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Youth centers, peer education, and one-off public meetings have generally been ineffective in facilitating young people's access to sexual and reproductive health (SRH) services, changing their behaviors, or influencing social norms around adolescent SRH. Approaches that have been found to be effective when well implemented, such as comprehensive sexuality education and youth-friendly services, have tended to flounder as they have considerable implementation requirements that are seldom met. …
Numerous definitions of sexual health have been developed over the past few years. Perhaps the best known and most widely accepted of them is the World Health Organization’s (WHO) working definition, which reads as follows: ". . . a state of physical, emotional, mental and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity. …
Globally, adolescents aged 12–15 years are making sexual and reproductive decisions of profound significance for their future, often based on misguided, inadequate or dangerously wrong information. Very few countries provide evidential and comprehensive education about puberty, sexuality, and reproductive health and safety to children and young adolescents at school, when it is most effective and beneficial. UNESCO has produced a culturally applicable framework for such education, with the primary aim of reducing sexual risk behaviour and sexually transmitted infections including HIV/AIDS. …
The ability of specific behaviour-change interventions to reduce HIV infection in young people remains questionable. Since January 1999, an adolescent sexual and reproductive health (SRH) intervention has been implemented in ten randomly chosen intervention communities in rural Tanzania, within a community randomised trial (see below; NCT00248469). The intervention consisted of teacher-led, peer-assisted in-school education, youth-friendly health services, community activities, and youth condom promotion and distribution. …