International Technical Guidance on Sexuality Education
An evidence-informed approach for schools,
teachers and health educators (December 2009)

Volume II: Topics and learning objectives

Based on a rigorous and current review of evidence on sexuality education programmes, this International Technical Guidance on Sexuality Education is aimed at education and health sector decision-makers and professionals. It has been produced to assist education, health and other relevant authorities in the development and implementation of school-based sexuality education programmes and materials. Volume I focuses on the rationale for sexuality education and provides sound technical advice on characteristics of effective programmes. A companion document, (Volume II) focuses on the topics and learning objectives to be covered in a ‘basic minimum package’ on sexuality education for children and young people from 5 to 18+ years of age and includes a bibliography of useful resources. The International Technical Guidance is relevant not only to those countries most affected by HIV and AIDS, but also to those facing low prevalence and concentrated epidemics.

The designations employed and the presentation of materials throughout this document do not imply the expression of any opinion whatsoever on the part of UNESCO concerning the legal status of any county, territory city or area or its authorities, or concerning its frontiers and boundaries.

Published by UNESCO © UNESCO 2009 Section on HIV and AIDS
Division for the Coordination of UN Priorities in Education
Education Sector, UNESCO
7, place de Fontenoy 75352 Paris 07 SP, France
Website:
www.unesco.org/aids  Email: aids@unesco.org

Table of Contents
Acknowledgements
Acronyms
Topics and learning objectives
1.    Introduction
2.    Age range
3.    Components of learning
4.    Stand-alone or integrated programmes
5.    Structure
6.    Overview of key concepts and topics
7.    Tables of learning objectives
References
Appendices
I.    International conventions and agreements relating to sexuality education
II.    Interview schedule and methodology
III.    People contacted and key informant details
IV.    List of participants in the UNESCO global technical consultation on sexuality education
V.    Bibliography of resources

Acknowledgements

This International Technical Guidance on Sexuality Education was commissioned by the United Nations Educational, Scientific and Cultural Organization (UNESCO). Its preparation, under the overall guidance of Mark Richmond, UNESCO Global Coordinator for HIV and AIDS, was organized by Chris Castle, Dhianaraj Chetty and Ekua Yankah in the Section on HIV and AIDS, Division for the Coordination of UN Priorities in Education at UNESCO.

Nanette Ecker, former Director of International Education and Training at the Sexuality Information and Education Council of the United States (SIECUS) and Douglas Kirby, Senior Scientist at ETR (Education, Training, Research) Associates, were contributing authors of this document. Peter Gordon, independent consultant, edited various drafts.

UNESCO would like to thank the William and Flora Hewlett Foundation for hosting the global technical consultation that contributed to the development of the guidance. The organizers would also like to express their gratitude to all of those who participated in the consultation, which took place from 18-19 February 2009 in Menlo Park, USA (in alphabetical order):

Prateek Awasthi, UNFPA; Arvin Bhana, Human Sciences Research Council (South Africa); Chris Castle, UNESCO; Dhianaraj Chetty, formerly ActionAid; Esther Corona, Mexican Association for Sex Education and World Association for Sexual Health; Mary Guinn Delaney, UNESCO; Nanette Ecker, SIECUS; Nike Esiet, Action Health, Inc. (AHI); Peter Gordon, independent consultant; Christopher Graham, Ministry of Education, Jamaica; Nicole Haberland, Population Council/USA; Sam Kalibala, Population Council/Kenya; Douglas Kirby, ETR Associates; Wenli Liu, Beijing Normal University; Elliot Marseille, Health Strategies International; Helen Omondi Mondoh, Egerton University; Prabha Nagaraja, Talking about Reproductive and Sexual Health Issues (TARSHI); Hans Olsson, The Swedish Association for Sexuality Education; Grace Osakue, Girls' Power Initiative (GPI) Nigeria; Jo Reinders, World Population Foundation (WPF); Sara Seims, the William and Flora Hewlett Foundation; and Ekua Yankah, UNESCO.

Written comments and contributions were also gratefully received from (in alphabetical order):

Peter Aggleton, Institute of Education at the University of London; Vicky Anning, independent consultant; Andrew Ball, World Health Organization (WHO); Prateek Awasthi, UNFPA; Tanya Baker, Youth Coalition for Sexual and Reproductive Rights; Michael Bartos, UNAIDS; Tania Boler, Marie Stopes International and formerly with UNESCO; Jeffrey Buchanan, formerly with UNESCO; Chris Castle, UNESCO; Katie Chau, Youth Coalition for Sexual and Reproductive Rights; Judith Cornell, UNESCO; Anton De Grauwe, UNESCO International Institute for Educational Planning (IIEP); Jan De Lind Van Wijngaarden, UNESCO; Marta Encinas-Martin, UNESCO; Jane Ferguson, WHO; Claudia Garcia-Moreno, WHO; Dakmara Georgescu, UNESCO International Bureau of Education (IBE); Cynthia Guttman, UNESCO; Anna Maria Hoffmann, United Nations Children's Fund (UNICEF); Roger Ingham, University of Southampton; Sarah Karmin, UNICEF; Eszter Kismodi, WHO; Els Klinkert, UNAIDS; Jimmy Kolker, UNICEF; Steve Kraus, UNFPA; Changu Mannathoko, UNICEF; Rafael Mazin, Pan American Health Organization (PAHO); Maria Eugenia Miranda, Youth Coalition for Sexual and Reproductive Rights; Jean O'Sullivan, UNESCO; Mary Otieno, UNFPA; Jenny Renju, Liverpool School of Tropical Medicine & National Institute for Medical Research; Mark Richmond, UNESCO; Pierre Robert, UNICEF, Justine Sass, UNESCO; Iqbal H. Shah, WHO, Shyam Thapa, WHO; Barbara Tournier, UNESCO IIEP; Friedl Van den Bossche, formerly UNESCO; Diane Widdus, UNICEF; Arne Willems, UNESCO; Ekua Yankah, UNESCO; and Barbara de Zalduondo, UNAIDS.

UNESCO would like to acknowledge Masimba Biriwasha, UNESCO; Sandrine Bonnet, UNESCO IBE; Claire Cazeneuve, UNESCO IBE; Claire Greslé-Favier, WHO; Magali Moreira, UNESCO IBE; and Lynne Sergeant, UNESCO IIEP for their contributions to the bibliography of resources. Finally, thanks are offered to Vicky Anning who provided editorial support, Aurélia Mazoyer and Myriam Bouarour who undertook the design and layout, and Schéhérazade Feddal who provided liaison support for the production of this document.

