Governments need to provide sexual health services to their citizens. (From the President).

I am writing to you from the 14th Annual International AIDS Conference in Barcelona, Spain, where more than 10,000 scientists, activists, policy- makers, and people living with HIV/AIDS are meeting to discuss ways to prevent and treat this virus and subsequent disease.

This Conference has made one thing crystal clear. With nearly a billion of the world's population between the ages of 15 and 24, it is critical that comprehensive sexuality education programs, including information about both abstinence and condom use, become a key part of any prevention and treatment plan. (1)

The statistics about the spread of AIDS around the world paint a picture of people in desperate need of the information that SIECUS has long encouraged both in the United States and around the world.

CULTURALLY RELEVANT EDUCATION PROGRAMS

When developing such programs outside the United States, it is critical that social service providers and non-governmental organizations--working in conjunction with government agencies--plan them in a culturally relevant and appropriate manner that address the specific social and cultural issues, contexts, and language needs of the people they are serving.

When programs and services are based on such cultural competencies, they have a significantly increased potential to succeed in meeting people's sexual health needs and concerns as well as promoting safer sexual behavior.

At the same time, providers must work to change the negative--and ultimately harmful--social and community norms relating to sexuality that are prevalent in so many parts of the world. This is critical if they are going to help people see sexuality education both as a way to create a healthy and positive sexual life and prevent disease.

As providers seek to accomplish this important work, they also need to build a foundation of trust with their clients. Discussions relating to sexuality and sexual health are intimate and personal. Providers will succeed only if they have the tools and the training to help their clients feel comfortable, open, and respected.

CONTROVERSIAL SUBJECT

Discussion of sexuality is generally a controversial subject all over the world, particularly when it comes to young people and their access to information. Many societies currently view sex and sexuality as shameful. Many also have strong taboos about open discussions relating to sexuality.

Strong opposition exists about providing people with the tools, knowledge, and skills they need to empower and protect themselves sexually. Fueled more by adult fears than by research or reality, this opposition denies people life-saving and life-enhancing information. Even those who have access to sexuality education or sexual health services find that the programs and curricula are fragmented and limited in scope.

People have the right to information, education, and medical services to safeguard their health. It is the responsibility of governments, with the support and assistance of nongovernmental organizations, to provide and fund such life-saving programs and services.

As advocates, we need to include our policymakers in our work to inform people about sexual health. We need to broaden their understanding of the roles they can play in developing and supporting positive and comprehensive sexual health programs. Policymakers have the potential to be one of our greatest allies. We need to continue to work to achieve this goal.

RECENT U.N. SUMMIT ACTION

We must also listen carefully to our youth as we develop sexuality education and sexual health programs. They are the ones who can provide us with the insight and the perspective we need to make certain that we are providing them with what they need. But there is controversy.

No where was the controversy over sexuality education for young people more apparent than at the recent United Nations Summit on Children this past May. A number of conservative groups worked diligently to include information about abstinence-only-until-marriage programs in the summit's language. While the final document did not include any information about the programs, it still lacks a strong commitment to providing young people the sexual and reproductive health information, resources, and services they need.

Driven by misinformation about sexuality education and sexual health, opponents of comprehensive sexuality education falsely believe that it will promote premature sexual activity and an increase in sexual partners. We know this simply is not true.

The dangerous and misguided attempts by countries like the United States to promote unproven abstinence-only-until-marriage education can only continue to harm and deny young people their right to information and education about sexuality.

SEXUALITY EDUCATION LEADS TO SEXUAL HEALTH

Because many people become sexually active in their teen years, they need to receive information and education at the time when it has the potential to most positively affect their future.

With high rates of pregnancy, sexually transmitted infections (STIs), HIV, and sexual violence currently prevalent among young people, it is critical that they receive the type of sexuality education that will help ensure that they have the social and economic opportunities to succeed in life.

Women are in particular need of this information and education. According to the UNAIDS report just released at Barcelona, women are at particular risk for contracting HIV because of gender inequity, specifically the lack of resources, knowledge, and power because of their gender. (2)

Not surprisingly, the majority of young people 15 through 24 years of age living with HIV/AIDS in SubSaharan Africa and Asia are young women. (3) That is because these females often have unsafe sexual relationships with infected older men who seek them out. Because of their diminished power both in these relationships and in society, these young women, in particular, need access to information, education, and services to protect their health.

When sexuality education and sexual health services are more than limited anatomy lessons and are well grounded in providing decision-making skills, they will help people take measures to protect themselves and their partners.

According to the United Nations Joint Programme on AIDS, access to quality, comprehensive education about sexuality and HIV/AIDS will lead to a delay in sexual debut among young people and an increase in contraceptive and condom use among sexually active ones. (4)

COUNTRIES SET STANDARD

We know what we need to do as a global community. We know that prevention programs, comprehensive education, and quality services work to promote healthy sexual behavior and reduce negative sexual health outcomes.

We have excellent models which are supported by governments and taken to scale to reach as many people as possible. It is vital that we look to these models to guide our policymaking and program development.

One example is the work accomplished in Nigeria by nongovernmental organizations and service providers collaborating with the country's Ministry of Education. Recognizing that sexual health information and education is critical in stemming the rise of HIV, the Ministry of Education has recently implemented a national sexuality education policy and curriculum for secondary school-age youth throughout the country.

Another example is the work of the government in Uganda, where comprehensive HIV-prevention programs and condom distribution efforts are supported. As a result, the adult HIV prevalence rate was reduced from 14 percent in the early 1990s to eight percent in 2000, and prevalence rates among teenage women dropped from 28 percent in 1991 to six percent in 1998. (5)

A final example is the work in Thailand. With the strong support of policymakers, Thailand's comprehensive prevention efforts have reduced the number of new HIV infections to 30,000 from a high of 140,000 in 1990. (6)

Country-specific programs like these are setting the standard that the rest of the world should--and must--follow in order to promote healthy sexuality for all people.

REFERENCES

(1.) UNAIDS, Report on the Global HIV/AIDS Epidemic, 2002 (New York: United Nations, 2002).

(2.) Ibid.

(3.) UNICEF, The Progress of Nations, 2000 (New York: United Nations, 2000).

(4.) UNAIDS, Children and Young People in a World of AIDS (New York: United Nations, 2001).

(5.) UNAIDS, Global Crisis--Global Action (New York: United Nations, 2001).

(6.) UNAIDS, AIDS Epidemic Update (New York United Nations, 2001).