp://www. publicacoes/MANUAL%20M.pdf www.promundo.org.br/materiais%20de%20apoio/ and Health.RiodeJaneiro, InstitutoPromundo. http:// Working Young With Women: Empowerment,Rights Instituto PAPAI andWorld Education.2008.ProjectM: 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. Riode publications/Our_Future_Grades_8-9.pdf Alliance. http://ovcsupport.net/graphics/secretariat/ Conference ReadyVersion WPF (World PopulationFoundation)Indonesia,YPI. WPF (World PopulationFoundation).2008. WPF (World PopulationFoundation)Indonesia, WPF (World PopulationFoundation),CSA(Centre WPF (World PopulationFoundation)andSNU WPF (World PopulationFoundation). 2003.The Instituto Promundo, Salud yGénero, ECOS, Instituto Promundo, PAHO andWHO.2002. Indonesia, WPF. 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71 Part 3 72 Part 3 Power Initiative). an EmpoweredWomanhood. Calabar, GPI(Girls’ Gender-Based ApproachonHumanSexualitytowards Sexuality, SexualandReproductiveHealthRights: Incorporated. Federal MinistryofEducationandActionHealth Teachers LearningforanHIVFreeGeneration.Nigeria Curricular ActivitiesonHIVandAIDS–Students Incorporated. 2007.FacilitatingSchool-BasedCo- (abstract) www.actionhealthinc.org/publications/guides.htm Handbook. Ibadan,SpectrumBooksLimited.http:// Schools,Students’ HIV EducationforJuniorSecondary actionhealthinc.org/publications/guides.htm (abstract) Guide. Ibadan,SpectrumBooksLimited.http://www. Schools,Teachers’HIV EducationforJuniorSecondary org/publications/guides.htm (abstract) Action HealthIncorporated.http://www.actionhealthinc. Sexuality Education,Trainers’ ResourceManual.Lagos, based sexualityeducationprogramme) (WPF’s computer-based, comprehensive andrights- Nam,WPF,Education. Viet UniversityofDanang. For theTeacher EducationatDanangUniversityof University ofDanang.2009.JourneytoAdulthood. programme) comprehensive andrights-based sexualityeducation in Indonesia.Indonesia,WPF. (WPF’s computer-based, Pastiku! the MinistryofSpecialEducation,YPI.2008.Langhka sexuality educationprogramme) computer-based, comprehensive andrights-based WPF, theMinistryofSpecialEducation,YPI.(WPF’s Juvenile CorrectionInstitutesinIndonesia.Indonesia, Ministry ofSpecialEducation,YPI.2008.SERU!For Conference ReadyVersion Curricula -Sub-SaharanAfrica GPI (Girls’PowerInitiative).2004.Adolescent Federal MinistryofEducationandActionHealth Action HealthIncorporated.2007.FamilyLifeand Action HealthIncorporated.2007.FamilyLifeand WPF (World Nam, Population Foundation) Viet WPF (World Population Foundation) Indonesia, Action HealthIncorporated.2003.Comprehensive WPF (World PopulationFoundation) Indonesia,the For SpecialEducationSchoolsforBlindYouth org/publications/downloads/jnrcurriculum.pdf and DevelopmentCouncil).http://www.actionhealthinc. Nigeria. Abuja,NERDC(NigerianEducationalResearch Schoolin HIV EducationCurriculumforJuniorSecondary Development Council).2003.NationalFamilyLifeand (abstract) www.phoenixpublishers.co.ke/display.php?catID=1 Experience: Chela4.Nairobi, PhoenixPublishers.http:// A., Sikenyi,V., Changeiywo,J.M.2006Naomi’s (abstract) www.phoenixpublishers.co.ke/display.php?catID=1 Festival: