Promoting Youth Sexual Health

Home, School, and Community Collaboration

Gina Coffee, Pamela Fenning, Tommy L. Wells

• Publisher: Routledge
• Year: 2015
• Print ISBN: 9781138774643
• eBook ISBN: 9781317684251
• Topic: Psicologia
• Subtopic: Sessualità umana in psicologia

Promoting Youth Sexual Health, written for preventionists and interventionists who work with children and adolescents across home, school, or community settings, offers guidance on how to promote sexual health among youth. The reader is first introduced to the state of the field, including sexual behaviors in which youth engage, sexual risk and protective factors, standards and professional guidelines for promoting sexual health of youth, developmental and cultural considerations, and considerations in supporting LGBTQ youth. Evidence-based strategies to support child and adolescent sexual health in homes, schools, and communities are then presented. The book concludes with a proposed model for integrating supports across settings to comprehensively promote youth sexual health.

1 An Introduction to Child and Adolescent Sexual Health

DOI: 10.4324/9781315774381-1

The World Health Organization (WHO) defines sexual health as “a state of physical, emotional, mental and social well-being related to sexuality; it is not merely the absence of disease, dysfunction or infirmity. Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence. For sexual health to be attained and maintained, the sexual rights of all persons must be respected, protected and fulfilled” (2002).

The WHO (2002) further advances that:

• “Sexual health is about well-being, not merely the absence of disease.
• Sexual health involves respect, safety and freedom from discrimination and violence.
• Sexual health depends on the fulfilment of certain human rights.
• Sexual health is relevant throughout the individual's lifespan, not only to those in the reproductive years, but also to both the young and the elderly.
• Sexual health is expressed through diverse sexualities and forms of sexual expression.
• Sexual health is critically influenced by gender norms, roles, expectations and power dynamics.”

Within this context, the purpose of this book is to provide school- and community-based health professionals and preventionists/interventionists who work with children and adolescents (e.g., psychologists, social workers, counselors, nurses, educators)—especially those who work collaboratively with homes, schools, and communities—with guidance in promoting sexual health among children and adolescents. In our collective experiences as mental health professionals who work with youth in schools and who collaborate with educators, families, and community members to support youths’ health development, it is our belief that the promotion of sexual health among youth is an essential component to overall physical, emotional, cognitive, and social health.

Current State of Promoting Sexual Health among Children and Adolescents

In recent years, there have been many positive trends in the sexual behaviors of American youth (NCSH, 2013). For example, “youth are waiting longer to initiate sex, rates of condom usage have increased, the number of youths’ sexual partners has decreased, and the teen pregnancy and birth rates have declined significantly. Many youth today engage in conversations about sex and sexual health with their partners and parents, and most access sexual and reproductive health care services” (2013, p. 2). Notwithstanding these encouraging trends, however, the need for attention to and promotion of sexual health among children and adolescents, if even just from a physical standpoint, continues to be great, as youth are still contracting and transmitting sexually transmitted infections (STIs) and human immunodeficiency virus (HIV), becoming pregnant, and engaging in sexual risk behaviors (see Chapter 2). In fact, some data indicate that youth 15–24 years of age represent 9.1 million of the 18.9 million new cases of STIs annually, and 615,000 adolescents become pregnant each year (Guttmacher Institute, 2014).

Although the sexual health of youth, as well as engagement in sexual risk behaviors, may certainly be influenced by many factors, access to and the provision of comprehensive and effective sexuality education may well be a necessary, though not sufficient, tool for prevention (see Chapter 4). To that end, through the collaborative efforts of the Future of Sex Education (FoSE) initiative, the National Sexuality Education Standards: Core Content and Skills, K-12 (FoSE, 2012) were recently developed to provide a framework for school-based, developmentally and age-appropriate sexuality education for young people—noting that sexuality education is inconsistently implemented across the nation and school curricula typically only provide a median of 17.2 hours of instruction (across elementary, middle, and high school) devoted to HIV, STIs, and pregnancy prevention (FoSE, 2012). In alignment with the WHO definition of sexual health, the National Sexuality Education Standards have identified seven domains of sexuality education that are essential for youth: anatomy and physiology, puberty and adolescent development, identity, pregnancy and reproduction, sexually transmitted diseases (STDs) and HIV, healthy relationships, and personal safety.

Sexual Health Resources

The development of the National Sexuality Education Standards represents a significant advance in the field, as the standards not only call attention to the sexuality education needs of youth across childhood and adolescence but also provide a guiding framework for health professionals and preventionists/interventionists who wish to develop and/or implement developmentally and age-appropriate sexuality education.

In addition to the National Sexuality Education Standards, a multitude of sexual health resources is available online for health professionals, preventionists/interventionists, families, and youth themselves. That is, government agencies, advocacy groups, and others have developed invaluable and informative resources designed not only to raise awareness of the sexual health needs of youth but also to educate and inform youth and those who work with them of practices and strategies to promote sexual health.

Examples of online resources for sexual health are presented in Tables 1.1 and 1.2. In addition to providing educational materials for its users, the websites presented in Table 1.2 also include databases of youth sexual behaviors. For example, Child Trends (http://www.childtrends.org) is a nonprofit, nonpartisan research center. Among the data compiled and reported regarding teen pregnancy and reproductive health, the Child Trends indicator list includes information about adolescents who have ever been raped, birth control pill use, children and youth with AIDS, condom use, dating, oral sex behaviors among teens, sexually active teens, sexually experienced teens, STIs, and statutory rape. Through an examination of the data available from multiple institutions, the interested reader may stay abreast of the current state of youth sexual health and behaviors.