Acronyms

AIDS

Acquired Immune Deficiency Syndrome

ART

Anti-retroviral Therapy

CEDAW

Convention on the Elimination of All Forms of Discrimination against Women

CRC

Convention on the Rights of the Child

EFA

Education for All

ETR

Education, Training and Research

FHI

Family Health International

FGC

Female Genital Cutting

FGM

Female Genital Mutilation

FWCW

Fourth World Conference on Women

HIV

Human Immunodeficiency Virus

HPV

Human Papilloma Virus

IATT

Inter-Agency Task Team

IBE

International Bureau of Education (UNESCO)

ICPD

International Conference on Population and Development

IIEP

International Institute for Educational Planning (UNESCO)

IPPF

International Planned Parenthood Federation

MDG

Millennium Development Goal

MoE

Ministry of Education

MoH

Ministry of Health

NGO

Non-Governmental Organization

PEP

Post-exposure prophylaxis

PFA

Platform for Action

POA

Programme of Action

SIECUS

Sexuality Information and Education Council of the United States

SRE

Sex and relationships education

SRH

Sexual and reproductive health

SRHR

Sexual and reproductive health and rights

STD

Sexually transmitted disease

STI

Sexually transmitted infection

UN

United Nations

UNAIDS

Joint United Nations Programme on HIV/AIDS

UNESCO

United Nations Educational, Scientific and Cultural Organization

UNFPA

United Nations Population Fund

UNICEF

United Nations Children’s Fund

VCT

Voluntary Counselling and Testing (for HIV)

WHO

World Health Organization

 

Topics and learning objectives

1. Introduction

What is sexuality education and why is it important?

Few young people receive adequate preparation for their sexual lives. This leaves them potentially vulnerable to coercion, abuse and exploitation, unintended pregnancy and sexually transmitted infections (STIs), including HIV. Many young people approach adulthood faced with conflicting and confusing messages about sexuality and gender. This is often exacerbated by embarrassment, silence and disapproval of open discussion of sexual matters by adults, including parents and teachers, at the very time when it is most needed. There are many settings globally where young people are becoming sexually mature and active at an earlier age. They are also marrying later, thereby extending the period of time from sexual maturity until marriage.

Countries are increasingly signalling the importance of equipping young people with knowledge and skills to make responsible choices in their lives, particularly in a context where they have greater exposure to sexually explicit material through the Internet and other media. There is an urgent need to address the gap in knowledge about HIV among young people aged 15-24, with 60 per cent in this age range not able to correctly identify the ways of preventing HIV transmission (UNAIDS, 2008). A growing number of countries have implemented or are scaling up sexuality education1 programmes, including China, Kenya, Lebanon, Nigeria and Viet Nam, a trend confirmed by the ministers of education and health from countries in Latin America and the Caribbean at a summit held in July 2008. These efforts recognise that all young people need sexuality education, and that some are living with HIV or are more vulnerable to HIV infection than others, particularly adolescent girls married as children, those who are already sexually active, and those with disabilities.

Effective sexuality education can provide young people with age-appropriate, culturally relevant and scientifically accurate information. It includes structured opportunities for young people to explore their attitudes and values, and to practise the decision-making and other life skills they will need to be able to make informed choices about their sexual lives.

Effective sexuality education is a vital part of HIV prevention and is also critical to achieving Universal Access targets for reproductive health and HIV prevention, treatment, care and support (UNAIDS, 2006). While it is not realistic to expect that an education programme alone can eliminate the risk of HIV and other STIs, unintended pregnancy, coercive or abusive sexual activity and exploitation, properly designed and implemented programmes can reduce some of these risks and underlying vulnerabilities.

Effective sexuality education is important because of the impact of cultural values and religious beliefs on all individuals, and especially on young people, in their understanding of this issue and in managing relationships with their parents, teachers, other adults and their communities.

School settings provide an important opportunity to reach large numbers of young people with sexuality education before they become sexually active, as well as offering an appropriate structure (i.e. the formal curriculum) within which to do so.

Basic minimum package for a sexuality education programme

The International Technical Guidance on Sexuality Education comprises two parts. Volume I focuses on the rationale for sexuality education and provides sound technical advice on characteristics of effective programmes. This companion document (Volume II) presents a ‘basic minimum package' of topics and learning objectives for a sexuality education programme for children and young people from 5 to 18+ years of age and includes a bibliography of useful resources. The intention is to provide concrete guidance for the development of locally adapted curricula.

The development of the topics and learning objectives was informed by a specially commissioned review of existing curricula from 12 countries2, guidelines and standards as identified by key informants, and through searches of relevant databases, websites and electronic mailing lists3 (see References). The Guidance was further developed through key informant interviews with recognised experts (see list in Appendix III), and through a global technical consultation meeting held in February 2009 with experts from 13 countries (see list in Appendix IV). Colleagues from UNAIDS, UNESCO, UNFPA, UNICEF and WHO have also provided input into this document. Thus, while by no means exhaustive, some of the topics and learning objectives are solidly embedded in evidence and all are grounded upon practical experience.

In addition, the topics covered in those evaluated programmes that effectively changed behaviour, reviewed in the companion document (Volume I) on the rationale for sexuality education (http://www.unesco.org/aids), informed some of the learning objectives. Additional programmes referred to in the rationale for sexuality education covered some but not all of the learning objectives described in this volume.

Future versions of the International Technical Guidance will be produced and will incorporate feedback from users around the world, and will continue to be based on the best available evidence.

The goals of the topics and learning objectives are to:

•    provide accurate information about topics that children and young people are curious about and about which they have a need to know;

•    provide children and young people with opportunities to explore values, attitudes and norms concerning sexual and social relationships;

•    promote the acquisition of skills; and

•    encourage children and young people to assume responsibility for their own behaviour and to respect the rights of others.

As a comprehensive package, all learning objectives address children’s and young people’s need for information and right to education. However, while only some of these learning objectives are specifically designed to reduce risky sexual behaviour, others will attempt to change social norms, facilitate communication of sexual issues, remove social and attitudinal barriers to sexuality education and increase knowledge.

2. Age range

The topics and learning objectives in this volume are intended for young people at primary and secondary school levels. However, many people have not received any sexuality education at those levels and so learners in tertiary institutions may also benefit from the learning objectives in the International Technical Guidance. Indeed, the need for sexuality education at tertiary level may be especially critical, given that many students will be living away from home for the first time, may develop relationships, and may become sexually active. In addition, the topics and learning objectives may prove useful for teacher training and curriculum development or simply as a checklist to review existing curricula and programmes.

It is equally important to provide sexuality education to children and young people out of school, especially for those who may be marginalised for a variety of reasons, and particularly vulnerable to an early, unprepared sexual debut and sexual exploitation and abuse.

The topics and learning objectives address four age groups and corresponding levels:

1.    ages 5 to 8 (Level I)

2.    ages 9 to 12 (Level II)

3.    ages 12 to 15 (Level III)

4.    ages 15 to 18+ (Level IV)

The learning objectives are logically staged, with concepts for younger students typically including more basic information, less advanced cognitive tasks, and less complex activities. There is a deliberate overlap between levels 3 and 4 in order to accommodate the broad age range of learners who might be in the same class. Level 4 addresses learners from ages 15 to 18+ to acknowledge that some learners in the secondary level may be older than 18 and that the topics and learning objectives can also be used with more mature learners in tertiary institutions. All information discussed with the above-mentioned age groups should be in line with learners' cognitive abilities and pay attention to children and young people with intellectual/learning disabilities.

The sexual and reproductive health needs and concerns of children and young people, as well as the age of sexual debut, vary considerably within and across regions, as well as within and across countries and communities. This, in turn, is likely to affect the perceived appropriateness of particular learning objectives when developing curricula, materials and programmes. Learning objectives should therefore be adjusted to their context. However, this should be done in response to the available data and evidence rather than because of personal discomfort or perceived opposition.