Chela3.Nairobi, PhoenixPublishers.http:// Sikenyi, V., Changeiywo,J.M.2006.TheDrama (abstract) www.phoenixpublishers.co.ke/display.php?catID=1 Wedding: Chela2.Nairobi, PhoenixPublishers.http:// V., Changeiywo,J.M.2006.JourneytoCheptoo’s (abstract) www.phoenixpublishers.co.ke/display.php?catID=1 visit: Chela1.Nairobi, PhoenixPublishers.http:// Sikenyi, V., Changeiywo,J.M.2006.Grandmother’s (abstract) http://www.questafrica.org/ItemDetail.aspx?itemId=70 SchoolinKenya.Nairobi,Primary PhoenixPublishers Lt. of GrowingUpandSexualMaturation:theRole Omar, Management N.O.2006.TheContemporary Prevention. NewYork, NY, SelectMedia. 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, 2005. NERDC (NigerianEducationalResearch and 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.Let HCP (HealthCommunicationPartnership)Ethiopia. Activity book:Beaconschools.AddisAbaba,

UNICEF. Educational Research and DevelopmentCouncil)and Basic ScienceandTechnology. Abuja,NERDC(Nigerian Family LifeandHIVEducation–Teachers’ Guidein Development Council)andUNICEF. 2006.National Development Council). Abuja, NERDC(NigerianEducationalResearch and Schools. HIV EducationCurriculum–UpperPrimary Development Council).2004.NationalFamilyLifeand School ofHygieneand Tropical Medicine).http:// and Research Foundation)andLSHTM(London Institute forMedicalResearch), AMREF(AfricanMedical of HealthandEducation,NIMR(Tanzania National Teacher’s GuideforStandard7.Tanzanian Ministries Schools. Reproductive HealthEducationforPrimary and Ross,D.A.2004.GoodThingsforYoung People: 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.Tanzanian Ministries Schools. Reproductive HealthEducationforPrimary and Ross,D.A.2004.GoodThingsforYoung People: 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(AfricanMedical of HealthandEducation,NIMR(Tanzania National Teacher’s GuideforStandard5.Tanzanian Ministries Schools. Reproductive HealthEducationforPrimary and Ross,D.A.2004.GoodThingsforYoung People: Mmassy, G.,Makohka,M.,Plummer, M.L.,Kudrati, Educational Research and DevelopmentCouncil). Action HealthIncorporatedandNERDC(Nigerian Nigeria, Version 1.1.OneWorld UK,Butter fl about Living.TheElectronicVersion ofFLHE.North Research andDevelopment Council).2009.Learning Incorporated andNERDC(NigerianEducational OneWorld UK,Butterfl 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., y Works, ActionHealth y Works, y lifeskills/fi Republic ofNamibia,UNICEF. http://www.unicef.org/ Health andDevelopmentProgramme,of Government TheYouthFuture IsMyChoiceFacilitators.Windhoek, for theTrainers ofTrainers. My FutureisChoiceFacilitatorTraining: AGuide ofRepublic Namibia,UNICEF.Government 2001. pdf www.unicef.org/lifeskills/fi ofRepublicNamibia,UNICEF.Government http:// The Youth HealthandDevelopmentProgramme, Protecting OurPeersfromHIVInfection.Windhoek, Training ManualforAdolescents13to18Years ofAge. My FutureIsChoice:ExtracurricularLifeSkills ofRepublicNamibia,UNICEF.Government 1999. org/publications/details.php?i=1590 (abstract) Appropriate Technology inHealth).http://www.path. Workbook. Washington D.C.,PATH (Program for Young PeopleinAfrica,BotswanaVersion. Participant’s Health). 