Sexual Development Awareness

This is the kind of message we hope youth can hear:

"The importance sexuality has in your life will change at different times, and you may not always be sexually active or want to be. Like any other subject, sex education should be accurate, enable you to make informed choices and give answers and solutions to your own concerns. Whatever your starting point, your experience is an individual one, and you are already on this journey. It is, however, often an experience of life or death."

(For reading source, click here.)

Unprotected Sex

Having unprotected sex (anal, oral or vaginal) and/or sharing unclean needles such as intravenous drug syringes (the works) and needles used for tattooing and body piercing with a person who is HIV positive or unaware of his/her HIV status are all actions that put you at risk.

The use of drugs and/or alcohol can make it harder for you to practice safer sex and to set limits for yourself.

In 8 out of 10 cases, HIV is transmitted during sex between a man and a woman or between two men.

The virus is passed on when infected blood, semen, or vaginal fluids from one partner enters the body of the other partner through the very thin skin of their sex organs, mouth or anus, or through sores or cuts on their mouth, hands or body.

Dry sex increases the risk of HIV transmission because friction can cause sores in the vaginal wall.

Girls and Virginity

A virgin is someone who has not had sexual intercourse. Women have a membrane called a hymen surrounding the vaginal opening. The hymen can be stretched and/or torn by exercise, sports or the use of tampons. The presence of the hymen is not a sign of virginity. Some people believe that the hymen is the only proof of virginity. This belief can cause a lot of unhappiness and anxiety to a woman who has no hymen, but is a virgin.

Having penetrative sex for the first time can be scary. The need for gentleness and understanding is very important. The hymen is not a wall that needs to be battered down. The first act of sexual intercourse will not necessarily cause bleeding. The first time can be painful or sore whether you are a male or female. And you can become pregnant the first time you have sex. Do not have sex if you don't want to.

Menstruation

Girls are born with thousands of potential or immature eggs in each of their 2 ovaries. After puberty, one mature egg is released every month. This is called ovulation and happens around 14 days before a 'period' is due. If the egg is not fertilized by sperm, it will die and pass out of the body through the vagina as a period, along with the lining of the womb. The egg can't be seen as it's much too small. The menstrual cycle varies from 21 days to 40 days. Not all women have regular periods.

Changes in hormone levels before or during your cycle can affect your mood. You may feel energetic and sexy around ovulation and/or moody, tearful and angry just before your period is due. Your breasts may become sore or a bit larger and you may get spots on your face. Women release eggs until they reach menopause. Menopause occurs when women are in their late 40s and 50s and menstruation stops and they cannot become pregnant.

Changes During Puberty

Puberty happens to every young person some time after the age of 8. It is the transition into woman/manhood when the sex organs grow and develop and the body becomes ready and able to reproduce. These changes can make you feel proud and happy, and they can also make you feel confused or embarrassed.

Changes that affect girls:

Changes that affect boys:

The A-B-C Approach

Abstaining from sexual activity, faithfulness, and condom use are three behaviors that can prevent or reduce the likelihood of sexual transmission of HIV infection. These behaviors are often considered together as the "ABCs" of HIV prevention - A for abstinence (or delayed sexual initiation among youth), B for being faithful (or reducing one's number of sexual partners), and C for condom use, especially for casual sexual activity and other high-risk situations.

Understanding and promoting these behaviors are key elements in combating the spread of HIV/AIDS. Based on a growing body of evidence from a number of developing countries, USAID supports the ABC approach because it can target and balance A, B, and C interventions according to the needs of different at-risk populations and the specific circumstances of a particular country confronting the epidemic.

Background: The Decline of HIV Prevalence in Uganda

As one of the world's earliest success stories in confronting AIDS - and probably the most dramatic - Uganda experienced substantial declines in HIV prevalence during the 1990s. According to estimates by the U.S. Census Bureau and UNAIDS, national prevalence peaked at around 15 percent in 1991 and fell to 5 percent by 2001. Among pregnant women in urban areas, prevalence declined from a high of approximately 30 percent to about 10 percent, while among rural pregnant women it fell from more than 10 to less than 5 percent. Uganda's vivid decline in HIV prevalence remains unique worldwide. In other sub-Saharan African countries with epidemics of comparable severity and longevity, similar declines have yet to occur. Accordingly, Uganda's success has been the subject of intense study and analysis.

It is now clear that Uganda's decline in HIV prevalence followed positive changes in all three ABC behaviors: increased abstinence, including deferral or greatly reduced levels of sexual activity by youth since the late 1980s; increased faithfulness and partner reduction behaviors; and increased condom use by casual partners. In Uganda's particular circumstances, the most significant of these appear to be faithfulness or partner reduction behaviors by Ugandan men and women, whose reported casual sex encounters declined by well over 50 percent between 1989 and 1995. This conclusion is supported by comparisons with other African countries.

In addition, abstinence, deferral of sexual activity by youth, and condom use played substantial roles in reducing HIV prevalence. Uganda's successful combination of ABC approaches appears rooted in a community-based national response in which both the governmental and nongovernmental sectors, including faith-based organizations, succeeded at reaching different population groups with different messages and interventions appropriate to their need and ability to respond. Young persons who had not yet begun to have sex were cautioned to wait. If a young person had just begun to have sex, then he or she should return to abstinence. If a person was already sexually active, he or she should adopt the practice referred to locally as "zero grazing" - faithfulness in marriage or partner reduction outside of marriage. For those who could not heed this advice, free and affordable condoms were distributed and promoted.

