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Filling the Gaps: Improving Our Approach to SRHR

By Vandana M Kissoon

Intergovernmental and humanitarian organizations have been lobbying for the implementation of comprehensive sexual reproductive health care, education and research programs by governments in countries around the world for decades. Their campaigns, supported by the findings of several case studies, have stimulated various programs and policies. For instance, the three stage ‘Strategic Approach to Strengthening and Reproductive Health Policies and Programs’ developed by the World Health Organization (WHO) adopted in countries such as Ethiopia, Brazil and Zambia.

Despite the growing awareness and advocacy of the need for comprehensive sexual reproductive health care, education and research, studies have shown that there has been a significant gap in programs focusing on reproductive health and neglecting the importance and need for sexual health care. Sexual health care and education equips people, particularly adolescents, with accurate knowledge about anatomy, contraceptives, pregnancy, sexually transmitted infections (STIs) and sexually transmitted diseases (STDs) prevention, transmission, treatment and how to mitigate its effects.

Sexually transmitted infections continues to be a significant global health concern. The World Health Organization (WHO) in 2020, estimated approximately 36.6 million people globally living with the Human Immunodeficiency Virus (HIV). Which, although indicates a 30% decline in cases since 2010, is still off great concern when considering the drastic gender gap that is prevalent when analyzing the statistical data. Women are seen to be disproportionately affected by STIs and HIV when compared to their male counterparts. 48% of adults living with HIV are women globally with minority women in the United States being impacted to a greater extent. In the United States, cases of gonorrhea and chlamydia are statistically higher in women between the ages of 20-24 years in comparison to men of the same age group. Limited access to health care and in some instances the social dynamic of being engaged in unregulated and illegal sex work leaves marginalized groups vulnerable to being at a higher risk of being impacted by STDs

History reports evidence of sexually transmitted diseases dating back to as early as ancient civilizations. But how did we allow an age old public health issue to continue to affect us for centuries despite the advancements made in modern medical research? The social stigma attached to sex and embracing ones sexuality, propagated by the religious ideal of abstinence, birthed the sensitivity and taboo surrounding the discussion of sexually transmitted diseases and infections by the spread of misinformed over the centuries. This left the largest sexually active demographic in the world, young adults, at risk to serious sexual reproductive health issues.

Leah H. Keller identified a major barrier to comprehensive sexual education being the promotion of abstinence-only programs. This conservative approach fails to consider the many adolescents who would engage in sexual activity before marriage. By these programs withholding vital information on sexual reproductive health, adolescents who have attempted abstinence and engaged in sexual activity are less likely to use condoms that would protect them against STIs. These programs also perpetuates social stigma attached to premarital sex and harmful gender stereotypes preventing adolescents from seeking out sexual health care and information.

Jenna M. Piper, highlighted some categories in which primary preventative interventions to STIs and STDs can be grouped. Systematic initiatives, occur at a community level and includes encouraging STIs and STDs testing, diagnosis and treatment, sexual health education promotion and interventions to identify and reduce the barriers to access of sexual reproductive health care. Community based programs target lower-risk individuals through informational campaigns, the availability and accessibility of condoms and ensuring access to STI testing, treatment and counseling where necessary. Behavioral intervention focuses on the training of medical practitioners in the skills needed to effectively obtain sensitive sexual information and provide STI prevention counseling.  Sexual health education has also proven to be a cost effective approach to reducing social vulnerabilities that makes marginalized groups more susceptible to being at risk of being impacted by STIs.

“Education promotes gender equality and women empowerment; what’s more, it has added benefits such as delaying marriage for young girls and providing an avenue for family planning.” Awareness raised by sexual health education addresses myths and stigmas attached to STI testing, treatment and individuals living with STIs. Numerous countries have implemented initiatives aimed at educating adolescents on the indistinguishable link between sexual health and overall health. The Republic Of Congo is developing a policy to combat HIV/AIDS through the education sector. In Guyana, through a School Health, Nutrition, and HIV/AIDS Unit, teachers and other educators are trained on issues relating to STIs and how to provide support to HIV-positive students.

For sexual and reproductive health care to truly be comprehensive, we must acknowledge that sexual health and reproductive health are interwoven, one cannot be addressed without acknowledging the other.

Only when emphasis is placed on dealing with both issues in tandem with each other can we introduce policies that are effective in reducing the risk of sexual activity jeopardizing the health and quality of life of individuals, families and communities.

Vandana M Kissoon is the holder of an LLB (hons) and is currently pursuing her LPC. She is an animal lover and coffee enthusiast. Vandana is a writer at Feminitt Caribbean and is passionate about dismantling oppressive systems

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