2003.LifePlanningSkills:ACurriculumfor org/publications/details.php?i=1590 (abstract) Appropriate Technology inHealth).http://www.path. Manual. Washington D.C.,PATH (Program for Young PeopleinAfrica,BotswanaVersion. Facilitator’s Health). 2003.LifePlanningSkills:ACurriculumfor questafrica.org/ItemDetail.aspx?itemId=71 (abstract) Education. Nairobi, PhoenixPublishers Ltd.http://www. Among theLuoofKenya:RemovingBarrierstoQuality Ayieko, M.2006.GrowingUpandSexualMaturation pdf memakwavijana.org/pdfs/Teachers-Resource-Book. of HygieneandTropical Medicine).http://www. Research Foundation)and LSHTM(LondonSchool for MedicalResearch), AMREF (AfricanMedicaland Health andEducation,NIMR(Tanzania NationalInstitute Teacher’s ResourceBook.Tanzanian Ministriesof Schools. Reproductive HealthEducationforPrimary and Ross,D.A.2004.GoodThingsforYoung People: Mmassy, G.Makohka,M.,Plummer, M.L.,Kudrati, 7-English.pdf www.memakwavijana.org/pdfs/Teachers-Guide-Std- Conference ReadyVersion 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., les/mfmc_tot_manual.pdf les/mfmc_facilitator_manual. For theTraining ofNewMy

73 Part 3 74 Part 3 Health Issues).2006.BasicsandBeyond:Integrating downloads/blue-book.pdf and SexualHealthIssues).http://www.tarshi.net/ years. NewDelhi,TARSHI, (Talking AboutReproductive Book: WhatYou Want toKnowAboutYourself, 15+ Health Issues).2005(1999ReprintEdition).TheBlue downloads/red-book.pdf and SexualHealthIssues).http://www.tarshi.net/ years. NewDelhi,TARSHI, (Talking AboutReproductive Book: WhatYou Want toKnowAboutYourself, 10-14 Health Issues).1999(2005ReprintEdition).TheRed Framework_Merged.pdf hhd.org/sites/hhd.org/fi Kingston, EDC,UNICEFandCARICOM.http://www. Regional CurriculumFrameworkForAges9-14. and CARICOM.2008.HealthFamilyLifeEducation. Grade 7-9.Brooklyn, CaribbeanConsultingGroup. Family LifeEducation,Refi Grade 1-6.Brooklyn, CaribbeanConsulting Group. Family LifeEducation,Refi lifeskills/fi 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/ fi Programme, ofRepublicNamibia, Government TheYouthWindhoek, Health andDevelopment ActivitiesforClubs. A HandbookforAIDSAwareness ofRepublicNamibia,UNICEF.Government 2001. Conference ReadyVersion Curricula -AsiaandthePacifi the Caribbean Curricula –LatinAmericaand TARSHI (Talking AboutReproductive andSexual TARSHI (Talking About Reproductive andSexual EDC (EducationDevelopmentCenter, Inc.),UNICEF Caribbean ConsultingGroup. 2007.Healthand The Youth HealthandDevelopmentProgramme, TARSHI (Talking AboutReproductive andSexual Caribbean ConsultingGroup. 2007.Healthand The Youth HealthandDevelopmentProgramme, les/mfmc_club_manual.pdf les/HFLE%20Curriculum%20 ned Scope and Sequence, ned ScopeandSequence, Windhoek, TheYouthWindhoek, les/mfmc_ c