3. Components of learning

The topics and learning objectives cover four components of the learning process:

1.    Information: sexuality education provides accurate information about human sexuality, including: growth and development; sexual anatomy and physiology; reproduction; contraception; pregnancy and childbirth; HIV and AIDS; STIs; family life and interpersonal relationships; culture and sexuality; human rights empowerment; non-discrimination, equality and gender roles; sexual behaviour; sexual diversity; sexual abuse; gender-based violence; and harmful practices.

2.    Values, attitudes and social norms: sexuality education offers students opportunities to explore values, attitudes and norms (personal, family, peer and community) in relation to sexual behaviour, health, risk-taking and decision-making and in consideration of the principles of tolerance, respect, gender equality, human rights, and equality.

3.    Interpersonal and relationship skills: sexuality education promotes the acquisition of skills in relation to: decision-making; assertiveness; communication; negotiation; and refusal. Such skills can contribute to better and more productive relationships with family members, peers, friends and romantic or sexual partners.

4.    Responsibility: sexuality education encourages students to assume responsibility for their own behaviour as well as their behaviour towards other people through respect; acceptance; tolerance and empathy for all people regardless of their health status or sexual orientation. Sexuality education also insists on gender equality; resisting early, unwanted or coerced sex and rejecting violence in relationships; and the practice of safer sex, including the correct and consistent use of condoms and contraceptives.

4. Stand-alone or integrated programmes

Decisions need to be made about whether sexuality education should be: taught as a stand-alone subject (as it is in Malawi and Jamaica); integrated within an existing mainstream subject, such as health or biology (as it is in Viet Nam); delivered across several other subjects, such as civics, health and biology (as in Mexico); or included in guidance and counselling (as it has been in Kenya until recently).

Decisions will be influenced by general educational policies, the availability of resources (including the availability of supportive school administration, trained teachers and materials), competing priorities in the school curriculum, the needs of learners, community support for sexuality education programmes and timetabling issues. A pragmatic response might acknowledge that, while it would be ideal to introduce sexuality education as a separate subject, it may be more practical to build upon and improve what teachers are already teaching, and look to integrate it within existing subjects such as social science, biology or guidance and counselling.

Box 1. Sexuality education - Examples of point of entry from five countries

Malawi

In Malawi, sexuality education is taught as a stand-alone and examinable subject at the secondary school level and is integrated into carrier subjects and not yet examinable at the primary school level. In both cases, sexuality education is taught by trained teachers using specifically designed materials.

Mexico

In Mexico, sexuality education is integrated within various parts of the curriculum such as science and civics education, in recognition of the fact that sexuality is part of many aspects of life. Sexuality education may become a separate subject for learners (aged 15-18 years) in upper secondary school.

United Republic of Tanzania

In the United Republic of Tanzania, sexuality education is integrated within carrier subjects such as a science and civics education. The Tanzanian case proves that sexuality education does not need to be made an entirely separate subject in order to be included in curricula.

Viet Nam

In Viet Nam, the Ministry of Education is in the process of developing a compulsory extra-curricular component, which will complement intra-curricular content. The strategy also makes use of participatory approaches and peer support reinforced by a parallel parental programme.

5. Structure

The overarching topics under which learning objectives have been defined are organised around six key concepts:

1.    Relationships

2.    Values, attitudes and skills

3.    Culture, society and human rights

4.    Human development

5.    Sexual behaviour

6.    Sexual and reproductive health

Each topic is linked to specific learning objectives, grouped according to the four age levels. The learning objectives are the intended outcomes of working on particular topics. Learning objectives are defined at the level when they should be first introduced, but they need to be reinforced across different age levels. When a programme begins with older students, it may be necessary to cover topics and learning objectives from earlier age levels. Based on needs and country/region-specific characteristics, such as social and cultural norms and epidemiological context, the contents of the learning objectives could be adjusted to be included within earlier or later age levels. However, most experts believe that children and young people want and need sexuality and sexual health information as early and comprehensively as possible.

6. Overview of key concepts and topics

The tables below specify the topics and learning objectives which can provide a comprehensive ‘menu' for curriculum development. The topics and learning objectives are drawn from evidence concerning curricula that have been demonstrated to change behaviours, as well as from practical experience.

Key Concept 1:

Key Concept 2: Values,

Key Concept 3:

Relationships

Attitudes and Skills

Culture, Society and

Topics:

Topics:

Human Rights

1.1 Families

2.1 Values, Attitudes and Sources

Topics:

1.2 Friendship, Love and

of Sexual Learning

3.1 Sexuality, Culture and Human

Romantic Relationships

2.2 Norms and Peer Influence on

Rights

1.3 Tolerance and Respect

Sexual Behaviour

3.2 Sexuality and the Media

1.4 Long-term Commitment,

2.3 Decision-making

3.3 The Social Construction of

Marriage and Parenting

2.4 Communication, Refusal and

Gender

 

Negotiation Skills

3.4 Gender-Based Violence

 

2.5 Finding Help and Support

including Sexual Abuse,

 

 

Exploitation and Harmful

 

 

Practices

Key Concept 4:

Key Concept 5:

Key Concept 6: Sexual

Human Development

Sexual Behaviour

and Reproductive Health

Topics:

Topics:

Topics:

4.1 Sexual and Reproductive

5.1 Sex, Sexuality and the Sexual

6.1 Pregnancy Prevention

Anatomy and Physiology

Life Cycle

6.2 Understanding, Recognising

4.2 Reproduction

5.2 Sexual Behaviour and Sexual

and Reducing the Risk of

4.3 Puberty

Response

STIs, including HIV

4.4 Body Image

 

6.3 HIV and AIDS Stigma, Care,

4.5 Privacy and Bodily Integrity

 

Treatment and Support

7. Tables of learning objectives

Key Concept 1

- Relationships

1.1 Families

Learning Objective for Level I (5-8 years)

Define the concept of ‘family’ with examples of different kinds of family structures

Key Ideas:

•    Many different kinds of families exist around the world (e.g. two-parent, single parent, child-headed, guardian-headed, extended, nuclear and non-traditional families, etc.)

•    Family members have different needs and roles

•    Family members take care of each other in many ways, though sometimes they may not want to or be able to

•    Gender inequality is often reflected in the roles and responsibilities of family members

•    Families are important in teaching values to children

Learning Objective for Level II (9-12 years)

Describe the roles, rights and responsibilities of different family members

Key Ideas:

• Families can promote gender equality in terms of roles and responsibilities

• Communication within families, in particular between parents and children, builds better relationships

• Parents and other family members guide and support their children’s decisions

• Families help children to acquire values and influence their personality

• Health and disease can affect families in terms of their structure, capacities, roles and responsibilities

Learning Objective for Level III (12-15 years)

Describe how responsibilities of family members change as they mature

Key Ideas:

•    Love, cooperation, gender equality, mutual caring and mutual respect are important for good family functioning and healthy relationships

•    As they grow up, children’s worlds and affections expand beyond the family, and friends and peers become particularly important

•    Growing up means taking responsibility for oneself and others

•    Conflict and misunderstandings between parents and children are common, especially during puberty, and are usually resolvable

Learning Objective for Level IV (15-18 years)

Discuss how sexual and relationship issues can impact : on the family - e.g. disclosing an HIV-positive status, an unintended pregnancy, being in a same-sex relationship

Key Ideas:

• Family members’ roles may change when a young family member discloses an HIV-positive status, becomes : pregnant, refuses an arranged marriage or discloses their sexual orientation

• There are support systems that family members can turn to in times of crisis

• Families can survive crises when they support one another with mutual respect

1.2 Friendship, Love and Relationships

Learning Objective for Level I (5-8 years)

Define a ‘friend’

Key Ideas:

•    There are different kinds of friends (e.g. good friends versus bad friends, boyfriends, girlfriends)

•    Friendships are based on trust, sharing, empathy and solidarity

•    Relationships involve different kinds of love and love can be expressed in many different ways

•    Disability or health status is not a barrier to forming friendships and relationships or giving love

Learning Objective for Level II (9-12 years)

Identify skills needed for managing relationships

Key Ideas:

•    There are different ways to express friendship and to love another person

•    Friendships and love help people feel good about themselves

•    Gender roles affect personal relationships, and gender equality is a part of healthier relationships

•    Relationships can be healthy or unhealthy

•    An abusive relationship is an example of an unhealthy relationship

Learning Objective for Level III (12-15 years)

Differentiate between different kinds of relationships

Key Ideas:

•    Love, friendship, infatuation and sexual attraction involve different emotions

•    Friendships can have many benefits

•    Friends can influence one another positively and negatively

•    Close relationships can sometimes become sexual

•    Romantic relationships can be strongly affected by gender roles and stereotypes

•    Relationship abuse and violence are strongly linked to gender roles and stereotypes

Learning Objective for Level IV (15-18 years)

Identify relevant laws concerning abusive relationships

Key Ideas:

•    People can be taught skills to identify abusive relationships

•    There are laws against abuse in relationships in most countries

•    People have a responsibility to report abusive relationships

•    Support mechanisms typically exist to assist people in abusive relationships

Key Concept 1

- Relationships

1.3 Tolerance and Respect

Learning Objectives for Level I (5-8 years)

Define ‘respect’

Key Ideas:

•    The values of tolerance, acceptance and respect are key to healthy relationships

•    Every human being is unique and valuable and can contribute to society by being a friend, being in a relationship and by giving love

•    Every human being deserves respect

•    Making fun of people is harmful

Learning Objectives for Level II (9-12 years)

Define the concepts of bias, prejudice, stigma, intolerance, harassment, rejection and bullying

Key Ideas:

• It is disrespectful, hurtful and a violation of human rights to harass or bully anyone on the basis of health status, colour, origin, sexual orientation or other differences

• Stigma and discrimination on the grounds of difference are : a violation of human rights

• Everyone has a responsibility to defend people who are being harassed or bullied

Learning Objectives for Level III (12-15 years)

Explain why stigma, discrimination and bullying are harmful

Key Ideas:

•    Stigma and discrimination are harmful

•    Stigma can also be self-inflicted and lead to silence, denial and secrecy

•    Everyone has a responsibility to speak out against bias and intolerance

•    Support mechanisms typically exist to assist people experiencing stigma and discrimination (e.g. homophobia)

Learning Objectives for Level IV (15-18 years)

Explain why it is important to challenge discrimination against those perceived to be different’

Key Ideas:

• Discrimination impacts negatively upon individuals, communities and societies

• In many places, there are laws against stigma and discrimination

1.4 Long-term Commitments, Marriage and Parenting

Learning Objectives for Level I (5-8 years)

Explain the concepts of ‘family’ and ‘marriage’

Key Ideas:

•    Some people choose their marriage partners, others have arranged marriages

•    Some relationships end in separation and divorce, which can affect all family members

•    Different family structures affect children’s living arrangements, roles and responsibilities

•    Forced marriages and child marriages are harmful and are usually illegal

Learning Objectives for Level II (9-12 years)

Explain the key features of long-term commitments, marriage and parenting

Key Ideas:

• Laws and cultural practices shape how marriage, partnership formation and having children are organised in society

• Every person has the right to decide whether to become a parent, including people with disabilities and people living with HIV

• Parenting comes with responsibilities

• Adults can become parents in several ways: intended and unintended pregnancy, adoption, fostering, use of assisted fertility technologies and surrogate parenting

Learning Objectives for Level III (12-15 years)

Identify the key responsibilities of marriage and long-term commitments

Key Ideas:

•    Successful marriages and long-term commitments are based on love, tolerance and respect

•    Early marriage, child marriage and teenage parenting often have negative social and health consequences

•    Culture and gender roles impact upon parenting

Learning Objectives for Level IV (15-18 years)

Identify key physical, emotional, economic, and educational needs of children and associated responsibilities of parents

Key Ideas:

• Marriage and long-term commitments can be rewarding and challenging

• Children’s well-being can be affected by difficulties in relationships

• There are many factors that influence why people decide to have children or not

Key Concept 2

- Values, Attitudes and Skills

2.1 Values, Attitudes and Sources of Sexual Learning

Learning Objectives for Level I (5-8 years)

Define values and identify important personal values such as equality, respect, acceptance and tolerance

Key Ideas:

•    Values are strong beliefs held by individuals, families and communities about important issues

•    Values and beliefs guide decisions about life and relationships

•    Individuals, peers, families and communities may have different values

Learning Objectives for Level II (9-12 years)

Identify sources of values, attitudes and sexual learning

Key Ideas:

• In most families parents teach and exemplify their values to their children

• Values and attitudes imparted to us by families and communities are the sources of our sexual learning

• Values regarding gender, relationships, intimacy, love, sexuality and reproduction influence personal behaviour and decision-making

• Cultural values affect male and female gender role expectations and equality

Learning Objectives for Level III (12-15 years)

Describe their own personal values in relation to a range of sexuality and reproductive health issues

Provide clear examples of how personal values affect their own decisions and behaviours

Key Ideas:

•    It is important to know one’s own values, beliefs and attitudes, how they impact on the rights of others and how to stand up for them

•    Everyone needs to be tolerant of and have respect for different values, beliefs and attitudes

Learning Objectives for Level IV (15-18 years)

Explain how to behave in ways that are consistent with one’s own values

Key Ideas:

• As children grow up, they develop their own values which may differ from their parents

• Parent-child relationships are strengthened when parents and children talk to one another about their differences and develop respect for each other’s rights to have different values

• All relationships benefit when people respect each other’s values

2.2 Norms and Peer Influence on Sexual Behaviour

Learning Objectives for Level I (5-8 years)

Define peer pressure

Key Ideas:

•    Peer Influence exists in many different forms

•    Influence from one’s peers can be good or bad

Learning Objectives for Level II (9-12 years)

Describe social norms and their influence on behaviour

Key Ideas:

• Social norms influence values and behaviour, including sexual values and behaviour

• Negative social norms and peer pressure can be challenged through assertive behaviour and other means

Learning Objectives for Level III (12-15 years)

Explain how peer influence and social norms influence sexual decisions and behaviour

Key Ideas:

•    Social norms and peer influence, such as bullying and negative peer pressure, can affect sexual decision-making and behaviour

•    Being assertive means learning when and how to say ‘yes’ and ‘no’ about sexual relationships, and sticking to one’s decision

Learning Objectives for Level IV (15-18 years)

Demonstrate skills in resisting peer pressure

Key Ideas:

• It is possible to make rational decisions about sexual behaviour

• People can resist negative peer influence in their sexual decision-making

Key Concept 2

- Values, Attitudes and Skills

2.3 Decision-making

Learning Objectives for Level I (5-8 years)