The purpose of this chapter is to provide an introduction to child and adolescent sexual health. The remainder of this book is broadly structured around two complementary sections. In the first half of the book, we present an introduction to relevant topics surrounding sexual health of youth. In Chapter 2 (Sexual Risk Behaviors of Children and Adolescents), we present the reader with an overview of the sexual risk behaviors in which children and adolescents engage. The chapter begins with a definition and examples of sexual risk behaviors such as engaging in sexual intercourse, engaging in unprotected sexual intercourse, and/or having sex with four or more partners in their lifetime (CDC, 2014a). The chapter concludes with data regarding the prevalence of sexual risk behaviors among children and adolescents. We continue the discussion of sexual risk behaviors in Chapter 3 (Sexual Risk and Protective Factors) by exploring risk and protective factors that may contribute to engagement in sexual risk behaviors (e.g., Kirby & Lepore, 2007). Environmental and individual risk and protective factors known to influence sexual behavior, pregnancy, and STIs are identified and described. Environmental factors include those associated with the community, family, peer, and romantic partner. Individual factors include those associated with biological factors; race/ethnicity; attachment to and success in school; attachment to community; attachment to faith communities; problem or risk-taking behavior; cognitive and personality traits; emotional well-being and distress; sexual beliefs, attitudes, and skills; and relationships with romantic partners and previous sexual behavior. The chapter concludes with a specific focus on risk and protective factors that are alterable or amenable to change.

Table 1.1 Online Resources for Sexual Health

	Mission
ACT (Assets Coming Together) for Youth Center of Excellence—http://www.actforyouth.net	“ACT (Assets Coming Together) for Youth Center of Excellence connects research to practice in the areas of positive youth development and adolescent sexual health.”
Advocates for Youth—http://www.advocatesforyouth.org	“Established in 1980 as the Center for Population Options, Advocates for Youth champions efforts that help young people make informed and responsible decisions about their reproductive and sexual health. Advocates believes it can best serve the field by boldly advocating for a more positive and realistic approach to adolescent sexual health. Advocates focuses its work on young people ages 14–25 in the U.S. and around the globe.”
Answer: Sex Ed, Honestly—http://answer.rutgers.edu/	“Answer is now an award-winning, national organization, providing invaluable sexuality education resources to millions of young people and adults every year. Our strategic plan for 2013–2017 is an ambitious one that will enable us to revolutionize sexuality education in the United States.”
Centers for Disease Control and Prevention (CDC) Adolescent and School Health—http://www.cdc.gov/healthyyouth/sexualbehaviors/index.htm	“CDC promotes the health and well-being of children and adolescents to enable them to become healthy and productive adults.”
GSA Network—http://www.gsanetwork.org/sexualhealth	The GSA Network offers resources for the sexual health needs of lesbian, gay, bisexual, and transgender youth.
American Sexual Health Association—http://www.iwannaknow.org/teens/index.html	“iwannaknow.org offers information on sexual health for teens and young adults. This is where you will find the facts, the support, and the resources to answer your questions, find referrals, and get access to in-depth information about sexual health, sexually transmitted infections (STIs), healthy relationships, and more.”
Illinois Caucus for Adolescent Health (ICAH)—http://www.icah.org/sexed	“ICAH is a network of empowered youth and allied adults who transform public consciousness and increase the capacity of family, school and healthcare systems to support the sexual health, rights and identities of youth.”
National Campaign—http://thenationalcampaign.org	“Our mission is to improve the lives and future prospects of children and families and, in particular, to help ensure that children are born into stable, two-parent families who are committed to and ready for the demanding task of raising the next generation.Our strategy is to prevent teen pregnancy and unplanned pregnancy, especially among single, young adults.”
National Coalition for Sexual Health (NCSH)—http://nationalcoalitionforsexualhealth.org	“The NCSH aims to make sexual health a common part of our national discourse and promote high quality sexual health care services. The NCSH brings together organizations and individuals who have a stake in not just advancing sexual health, but in advancing the overall health of our nation.”
The Sexuality Information and Education Council of the United States (SIECUS)—http://www.siecus.org	“SIECUS educates, advocates, and informs.Educate: We help schools and communities develop comprehensive sexuality education curricula, train teachers to provide high quality sexuality education in the classroom, and help parents talk to their kids about sex.Advocate: We educate policymakers and their staff about issues related to sexuality and train advocates on the local, state, and national levels to build support for comprehensive sexuality education and access to reproductive health information and services.Inform_ We produce countless resources for a wide variety of audiences—from policymakers to parents, healthcar...

Table of contents

• Cover Page
• Half-Title Page
• Title Page
• Copyright Page
• Dedication
• Table of Contents
• List of Figures
• List of Tables
• 1 An Introduction to Child and Adolescent Sexual Health
• 2 Sexual Risk Behaviors of Children and Adolescents
• 3 Sexual Risk and Protective Factors
• 4 Relevant Standards and Professional Guidelines for the Promotion of Sexual Health of Children and Adolescents
• 5 Developmental and Cultural Considerations in Promoting Sexual Health
• 6 Promoting the Sexual Health of LGBTQIA Youth
• 7 Promoting the Sexual Health of Children and Adolescents at Home
• 8 Promoting the Sexual Health of Children and Adolescents at School
• 9 Promoting the Sexual Health of Children and Adolescents in the Community
• 10 Conclusion and Future Directions
• Index