Reproductive andSexualHealth Issues). A GuideforParents.NewDelhi,TARSHI, (Talking About Why, WhatandHowtoTalk To Your KidsAboutSexuality, Health Issues).Forthcomingin2009.TheWhiteBook: Sexual HealthIssues). New Delhi,TARSHI, (Talking AboutReproductive and Didn’t KnowWhotoAsk,ABookforYoung Couples. All You Want toKnowAboutSexualRelationshipsand Health Issues).Forthcomingin2009.TheGreenBook: (abstract) www.tarshi.net/publications/publications_training.asp About Reproductive andSexual HealthIssues).http:// - AManualForTrainers. NewDelhi,TARSHI, (Talking Sexuality, SexualAndReproductiveHealthRights a86f2b1b04 www.bzga.de/pdf.php?id=ae90c181d0cd3dbed43f78 Bundeszentrale fürgesundheitlicheAufklärung.http:// planning: Teenage pregnanciesinternationally.Cologne, Aufklärung). 2007.FORUMSexeducationandfamily hp?id=39fc40c228a5226f48ab13b7a7e7fd8b gesundheitliche Aufklärung.http://www.bzga.de/pdf.p planning: Migration.Cologne,Bundeszentralefür Aufklärung). 2006.FORUMSexeducationandfamily hp?id=44f5170caadcbb182d188a626ead956b gesundheitliche Aufklärung.http://www.bzga.de/pdf.p planning: International.Cologne,Bundeszentralefür Aufklärung). 2006.FORUMSexeducationandfamily d7afc68ec56243700d3250312 Aufklärung. http://www.bzga.de/pdf.php?id=d8edee7 Cologne, Bundeszentralefürgesundheitliche planning: youngpregnantwomenandmothers. Aufklärung). 2001.FORUMSexeducationandfamily 9bbd496faa0ebfc5a894a58dc Aufklärung. http://www.bzga.de/pdf.php?id=d2de062 Cologne, Bundeszentralefürgesundheitliche Sex education,contraceptionandfamilyplanning. Aufklärung). 1999.Conceptsexeducationforyouths: Curricula -Europe TARSHI (Talking AboutReproductive andSexual TARSHI (Talking AboutReproductive andSexual BZgA (Bundeszentralefürgesundheitliche BZgA (Bundeszentralefürgesundheitliche BZgA (Bundeszentralefürgesundheitliche BZgA (Bundeszentralefürgesundheitliche BZgA (Bundeszentralefürgesundheitliche draw_pr.pdf (overview) http://www.thenationalcampaign.org/EA2007/desc/ Pregnancy. Grade7.ScottsValley, CA,ETRAssociates. Respect theLine:SettingLimitstoPreventHIV, STDand andETRAssociates. 2003.DrawtheLine, California /draw_pr.pdf (overview) http://www.thenationalcampaign.org/EA2007/desc Pregnancy. Grade6.ScottsValley, CA,ETRAssociates. Respect theLine:SettingLimitstoPreventHIV, STDand andETRAssociates. 2003.DrawtheLine, California productdetails.cfm?PC=721 (product details) of Congregations). http://www.uuabookstore.org/ 12. Boston,UUA(UnitarianUniversalistAssociation 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. ScottsValley, CA,ETR 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.ASexatlasforSchools.Stockholm, PDF-Material/YMEPguidebookapril08.pdf for SexualityEducation).http://www.rfsu.org/upload/ Equal Partners.Stockholm,RFSU(SwedishAssociation Association forSexualityEducation). as aCulturalPhenomena.Stockholm,RFSU(Swedish Curricula -NorthAmerica Center forAIDSPrevention Studies/Universityof Center forAIDSPrevention Studies/Universityof Casparian, E.M.andGoldfarb,E.S.2000.Our Casparian, E.M.andGoldfarb,E.S.2000.Our Barth, R.P.2004 (4thedition).Reducingthe Barth, R.P.2004 (4thedition).ReducingtheRisk: Olsson, H.RFSU(SwedishAssociationforSexuality Centerwall, E.andLaack,S.2008.Young Menas Centerwell, E.2008.Sexualities:ExploringSexuality to HIV/STDsandTeen Pregnancy Prevention.New 2004. Focus onKids)http://www.etr.org/foy/ (overview) Valley, CA,ETRAssociates.