Identify examples of good and bad decisions and their consequences

Key Ideas:

•    Individuals deserve to be able to make their own decisions

•    All decisions have consequences

•    Decision-making is a skill that one can learn

•    Children and young people may need help from adults to make certain decisions

Learning Objectives for Level II (9-12 years)

Apply the decision-making process to address problems

Key Ideas:

•    Decision-making may involve different steps

•    Decision-making has consequences and these can often be anticipated; therefore it is important to choose with the best outcome in mind

•    There are multiple influences on decisions, including friends, culture, gender role stereotypes, peers and the media

•    Trusted adults can be a source of help for decision-making

Learning Objectives for Level III (12-15 years)

Evaluate advantages, disadvantages and consequences of different decisions

Apply the decision-making process to address sexual and/or reproductive health concerns

Key Ideas:

•    Barriers can stand in the way of making rational decisions on sexual behaviour

•    Emotions are a factor in decision-making about sexual behaviour

•    Alcohol and drugs can impair rational decision-making on sexual behaviour

•    Making decisions about sexual behaviour includes consideration of all of the potential consequences

•    Decisions on sexual behaviour can affect people’s health, future and life plans

Learning Objectives for Level IV (15-18 years)

Identify potential legal, social and health consequences of sexual decision-making

Key Ideas:

•    Sexual behaviour has consequences on oneself and others, and may include legal consequences as well as unintended pregnancy or STIs, including HIV

•    National laws can affect what young people can and cannot do

•    There are international conventions and agreements relating to sexual and reproductive health that provide useful orientation to human rights standards (e.g. CEDAW, CRC) that can be looked at in conjunction with national laws related to access to health services, age of sexual consent, etc.

2.4 Communication, Refusal and Negotiation Skills

Learning Objectives for Level I (5-8 years)

Demonstrate understanding of different types of communication

Key Ideas:

•    All people have the right to express themselves

•    Communication is important in all relationships including between parents and children, trusted adults and friends

•    People have different ways of communicating, including verbal and non-verbal communication

•    Clearly communicating ‘yes’ and ‘no’ protects one’s privacy and bodily integrity

Learning Objectives for Level II (9-12 years)

Demonstrate examples of effective and ineffective communication

Key Ideas:

•    Effective communication uses different modes and styles, and can be learned

•    Being assertive is an important aspect of communication

•    Gender roles can affect communication between people

•    Negotiation requires mutual respect, cooperation and often compromise from all parties

Learning Objectives for Level III (12-15 years)

Demonstrate confidence in using negotiation and refusal skills

Key Ideas:

•    Good communication is essential to personal, family, romantic, school and work relationships

•    Barriers can stand in the way of effective communication

•    Effective communication can help children and young people refuse unwanted sexual pressure and abuse by people in positions of authority and other adults

•    Gender roles and expectations influence the negotiation of sexual relationships

Leaning Objectives for Level IV (15-18 years)

Demonstrate effective communication of personal needs and sexual limits

Key Ideas:

•    Consensual and safer sex requires effective communication skills

•    Assertiveness and negotiation skills can help one to resist unwanted sexual pressure or reinforce the intention to practise safer sex

Key Concept 2

- Values, Attitudes and Skills

2.5 Finding Help and Support

Learning Objectives for Level I (5-8 years)

Identify specific ways in which people can help each other

Key Ideas:

•    All people have the right to be protected and supported

•    Friends, family, teachers, clergy and community members can and should help each other

•    Trusted adults can be sources of help and support

Learning Objectives for Level II (9-12 years)

Identify specific problems and relevant sources of help

Key Ideas:

•    There are different sources of help and support in your school and wider community

•    Some problems may require asking for help outside of the school or community

•    Unwanted sexual attention, harassment or abuse needs to be reported to a trusted source of help

Learning Objectives for Level III (12-15 years)

Identify appropriate sources of help

Key Ideas:

•    Shame and guilt should not be barriers to seeking help

•    Critical assessment is needed when using the media (e.g. the Internet) as a source of help

•    There are places where people can access support for sexual and reproductive health (e.g. counselling, testing and treatment for STIs/HIV; services for contraception, sexual abuse, rape, domestic and gender-based violence, abortion and post-abortion care4 and stigma and discrimination)

•    A good source of help maintains confidentiality5 and protects privacy

Learning Objectives for Level IV (15-18 years)

Demonstrate appropriate help-seeking behaviour

Key Ideas:

•    Assertiveness is a necessary skill for identifying an appropriate source of help

•    Everyone has the right to affordable, factual, and respectful assistance that maintains confidentiality5 and protects privacy

Key Concept 3

- Culture, Society and Human Rights

3.1 Sexuality, Culture and Law

Learning Objectives for Level I (5-8 years)

Identify sources of our information about sex and gender

Key Ideas:

•    Families, individuals, peers and communities are sources of information about sex and gender

•    Values and beliefs from families and communities guide our understanding of sex and gender

Learning Objectives for Level II (9-12 years)

Identify key cultural, religious and human rights and supportive legal norms and messages about sexuality

Demonstrate willingness to listen to the opinions of others regarding sexuality

Key Ideas:

• Culture, society and human rights and legal standards influence our understanding of sexuality

• All cultures have norms and taboos related to sexuality and gender that have changed over time

• Each culture has its specific rites of passage to adulthood

• Respect for human rights requires us to consider others’ opinions on sexuality

Learning Objectives for Level III (12-15 years)

Identify key cultural norms and sources of messages relating to sexuality

Identify national laws and local regulations affecting the enjoyment of human rights related to sexual and reproductive health

Key Ideas:

•    International agreements and human rights instruments provide guidance on sexual and reproductive health

•    Cultural factors influence what is considered acceptable and unacceptable sexual behaviour in society

Learning Objectives for Level IV (15-18 years)

Explain the concepts of human rights related to sexual and reproductive health

Key Ideas:

• There are international and national legal instruments concerning child marriage, female genital mutilation/cutting (FGM/C), age of consent, sexual orientation, rape, sexual abuse, and people’s access to sexual and reproductive 1 health (SRH) services

• Respect for human rights requires us to accept people of differing sexual orientation and gender identity

• Culture, human rights and social practices influence gender : equality and gender roles

Key Concept 3

- Culture, Society and Human Rights

3.2 Sexuality and the Media

Learning Objectives for Level I (5-8 years)

Identify different forms of media

Distinguish between examples from reality and fiction (e.g. television, Internet)

Key Ideas:

•    Television, the Internet, books and newspapers are different forms of media

•    All media present stories which may be real or imagined

Learning Objectives for Level II (9-12 years)

Identify examples of how men and women are portrayed in the mass media

Describe the impact of mass media upon personal values, attitudes and behaviour relating to sex and gender

Key Ideas:

•    The mass media may be positive and negative in their representation of men and women

•    The mass media influence personal values, attitudes and social norms concerning gender and sexuality

Learning Objectives for Level III (12-15 years)

Identify unrealistic images in the mass media concerning sexuality and sexual relationships

Describe the impact of these images on gender stereotyping

Key Ideas:

•    The mass media influences our ideals of beauty and gender stereotypes

•    Pornographic media tend to rely on gender stereotyping

•    Negative mass media portrayals of men and women influence one’s self-esteem

Learning Objectives for Level IV (15-18 years)

