Speak with them! Promoting safe sexual health in adolescents
March 18-24 is being recognised as Global Teen Health Week, aimed at raising the profile of adolescent health. Below is an article from the Paediatrics Association of Jamaica.
Often when we hear the words 'adolescent sexual health', we think, how do we prevent our teenagers from having sex, getting pregnant and contracting sexually transmitted infections (STIs). While reasonable goals, parents should consider that adolescent sexual health is really about ensuring that young people develop into healthy sexual beings.
Sexuality is a complex interplay of biological and cultural factors, sexual attraction and behaviour, understanding gender identity and gender roles. All humans are sexual beings, and adolescence is the challenging transition from childhood through the changes of puberty into adulthood. As their bodies develop, secondary sexual characteristics such as breasts, penile and testicular growth and pubic hair, they start looking more adult.
Their brains also undergo significant development - first becoming more responsive to emotional arousal and pleasure-seeking; later becoming more efficient at making choices and weighing pros and cons of their actions. This is a challenging, but should also be an enjoyable, phase. Parents and guardians have a major role to support their adolescents through these changes - lovingly guiding them to not fear these changes or respond to them in risk-creating ways but allowing them to develop optimally.
The World Health Organization (WHO) defines sexual health as a state of physical, mental and social well-being in relation to sexuality. It requires a positive and respectful approach to sexuality and sexual relationships, enabling pleasurable and safe sexual experiences, free of coercion, discrimination and violence.
In Jamaica, an adolescent may legally give consent, or say yes, for sexual activity at 16 years old. This doesn't mean it is the recommended age to start having sex, but the age when the law recognises that adolescents are capable of weighing the pros and cons of having sex, such as mistimed pregnancy, sexually transmitted infections and emotional and psychosocial repercussions of making this choice. Effectively understanding these risks however, require relevant information and skills.
Adults should engage in open, honest two-way, non-judgemental communi-cation with children and adolescents about sex and sexuality. Ensure that you listen to their concerns. Don't preach, speak with them. Use opportunities such as if your son tells you about a girl he likes, to have these talks. Don't panic; ask and listen to why he likes her. Reasonable questions will force the adolescent to rationally examine their own thoughts and actions. Discuss relationships that don't involve sex, delaying onset of sex but also about safe sex. Remind your adolescent that both persons must agree and neither should feel pressured to have sex.
Adolescents should learn how to recognise unhealthy relationships; to be wary when a partner wants more than they are ready to share or are willing to give in return. They need to recognise when a partner is being verbally, emotionally, physically or sexually abusive. Encourage them to feel confident to tell a responsible adult if this happens and get support, and when necessary, to report this to the relevant authorities. Healthy relationships are positive experiences which develop self-confidence, personal strength and a sense of ability to succeed. They don't require gifts, cash or in-kind payments; the reward is enjoying special times with someone they value. Discuss how having an older partner can create an imbalance of power particularly in sexual decision making. Parents, be your adolescent's role model - if you are in an unhealthy relationship - get help.
Discuss behaviours that can lead to poor reproductive health outcomes. While drinking alcohol and using other substances may seem cool or adult, adolescents must understand that these behaviours impair judgement and can increase the likelihood of engaging in unsafe sex (without a condom), intercourse with multiple partners, including high-risk partners. Discussing music, movies and other forms of enter-tainment where these behaviours are modelled, is a good way to alert the adolescent.
Debate the advantages of delaying sexual activity. Discuss the importance of positive goals: forming a strong relationship with a long-term partner (versus a boyfriend who may be gone in two months); adhering to religious values; meeting family expectations; going to university, etc.
Our goal should be to help adolescents develop into sexually healthy adults - free from fear, shame or other psychological factors that inhibit normal sexual responses or impair sexual relationships. Let us all work towards being healthy sexual beings.
Dr Abigail Harrison is an adolescent medicine physician, Department of Child and Adolescent Health, University of the West Indies (UWI). Dr Althea Bailey is lecturer, Department of Community Health and Psychiatry, UWI, Mona.