(Previously publishedas Prevention ProgramforAfrican-AmericanYouth. Scotts Associates. Peer LeaderWorkbook. Level2.ScottsValley, CA,ETR Choices: PreventingHIV, OtherSTDandPregnancy. Associates. Peer LeaderWorkbook. Level1.ScottsValley, CA,ETR Choices: PreventingHIV, OtherSTDandPregnancy. Associates. Peer LeaderTraining Guide.ScottsValley, CA,ETR Choices: PreventingHIV, OtherSTDandPregnancy. Associates. Level 2.StudentWorkbook. ScottsValley, CA,ETR Choices: PreventingHIV, OtherSTDandPregnancy. Associates. Level 1.StudentWorkbook. ScottsValley, CA,ETR Choices: PreventingHIV, OtherSTDandPregnancy. Level 2.ScottsValley, CA,ETRAssociates. Choices: PreventingHIV, OtherSTDandPregnancy. Level 1.ScottsValley, CA,ETRAssociates. Choices: PreventingHIV, OtherSTDandPregnancy. (overview ofthewholeSaferChoicesCurricula) thenationalcampaign.org/EA2007/desc/safer_pr.pdf Manual. ScottsValley, CA,ETRAssociates.http://www. Preventing HIV, OtherSTDandPregnancy. Implementation draw_pr.pdf (overview) http://www.thenationalcampaign.org/EA2007/desc/ Pregnancy. Grade8.ScottsValley, CA,ETRAssociates. Respect theLine:SettingLimitstoPreventHIV, STDand andETRAssociates.2003.DrawtheLine, California Conference ReadyVersion Jemmott, L.S.,J.,andMcCaffree, K. ETR Associates.2009.FocusonYouth: AnHIV ETR Associates.2007(RevisedEdition).Safer ETR Associates.2007(RevisedEdition).Safer ETR Associates.2007(RevisedEdition).Safer ETR Associates.2007(RevisedEdition).Safer ETR Associates.2007(RevisedEdition).Safer ETR Associates.2007(RevisedEdition).Safer ETR Associates.2007(RevisedEdition).Safer ETR Associates.2007(RevisedEdition).SaferChoices: Center forAIDSPrevention Studies/Universityof Making ProudChoices:A Safer-Sex Approach

75 Part 3 76 Part 3 Conference ReadyVersion (product details) www.uuabookstore.org/productdetails.cfm?PC=720 Universalist AssociationofCongregations). http:// education forgrades7-9.Boston,UUA(Unitarian (product details) www.uuabookstore.org/productdetails.cfm?PC=772 Universalist AssociationofCongregations). http:// Young Adults,Ages18-35.Boston,UUA(Unitarian S. 2008.OurWholeLives:SexualityEducationfor bart.htm (overview) CA, ETRAssociates.http://www.etr.org/traininginstit/ Reduction ProgrammeforAdolescents.ScottsValley, Becoming aResponsibleTeen (BART): anHIVRisk- (product details) www.uuabookstore.org/productdetails.cfm?PC=718 Universalist AssociationofCongregations). http:// Education forGradesK-1.Boston,UUA(Unitarian dtopics/stds/stded.pdf Teen Network.www.health.state.mn.us/divs/idepc/ HIV EducationPrograms.Washington, DC,Healthy Assess theCharacteristicsofEffectiveSexandSTD/ org/curriculum.asp?curid=3 (product details) York, NY, SelectMedia,Inc.http://www.selectmedia. Wilson, P.Wilson, M.1999.Ourwholelives:sexuality M.J.,Stuart,L.A.andGibbMillspaugh, Tino, St.Lawrence, J.S.2005 (RevisedEdition). Sprung, B.1999.OurWholeLives:Sexuality Kirby, M.M.2007.Tool D.,Rolleri,L.A.,Wilson, 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 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 San Francisco, USA relationships andHIV/STIeducation, 18-19February 2009, from theUNESCO/UNFPA globaltechnicalconsultationonsex, List ofparticipants Appendix VII: 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 ReadyVersion