Evidence From Other Countries

While Uganda provides the most dramatic example of the effect of ABC behavior changes on slowing the spread of HIV infection, there is growing evidence from other countries as well. In Thailand, the first Asian country to face a severe AIDS epidemic, commercial sex was the main source of HIV infection. In the early 1990s, the government successfully instituted a "100 percent condom use" policy in commercial sex establishments, and this policy was widely credited with drastically reducing the spread of HIV infection. In addition to increased condom use, between 1990 and 1995 the proportion of men reporting paying for sex also declined by more than 50 percent. In addition to condom use, partner reduction in Thailand undoubtedly had a substantial effect on slowing the country's HIV/AIDS epidemic. As in Uganda, the government's willingness to address the epidemic openly was crucial.

Zambia, Cambodia, and the Dominican Republic are other countries in which various combinations of ABC behaviors have contributed to declines in HIV prevalence. In Zambia, some decline in prevalence appears to have occurred among urban youth during the 1990s, during which time national surveys reported clear, positive changes in all three ABC behaviors. The grassroots involvement of faith-based and other community-based organizations was crucial in promoting these changes. As occurred in Uganda, the main reported change was a large decline in casual sex among both men and women. Cambodia is replicating Thailand's success in applying a 100 percent condom policy in commercial sex establishments. Also similar to Thailand, the country has experienced a steep decline in the number of men visiting sex workers (from 27 to 11 percent between 1996 and 2000). In the Dominican Republic, partner reduction by men and increased condom use with non-regular sexual partners also appear to have slowed the spread of infection.

Balancing and Targeting a Comprehensive ABC Approach

A USAID-funded review of data finds the need for appropriately balanced and targeted ABC approaches. This study has analyzed how ABC behaviors appear to have affected HIV prevalence in three countries where prevalence has declined (Uganda, Zambia, and Thailand) compared to three countries where there is little evidence of a decline (Cameroon, Kenya, and Zimbabwe). In the case of the five African countries, it found that significant delays in the onset of sexual activity, declines in premarital sex, and large declines in extramarital sex and multiple sexual partnerships occurred in Uganda and Zambia during the 1990s, while comparable changes appear not to have occurred in Cameroon, Kenya, or Zimbabwe. Condom use increased greatly in all of the countries.

In September 2002, USAID hosted a meeting of technical experts from HIV/AIDS programs and research institutions to consider the evidence regarding ABC behavior change approaches to HIV prevention. The meeting identified areas of consensus that may have important implications for program planning and decision making:

There is a clear need for a balance of A, B, and C interventions. One approach should not be favored over another. Approaches should instead be combined as appropriate based on the local cultural context as well as the state of the HIV epidemic.

Interventions need to be targeted for efficiency and respond to crucial differences among target groups. For example, balanced ABC approaches might be implemented in the form of A interventions promoting sexual deferral to youth; B interventions promoting partner reduction to those not in monogamous relationships; and C interventions promoting condom use to highly sexually active groups, especially sex workers and their clients, and people living with HIV/AIDS.

The nature of the epidemic is a major factor in determining the appropriate balance. In Southeast Asia, HIV/AIDS is still largely confined to high-risk populations, in which correct and consistent condom use is relatively easy to implement. In many African countries, the epidemic is more generalized and thus requires an appropriate mix of A, B, and C approaches.

Continuing studies are needed. Continuing studies in other countries will yield more evidence of the most effective balance of ABC approaches in different settings. Senegal, for example, has achieved Uganda-like behavior change with a balanced ABC program in a low-prevalence setting. Further study of such successes is needed to consider their potential application elsewhere.

The A-B-C Approach: Abstinence

Abstinence means avoiding sex. Sex can have different definitions for different people. Some people define sex as penis-in-vagina intercourse. Others may include oral sex, anal sex, or even kissing and touching. The way you define "sex" determines what activities to avoid if you want to abstain. For the purpose of this page, we will focus on abstaining from penis-in-vagina intercourse because the goal of these materials is to help you prevent pregnancy.

Please remember that it's OK to go through periods of your life, or periods of time within a single relationship, in which you want to abstain and periods in which you want to have sex. The decision to have sex is YOUR decision, each and every time.

Advantages:

The A-B-C Approach - Be Faithful

To "B-e Faithful" as a means of AIDS prevention means to remain loyal to one's sexual partner. By doing such, one lowers the risk of exposure to HIV-infected individuals. By choosing to remain in a faithful, committed relationship each partner is choosing to be exclusive and only have sexual intercourse with one another. Thus, if you choose to be sexually active, rather than to abstain from sex, being faithful to your sexul partner is the next step in the ABC prevention plan as a way to reduce the risk of transmitting HIV.

The A-B-C Approach: Condoms

Studies have shown that latex condoms are highly effective in preventing HIV transmission when used consistently and correctly. These studies looked at uninfected people considered to be at very high risk of infection because they were involved in sexual relationships with HIV-infected people. The studies found that even with repeated sexual contact, 98-100 percent of those people who used latex condoms correctly and consistently did not become infected.

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