Critically assess the potential influence of mass media messages about sexuality and sexual relationships

Identify ways in which the mass media could make a positive contribution to promoting safer sexual behaviour and gender equality

Key Ideas:

•    Negative and inaccurate mass media portrayals of men and women can be challenged

•    Mass media have the power to influence behaviour positively and promote equal gender relations

3.3 The Social Construction of Gender

Learning Objectives for Level I (5-8 years)

Define gender

Key Idea:

• Families, schools, friends, media and society are sources of learning about gender and gender stereotypes

Learning Objectives for Level II (9-12 years)

Explore ways in which gender inequality is driven by boys and girls, women and men

Key Ideas:

• Social and cultural norms and religious beliefs are some of the factors which influence gender roles

• Gender inequalities exist in families, friendships, in communities and society, e.g. male/son preference

• Human rights promote the equality of men and women and boys and girls

• Everyone has a responsibility to overcome gender inequality

Learning Objectives for Level III (12-15 years)

Explain the meaning and provide examples of gender bias and discrimination

Key Ideas:

•    Personal values influence one’s beliefs about gender bias and discrimination

•    Gender equality promotes equal decision-making about sexual behaviour and family planning

•    Different and unequal standards sometimes apply to men and women

Learning Objectives for Level IV (15-18 years)

Identify personal examples of the ways in which gender affects people’s lives

Key Ideas:

• Sexual orientation and gender identity are widely understood to be influenced by many factors

• Gender inequality influences sexual behaviour and may increase the risk of sexual coercion, abuse and violence

Key Concept 3

- Culture, Society and Human Rights

3.4 Gender-Based Violence, Sexual Abuse, and Harmful Practices

Learning Objectives for Level I (5-8 years)

Describe examples of positive and harmful practices

Define sexual abuse

Key Ideas:

•    There are positive and harmful practices that affect health and well-being in society

•    Human rights protect all people against sexual abuse and gender-based violence

•    Inappropriate touching, unwanted and forced sex (rape) are forms of sexual abuse

•    Sexual abuse is always wrong

Learning Objectives for Level II (9-12 years)

Explain how gender role stereotypes contribute to forced sexual activity and sexual abuse

Define and describe gender-based violence, including rape and its prevention

Demonstrate relevant communication skills (e.g. assertiveness, refusal) in resisting sexual abuse

Key Ideas:

•    Traditional beliefs and practices can be a source of positive learning

•    Honour killings, bride killings and crimes of passion are examples of harmful practices and gender inequality that violate human rights

•    There are ways to seek help in the case of sexual abuse and rape

•    Assertiveness and refusal skills can help to resist sexual abuse and gender-based violence, including rape

Learning Objectives for Level III (12-15 years)

Identify specific strategies for reducing gender-based violence, including rape and sexual abuse

Key Ideas:

•    All forms of sexual abuse and gender-based violence by adults, young people and people in positions of authority are a violation of human rights

•    Everyone has a responsibility to report sexual abuse and gender-based violence

•    There are trusted adults who can refer you to services that support victims of sexual abuse and gender-based violence

Learning Objectives for Level IV (15-18 years)

Demonstrate ability to argue for the elimination of gender role stereotypes and inequality, harmful practices and gender-biased violence

Key Idea:

• Everyone has a responsibility to advocate for gender equality and speak out against human rights violations such as sexual abuse, harmful practices and gender-based violence

Key Concept 4

- Human Development

4.1 Sexual and Reproductive Anatomy and Physiology

Learning Objective for Level 1 (5-8 years)

Distinguish between male and female bodies

Key Ideas:

•    Everyone has a unique body which deserves respect, including people with disabilities

•    All cultures have different ways of seeing our bodies

•    Men and women and boys and girls have different bodies which change over time

•    Some body parts are considered private and others not

Learning Objectives for Level II (9-12 years)

Describe the structure and function of the sexual and reproductive organs

Key Ideas:

•    Sexual and reproductive anatomy and physiology describe concepts such as the menstrual cycle, sperm production, erection and ejaculation

•    It is common for children and young people to have questions about sexual development e.g. why is one breast larger than the other? Do these changes happen to everyone?

Learning Objectives for Level III (12-15 years)

Distinguish between the biological and social aspects of sex and gender

Key Ideas:

•    The sex of a foetus is determined by chromosomes, and occurs at the early stages of pregnancy

•    Hormones play a major part in growth, development, and the regulation of reproductive organs and sexual functions

•    Cultural, traditional and religious practices are an important influence on one’s thinking about sex, gender, puberty and reproduction

•    All cultures have different ways of understanding sex, gender and when it is appropriate to become sexually active

Learning Objectives for Level IV (15-18 years)

Describe the sexual and reproductive capacity of males and females over the life cycle

Key Idea:

• Men and women’s bodies change over time, including their reproductive and sexual capacities and functions

Key Concept 4

- Human Development

4.2 Reproduction

Learning Objectives for Level 1 (5-8 years)

Describe where babies come from

Key Ideas:

•    Babies are formed when a human egg and a sperm cell combine

•    Reproduction includes a number of steps, including ovulation, fertilisation, conception, pregnancy and the delivery of the baby

•    A woman’s body undergoes changes during pregnancy

Learning Objectives for Level II (9-12 years)

Describe both how pregnancy occurs and how it can be prevented

Identify basic contraceptive methods

Key Ideas:

• Unprotected vaginal intercourse can lead to pregnancy and STIs, including HIV

• There are ways of preventing unintended pregnancy including abstaining from sex and using contraception

• The correct and consistent use of condoms and : contraception can prevent pregnancy, HIV and other STIs

• Hormonal changes regulate ovulation and the menstrual cycle

• At certain points in a woman’s menstrual cycle, conception is more likely to occur

• There are health risks associated with early marriage (voluntary and forced), and early pregnancy and birth

• Pregnancy does not endanger the health of an HIV-positive woman, and there are steps that can be taken to reduce the risk of HIV transmission to the baby

Learning Objectives for Level III (12-15 years)

Describe the signs of pregnancy, and the stages of foetal development and childbirth

Key Ideas:

•    There are signs and symptoms of pregnancy which can be confirmed by a test

•    Foetuses undergo many developmental stages

•    Steps can be taken to promote a healthy pregnancy and safe childbirth

•    There are health risks to foetal development associated with poor nutrition, smoking and using alcohol and drugs during pregnancy

Learning Objectives for Level IV (15-18 years)

Differentiate between reproductive and sexual functions and desires

Key Ideas:

• Mutual consent is a key requirement before sexual activity with a partner

• Sexual decision-making requires prior consideration of risk-reduction strategies to prevent unintended pregnancy and STIs

• Men and women experience changes in their sexual and reproductive functions throughout life

• Not everyone is fertile and there are ways of trying to address this

4.3 Puberty

Learning Objectives for Level I (5-8 years)

Describe how bodies change as people grow Describe the key features of puberty

Key Idea:

• Puberty is a time of physical and emotional change that happens as children grow and mature

Learning Objectives for Level II (9-12 years)

Describe the process of puberty and the maturation of the sexual and reproductive system

Key Ideas:

• Puberty signals changes in a person’s reproductive capability

• Young people experience a range of social, emotional and physical changes during puberty

• As the body matures, it is important to maintain good hygiene (e.g. washing the genitals, menstrual hygiene, etc.)