77 Part 3 78 Part 3 Conference ReadyVersion http://www.tarshi.net/ New Delhi110014,India 11, MathuraRoad,1stFloor, JangpuraB (TARSHI) Talking AboutReproductive andSexualHealthIssues Prabha Nagaraja Egerton-20115, Kenya P.O BOX 536 Egerton University Helen OmondiMondoh Walnut Creek, CA94596,USA 1743 CarmelDrive#26 Health StrategiesInternational Elliot Marseille Beijing, 100875,China #19, Xinjiekouwaidajie Beijing NormalUniversity Research CenterforScience Education 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 Amadasun Street, Girls’ PowerInitiative(GPI)EdoState Grace Osakue http://www.rfsu.se/ Stockholm, Sweden Box 4331,10267 The SwedishAssociationforSexualityEducation Hans Olsson 6. Duﬂ 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 Reference MaterialfortheInternationalGuidelines Appendix VIII from arandomizedevaluation inWestern Kenya. Education andHIV/AIDS prevention: Evidence International Health,13(10),1235-1244. design andbaselineresults. Tropical Medicineand intervention forruralyouthinZimbabwe–study multi-component community-basedHIVprevention controlled trialtodeterminetheeffectiveness ofa Regai DziveShiriProject: aclusterrandomised Dirawo, J.,Chidiya,S.,Jaffar, S., etal.2008.The 69. school. controlled interventioninaChileanpublichigh prevention: Anabstinence-centered randomized R., &Aranda,W. 2005.Adolescentpregnancy Thailand. Washington, D.C.:PopulationCouncil. of anHIV/AIDSprogrammeforcollegestudentsin McCauley, A.,&Rewthong,U.2003.Evaluation 11(Supplement 1),S121-S127. in publicnightschoolsSàoPaulo,Brazil.AIDS, sexual riskreduction programme foryoungadults J., Hudes,M.,etal.1997.EvaluatinganAIDS Adolescent Health,34(5),441-452. behaviour ofZambianadolescents.Journal normative beliefs,riskperceptions, andsexual school-based peersexualhealthinterventionon o, E.,Dupas,P., Kremer, M.,& Sinei,S.2006. Journal ofAdolescentHealth,36(1),64- 13. Jewkes, R.,Nduna,M.,Levin,J.,Jama,N.,Dunkle, 13. 12. James, S.,Reddy, P., Ruiter, R.,McCauley, A.,& Fitzgerald, A.,Stanton,B.,Terreri,11. N.,Shipena, H., 10. Fawole, I.,Asuzu,M.,Oduntan,S.,&Brieger, W. Erulkar, A.,Ettyang,L.,Onoka,C.,Nyagah,F., & 9. Eggleston,E.,Jackson,J.,Rountree, W., &Pan, 8. Dupas,P. 2006.Relativerisksandthemarketfor 7. Conference ReadyVersion Stones onincidenceofHIV andHSV-2 andsexual K., Puren, A.,etal.2008.ImpactofStepping Education andPrevention,18(4),281-294. students inKwaZulu-Natal,SouthAfrica,AIDS AIDS lifeskillsprogramme onsecondaryschool B.2006.The impactofanHIVand van denBorne, Adolescent Health,23(1),52-61. adolescents inanAfricansetting.Journalof based HIVrisk-reduction interventionstargeting Li, X.,Kahihuata,J.,etal.1999.Useofwestern- 675-683. of effectiveness. HealthEducationResearch,14(5), for secondaryschoolstudentsinNigeria:Areview 1999. Aschool-basedAIDSeducationprogramme Planning Perspectives,30(2),58-67. programme foryoungKenyans.InternationalFamily of aculturallyconsistentreproductive health Muyonga, A.2004.Behaviourchangeevaluation American JournalofPublicHealth,7(2),102-112. Revista PanamericanadeSaludPública/Pan programme foryoungadolescents inJamaica. Z. 2000.Evaluationofasexualityeducation Hanover: DartmouthCollege. sex: Teenagers, sugardaddiesandHIVinKenya. Action Lab. Boston: DepartmentofEconomicsandPoverty

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