Adolescent sexual and reproductive health: the challenge for society

Within almost all countries of the world there is a growing concern about the sexual and reproductive health of adolescents. This concern has resulted from either a real or a perceived increase in adolescent sexual activity, coupled with high rates of unplanned pregnancies, early childbearing and the transmission of sexually transmitted infections, including HIV. Although many adults have difficulties in accepting young people as sexual beings, there is now a growing consensus that young people need more information and services to help them ensure their sexual and reproductive health. Many of the programmes designed to make sexual and reproductive health information and services available to young people have used 'top down' approaches, based on adult-led risk and lifestyle orientation. In such programmes, young people are often looked upon negatively, in terms of their problems, rather than positively, in terms of their potential and capabilities. This article argues that a focus on the negative aspects of adolescent sexual and reproductive health means that young people are seen as collections of discrete problems. Furthermore, such approaches tend to view all young people as one homogeneous group when in reality adolescents are an enormously diverse group, not only in terms of age and gender, but also in terms of ability and beliefs. Such approaches therefore fail to address the vulnerabilities of particular young people and fail to contextualize sexual health within a wider framework of young people's lives. A challenge for the next century is to move away from focusing on risks, towards embracing needs and rights, and to involve young people in identifying issues and developing solutions.