• During puberty, young women need access to and knowledge about the proper use of sanitary pads and other menstrual aids

• Male hormonal changes regulate the beginning of sperm production

• Young men may experience wet dreams during puberty and later in life

Learning Objectives for Level III (12-15 years)

Describe the similarities and differences between girls and boys in relation to the physical, emotional, and social changes associated with puberty

Distinguish between puberty and adolescence

Key Ideas:

•    Puberty is a time of sexual maturation which leads to major physical and emotional changes and can be stressful

•    Puberty occurs at different times for different people, and has different effects on boys and girls

•    Adolescence is the time between the beginning of sexual maturation (puberty) and adulthood

Learning Objectives for Level IV (15-18 years)

Describe the key emotional and physical changes in puberty that occur as a result of hormonal changes

Key Ideas:

• Male and female hormones differ and have a major influence on the emotional and physical changes that occur over one’s lifetime

• Hormones can affect body shape and size, body hair growth, and other changes

Key Concept 4

- Human Development

4.4 Body Image

Learning Objectives for Level I (5-8 years)

Recognise that bodies are all different

Key Ideas:

•    All bodies (including those with disabilities) are special and unique

•    Everyone can be proud of their body

Learning Objectives for Level ll (9-12 years)

Differentiate between cultural ideals and reality in relation to physical appearance

Key Ideas:

• Physical appearance is determined by heredity, environment and health habits

• A person’s value is not determined by their appearance

• Ideals of physical attractiveness change over time and differ between cultures

Learning Objectives for Level lll (12-15 years)

Describe how peoples’ feelings about their bodies can affect their health, self-image and behaviour

Key Ideas:

•    The size and shape of the penis, vulva or breasts vary and do not affect reproduction or the ability to be a good sexual partner

•    The appearance of a person’s body can affect how other people feel about and behave towards them

•    Using drugs to change your body image (e.g. diet pills or steroids) to conform to unrealistic, gendered standards of beauty can be harmful

•    There are ways of seeking help and treating harmful eating disorders, e.g. anorexia and bulimia

Learning Objectives for Level IV (15-18 years)

Identify particular culture and gender role stereotypes and how they can affect people and their relationships

Key Ideas:

• Unrealistic standards about bodily appearance can be challenged

• One’s body image can affect self-esteem, decision-making and behaviour

4.5 Privacy and Bodily Integrity

Learning Objectives for Level I (5-8 years)

Describe the meaning of ‘body rights’

Key Ideas:

•    Everyone has the right to decide who can touch their body, where, and in what way

•    All cultures have different ways of respecting privacy and bodily integrity

Learning Objectives for Level ll (9-12 years)

Define unwanted sexual attention Demonstrate ways of resisting unwanted sexual attention

Key Ideas:

• During puberty, privacy about one’s body becomes more important

• Private space, including access to toilets and water, becomes more important as girls mature

• Unwanted sexual attention and harassment of girls during menstruation and, indeed, at all other times is a violation of their privacy and bodily integrity

• Unwanted sexual attention and harassment of boys is a violation of their privacy and bodily integrity

• For girls, communicating to their peers, parents and teachers about menstruation is nothing to be ashamed of

• Being assertive about privacy is a way of refusing harassment and unwanted sexual attention

Learning Objectives for Level III (12-15 years)

Identify key elements of keeping oneself safe from sexual harm

Key Ideas:

•    Everyone has the right to privacy and bodily integrity

•    Everyone has the right to be in control over what they will and will not do sexually

•    The Internet, cell phones and other new media can be a source of unwanted sexual attention

Learning Objectives for Level IV (15-18 years)

Describe some ways in which society, culture, law and gender roles can affect social interactions and sexual behaviour

Key Ideas:

• International human rights instruments affirm rights to privacy and bodily integrity

• Men’s and women’s bodies are treated differently and double standards of sexual behaviour may impact upon social and sexual interactions

Key Concept 5

- Sexual Behaviour

5.1 Sex, Sexuality and the Sexual Life Cycle

Learning Objectives for Level I (5-8 years)

Explain the concept of private pails of the body

Key Ideas:

•    Most children are curious about their bodies

•    It is natural to explore parts of one’s own body, including the private parts

Learning Objectives for Level II (9-12 years)

Describe sexuality in relation to the human life cycle

Key Ideas:

• Human beings are born with the capacity to enjoy their sexuality throughout life

• Many boys and girls begin to masturbate during puberty or sometimes earlier6

• Masturbation does not cause physical or emotional harm : but should be done in private6

• It is important to talk and ask questions about sexuality with a trusted adult

Learning Objectives for Level III (12-15 years)

Explain ways in which sexuality is expressed across the life cycle

Key Ideas:

•    Sexual feelings, fantasies and desires are natural and occur throughout life

•    Not all people choose to act on their sexual feelings, fantasies and desires

•    Interest in sexuality may change with age and can be expressed throughout life

•    Everyone needs to be tolerant of and have respect for the different ways sexuality is expressed across cultures and settings

Learning Objectives for Level IV (15-18 years)

Define sexuality in relation to its biological, social, psychological, spiritual, ethical and cultural components.

Key Ideas:

• Sexuality is complex and multi-faceted and includes biological, social, psychological, spiritual, ethical and : cultural components

• Sexuality can enhance one’s well-being, when expressed respectfully

5.2 Sexual Behaviours and Sexual Response

Learning Objective for Level I (5-8 years)

Explain that sexual activity is a mature way of showing care and affection

Key Ideas:

•    Adults show love and care for other people in different ways, including sometimes through sexual behaviours

•    People kiss, hug, touch and engage in sexual behaviours with one another to show care, love, physical intimacy and to feel good

•    Children are not ready for sexual contact with other people

Learning Objective for Level II (9-12 years)

Describe male and female response to sexual stimulation

Key Ideas:

• Men and women have a sexual response cycle, whereby sexual stimulation (physical or mental) can produce a physical response

• During puberty, boys and girls become more aware of their responses to sexual attraction and stimulation

• People can have sexual thoughts and feelings without acting on them and are generally able to control them when needed

• There is a range of ways in which couples can demonstrate love, care and feelings of sexual attraction, and show that love involves more than engaging in sexual behaviour

• Sexual relationships require emotional and physical maturity

• Critical thinking needs to be applied to making friends and forming sexual relationships.

