Title: Protecting adolescent sexual and reproductive health
Course: Adolescent and Youth Reproductive Health - Ethiopia (Full)

Protecting adolescent sexual and reproductive health

Adolescent sexual and reproductive health refers to the physical and emotional wellbeing of adolescents and includes their ability to remain free from unwanted pregnancy, unsafe abortion, STIs (including HIV/AIDS), and all forms of sexual violence and coercion.

One of the important concerns of young people is their sexual relationships. In particular, young people need to know how they can maintain healthy personal relationships. It is important to keep in mind that sex is never 100% 'safe', but you can advise young people on how to make sex as safe as they possibly can. That is why you should always talk about 'safer' sex and not 'safe sex'.

As a Health Extension Practitioner, you need to educate young people in what constitutes safer sex and the consequences of unsafe sexual practices. Safer sex is anything that can be done to lower the risk of STIs/HIV and pregnancy without reducing pleasure. The term reflects the idea that choices can be made and behaviours adopted to reduce or minimise risk.

Sexual activities may be defined as high risk, medium risk, low risk, or no risk based on the level of risk involved in contracting HIV or other STIs.

No risk

There are many ways to share sexual feelings that are not risky. Some of them include hugging, holding hands, massaging, rubbing against each other with clothes on, sharing fantasies, and self-masturbation.

Low risk

There are activities that are probably safe, such as using a condom for every act of sexual intercourse, masturbating your partner or masturbating together as long as males do not ejaculate near any opening or broken skin on their partners.

Medium risk

There are activities that carry some risk, such as introducing an injured finger into the vagina. Note that having sexual intercourse with improper use of a condom also carries a risk of HIV/STI transmission.

High risk

There are activities that are very risky because they lead to exposure to the body fluids in which HIV lives. This refers to having unprotected sexual intercourse.

Dual protection is the consistent use of a male or female condom in combination with a second contraceptive method, such as oral contraceptive pills. Often young people come to a healthcare facility for contraception and are given a method that protects them only from pregnancy. As a healthcare provider, you should ensure that all young people are using a method or combination of methods that protect them from both pregnancy and STIs/HIV to minimise their risk to the lowest level possible. Box 1.1 shows important components of adolescent and youth reproductive health programmes that should be available to all young people.

Box 1.1 Services that should be provided for young people

- Information and counselling on sexual and reproductive health issues
- Promotion of healthy sexual behaviours
- Family planning information, counselling and methods of contraception (including emergency contraceptive methods)
- Condom promotion and provision
- Testing and counselling services for pregnancy, HIV and other STIs
- Management of STIs
- Antenatal care (ANC), delivery services, postnatal care (PNC) and pregnant mother-to-child transmission (PMTCT)
- Abortion and post-abortion care
- Appropriate referral linkage between health facilities at different levels.