Thursday, June 11, 2009

Female adolescents at risk of STIs

A report on adolescents' sexual reproductive health in Ghana has revealed that female adolescents are exposed to greater reproductive health risks than male adolescents.

This is because women are physiologically more vulnerable than men to HIV infection. As a result, women have higher rates of Sexually Transmitted Infections (STIs), other than HIV, which in turn increases their risks of HIV infection.

The report entitled, "Protecting the Next Generation in Ghana: New Evidence on Adolescent Sexual and Reproductive Health Need", shows that the potential negative consequences of unprotected sex are greater for female adolescents than for male adolescents.

The 1989 UNICEF/UNFPA/WHO joint Statement and Strategy for Action on "The Reproductive Health of Adolescents" defined adolescents as people between the ages of 10-19. It terms the periods between 10-14 years as early adolescence and late adolescence from 15-19 years.

Adolescents aged 10-19 form more than one-fifth of Ghana's population.
Slightly more than half of adolescents aged 12-19 live in rural areas and almost half attended secondary school.

A recant analysis of HIV prevalence in Ghana found that women who had had sex by age 15 were 2.4 times as likely to be HIV positive as were women whose sexual debut occurred at a later age.

It stated that 7% of female adolescents aged 15-19 who dropped out of school did so because of pregnancy.

This no doubt limits her future economic opportunities if she is unable to continue her education after delivery.

According to the report, early marriage can increase the risk for poor reproductive health outcomes for adolescents. 28% of women aged 20-24 had married before age 18 and 47% had married before age 20.

In the 2004 National Survey of Adolescents (NSA) females aged 15-19 who were in union were about three times as likely as those not in union to have a sexual partner who was 10 or more years older.

"The fact that young women in unions tend to have older partners elevates their risk, because the age difference hinders their ability to negotiate for safer sex," it explained.

Again the 2004 NSA revealed that only 16% of female adolescents in unions reported that they and their partners were using the male condom, compared with 40% of female adolescents not in unions.

Besides, unprotected sex with a partner who has had multiple sexual partners can increase a young woman's risk of STIs.

Data from the 2003 Ghana Demographic and Health Survey (GDHS) showed that 16% of married or cohabiting men had had sex with a person other than their spouse within the past year.

This may partly explain why married and formerly married women had the highest rates of HIV infection in Ghana.

Thus, early marriage and large age differences between partners may be important factors in the sexual and reproductive health of married female adolescents.

In addition, knowledge of how to access reproductive health care services was consistently lower among adolescents in rural areas than their urban counterparts.

"Among females aged 15-19, 53% of those living in urban areas knew of at least one source of contraceptive compared to 31% of those in rural areas."

Even though the most convenient way to educate large numbers of adolescents about sexual and reproductive health issues is through school-based programmes, some adolescents do not attend school at all.

The report stated that not only is it harder to reach such youth, but their lifestyle put them at risk for STIs and unwanted pregnancies.

In a systematic review published by the WHO, researchers examined studies on programmes to prevent HIV/AIDS in young people in developing countries and concluded that there was evidence to recommend widely implementing community based interventions that target all adolescents.

A 2003 study found that youth who talked with peers about reproductive health were more likely to adopt protective behaviour against STIs and pregnancy than those who did not do so.

At the 2005 World Summit, the High-level Plenary Meeting of the 60th Session of the UN General Assembly, world leaders resolved to achieve universal access to reproductive health by 2015, promote gender equality and end discrimination against women.

In particular, they agreed to integrate the goal of access to reproductive health into national strategies to attain the MDGs.

The Special Session of the African Union Conference of Ministers of Health, held in Mozambique in 2006, focused on universal access to comprehensive sexual and reproductive health services in Africa.

The Ministers concluded that African leaders have a special obligation to respond to the sexual and reproductive health needs and rights of their people, and they endorsed an action plan to demonstrate their commitment to that end.

Currently the UN estimates that the world population will continue to increase, to reach 9 billion people in 2050, virtually all the population growth occurring in less developed countries.

Thus, during the next 40-50 years, people within the reproductive age will bracket will represent over 40% of the total population. The number of adolescents (aged 10-19 years) is predicted to grow to 1.3 billion by the year 2030, before starting to decline gradually.

Fulfilling the sexual, reproductive and post-reproductive health needs of the various population groups will require a wider range sexual and reproductive health products than is currently available.

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