Understanding cultural diversity is key to effective communication. (From the Editor).

When I first started working in New York City after living in the Washington, DC, area for over 20 years, I was in awe of the ethnic diversity of this enormous city. It is filled with neighborhoods that reflect the cultures of dozens of countries worldwide.

Even after working here for over 10 years, I am still amazed at the variety of cultures that coexist in this city. It is a humbling and exciting experience to try to understand--even to a very small extent--the various habits, beliefs, traditions, and languages of these cultures. I feel very lucky to live here and to have gained a fairly good idea of the cultural diversity of the world without leaving the city.

This issue of the SIECUS Report on "Sexual Health Issues Worldwide" emphasizes the importance of understanding various cultures as the foundation for communicating effectively about sexual health and sexual rights issues.

TALKING ABOUT SEXUALITY

Emily Smith, who is a senior science writer and editor for Network magazine at Family Health International in Research Triangle, NC, writes in her article "Discussing Sexuality Fosters Sexual Health" about the importance of providers discussing with their clients aspects of their lives that may impede optimal sexual health. She points out that providing quality reproductive health care is complex and involves an open dialogue between providers and clients about issues that are traditionally not discussed in many cultures.

Part of what makes her article so fascinating is her use of a wealth of research from around the world to make the point that there is still a great deal of work to do in this area. She discusses studies from Brazil, Boliva, India, Nicaragua, Sierra Leone, Indonesia, Pakistan, Bangladesh, Thailand, and Mexico.

PROMOTING SEXUAL HEALTH

The remainder of this SIECUS Report focuses on programs worldwide that are helping to promote sexual health in various countries.

Kathy Kirwan, the PASH project coordinator and manager of education services at Family Planning of Western Australia in Perth, Australia, writes about her organization's PASH (Promoting Sexual Health) program, which works with young people on sexuality issues from a holistic peer education perspective. "Respect for the young people and how they are managing their lives and their decisions is paramount in the course," she explains.

Next Denise Kohn, the program coordinator for adolescents of Planned Parenthood Federation's Western Hemisphere Region, writes in "Working with Out-of-School Youth in Belize and Peru" that targeting such youth is particularly challenging for sexual and reproductive health providers. She points out that one of the most important lessons that a provider can learn is to discuss issues in the context of other pressing concerns, such as jobs, or in informal "rap sessions." "Include practical issues--such as decision-making, self-esteem, and development of life goals--in programs so that young people will find them more useful," she adds.

Then Jashodhara Dasgupta, coordinator of SAHAYOG in Lucknow, Uttar Pradesh, India, recaps in "Experiences of Implementing a Sexual Health Strategy in Northern India" the compelling story of his staff's arrest and imprisonment after it published a study on HIV/AIDS in the area. "State AIDS organizations and government agencies denied that there was a need to address sexuality in discussions about AIDS and even dismissed the possibility of AIDS cases in the area," he said.

The remaining four articles discuss programs that are underway in four separate countries. They provide important information for individuals interested in similar work. The articles include "Youth Hotlines Succeed in Guatemala and Colombia," "AIDS Infoshare: Russian Public Health and Human Rights," "BBC's Sexwise Provides Critical Sexual Health Information Worldwide," "Lovelife and Independent Newspapers Join South African Fight Against HIV/AIDS."

POLICY UPDATE

William Smith, SIECUS' director of public policy, makes an excellent point in his article "Bush Administration 'Mission Creep' Affects Global Sexual Health Efforts" that the President is trying to convince the rest of the globe that the only effective way to address sexual and reproductive health issues is to tell people that they should remain abstinent until they marry and that they must remain monogamous and exercise fidelity after they marry.

He also highlights a recent study published in the June British Medical Journal pointing to the gamble the world will take if it accepts the Bush Administration's premise. The study found that the pregnancy rate among adolescent women in four abstinence programs was higher than in the control group that did not participate.

He also points to recent Bush Administration efforts to advance abstinence-only-until-marriage at the United Nations Children's Summit in May and to the phasing out of U.S. financial support for the United Nations Population Fund in the fiscal year 2003 federal budget. This is why SIECUS believes those gathering in Barcelona this July to assess the global HIV/AIDS epidemic and strategize about how to find solutions will not be looking to the U.S. government for inspired leadership.

NEW CULTURALLY COMPETENT RESOURCES

Finally this SIECUS Report includes the updated SIECUS Annotated Bibliography on "Culturally Competent Sexuality Education Resources." This is a critically important resource for all people working within cultures to help people become sexually healthy adults. It includes books of general interest, books for professionals, books for families, relevant curricula, a list of publishers, and a list of organizations that can provide additional information and resources.

I think that SIECUS Report readers will find this issue filled with important information that will help them in their work on sexual health issues worldwide.