• Few, if any, people have a sexual life that is without problems or disappointments

Key Concept 5

- Sexual Behaviour

5.2 Sexual Behaviours and Sexual Response (contd.)

Learning Objectives for Level III (12-15 years)

Describe common sexual behaviours

Describe the key elements of the sexual response cycle

Key Ideas:

•    Every society has its own myths about sexual behaviour - it is important to know the facts

•    Abstinence means choosing not to engage in sexual behaviours with others, and is the safest way to avoid pregnancy and STIs, including HIV

•    Condoms and other contraceptives enable people to engage in sexual behaviours that reduce the risk of unintended consequences

•    Non-penetrative sexual behaviours are without risk of unintended pregnancy, and offer reduced risk of STIs, including HIV

•    Transactional sexual activity is the exchange of money, goods or protection for sexual favours

•    Building children’s and young people’s assertiveness and refusal skills can help them to avoid transactional sexual activity

•    Everyone has the responsibility to report sexual harassment and coercion, which are violations of human rights

•    There are many stages and associated physical changes in the male and female human sexual response cycle

Learning Objectives for Level IV (15-18 years)

Define key elements of sexual pleasure and responsibility

Key Ideas:

•    The consequences of engaging in sexual behaviours are real, and come with associated responsibilities

•    Good communication can enhance a sexual relationship

•    Both sexual partners are responsible for preventing unintended pregnancy and STIs, including HIV

•    Many adults have periods in their lives without sexual contact with others

Key Concept 6

- Sexual and Reproductive Health

6.1 Pregnancy Prevention

Learning Objectives for Level I (5-8 years)

Recognise that not all couples have children

Key Ideas:

•    All people regardless of their health status, religion, origin, race or marriage status can raise a child and give it the love it deserves

•    Children should be wanted, cared for, and loved

•    Some people are unable to care for a child

Learning Objectives for Level II (9-12 years)

Describe key features of pregnancy and contraception

Key Ideas:

• There are many myths about condoms, contraceptives

•    and other ways to prevent unintended pregnancy - it is important to know the facts

• Not having sexual intercourse is the most effective form of contraception

• Correct and consistent use of condoms can reduce the risk of unintended pregnancy, HIV and other STIs

• Deciding to use a condom or other contraceptives is the : responsibility of men and women, and gender roles and peer norms may influence these decisions

• There are common signs and symptoms of pregnancy, and tests to confirm if one is pregnant

• Unintended pregnancy at an early age can have negative health and social consequences

Key Concept 6

- Sexual and Reproductive Health

6.1 Pregnancy Prevention (contd.)

Learning Objectives for Level III (12-15 years)

Describe effective methods of preventing unintended pregnancy and their associated efficacy

Explain the concept of personal vulnerability to unintended pregnancy

Key Ideas:

•    Different forms of contraception have different effectiveness rates, efficacy, benefits and side effects

•    Abstaining from sexual intercourse is the most effective method to prevent unintended pregnancy

•    The correct and consistent use of condoms can reduce the risk of unintended pregnancy among the sexually active

•    Emergency contraception (where legal and available) can prevent unintended pregnancy, including as a result of lack or misuse of contraception, contraceptive failure or sexual assault

•    Natural contraceptive methods should only be considered on the advice of a trained health professional

•    Sterilisation is a permanent method of contraception

•    Condoms and contraceptives can typically be accessed locally - although barriers may prevent or limit young people’s ability to obtain them

•    No sexually active young person should be refused access to contraceptives or condoms on the basis of their marital status, their sex or their gender

Learning Objectives for Level IV (15-18 years)

Describe personal benefits and possible risks of available methods of contraception

Demonstrate confidence in discussing and using different contraceptive methods

Key Ideas:

•    Contraceptive use can help people who are sexually active plan their families, with important related benefits for individuals and societies

•    Some contraceptive methods may cause side effects and/or be unadvisable for use in certain circumstances (also known as “contra-indicated”)

•    All contraception, including condoms and emergency contraception, must be used correctly

•    Among the sexually active, the decision about the most appropriate method or mix of contraceptives is often based on perceived risk, cost, accessibility and other factors

6.2 Understanding, Recognising and Reducing the Risk of STIs, including HIV

Learning Objective for Level I (5-8 years)

Describe the concepts of ‘health’ and ‘disease’

Key Ideas:

•    People can make choices and adopt behaviours that preserve and safeguard their health

•    The immune system protects the body from diseases and helps people to stay healthy

•    Some diseases can be transmitted from one person to another

•    Some people that have a disease can look healthy

•    All people - regardless of their health status - need love, care and support

Learning Objectives for Level II (9-12 years)

Explain how STIs and HIV are transmitted, treated and prevented

Demonstrate communication skills as they relate to safer sex

Key Ideas:

• HIV is a virus that can be transmitted through: unprotected sex with an infected person; blood transfusion with contaminated blood; using contaminated syringes, needles or other sharp instruments; or from an infected mother to her child during pregnancy, childbirth and breastfeeding

• The vast majority of HIV infections are transmitted through unprotected penetrative sexual intercourse with an infected partner

• HIV cannot be transmitted through casual contact (e.g. shaking hands, hugging, drinking from the same glass)

• There are ways to reduce the risk of acquiring or transmitting HIV, including before (e.g. using a condom) and after (e.g. Post-Exposure Prophylaxis) exposure to the virus

• It is possible to be tested for common STIs such as Chlamydia, Gonorrhoea, Syphilis and for HIV

• Treatments exist for many STIs

• There is currently no cure for HIV - although anti-retroviral therapy (ART) can suppress HIV and stop the progression of the disease commonly known as AIDS

• Communication, negotiation and refusal skills can help young people to resist unwanted sexual pressure or reinforce the intention to practice safer sex, including the correct and consistent use of condoms and contraceptives

Key Concept 6

- Sexual and Reproductive Health

6.2 Understanding, Recognising and Reducing Risk of STIs including HIV (contd.)

Learning Objectives for Level III (12-15 years)

Identify specific ways of reducing the risk of acquiring or transmitting HIV and other STIs including the correct use of condoms

Explain how culture and gender affect personal decisionmaking regarding sexual relationships

Demonstrate skills in negotiating safer sex and refusing unsafe sexual practices

Key Ideas:

•    STIs such as Chlamydia, Gonorrhoea, Syphilis, HIV and HPV (genital human papilloma virus) can be prevented

•    Not having sexual intercourse is the most effective protection against HIV and other STIs

•    If one is sexually active, there are other ways to reduce the risk of acquiring or transmitting HIV and other STIs including: avoiding penetrative sex; practicing ‘mutual monogamy’; reducing the number of sexual partners; consistently and correctly using condoms; avoiding having multiple concurrent partners; and getting tested and treated for other STIs

•    In certain settings where there are high levels of HIV and other STIs, age-disparate/intergenerational relationships can increase the risk of acquiring HIV

•    Post-exposure prophylaxis (PEP), or short-term ART, can reduce the likelihood of HIV infection after a potential exposure

•    Sexual health services, including VCT centres offering pre- and post-test counselling can help people to assess personal risk and perceived vulnerability, and explore their attitudes about safer sexual practices

•    Everyone has a right to confidentiality7 about their health, and should not be required to disclose their HIV status

•    Programmes promoting positive living can help people with HIV feel supported to practice safer sex and/or to voluntarily disclose their HIV status to their partner(s)

•    Culture, gender and peer norms can influence decisionmaking about sexual behaviour

•    Alcohol and drug use can impair rational decision-making and contribute to high-risk behaviours

Learning Objectives for Level IV (15-18 years)

Assess a range of risk reduction strategies for effectiveness and personal preference

Demonstrate communication and decision-making skills in relation to safer sex

Key Ideas:

• There is a range of factors that may make it difficult for people to practice safer sex

• Some risk reduction strategies offer dual protection against ; both unplanned pregnancy and STIs, including HIV

• Among the sexually active, the decision about the most appropriate risk reduction strategies to adopt is often : influenced by one’s self-efficacy, perceived vulnerability, gender roles, culture and peer norms

• Communication, negotiation and refusal skills can help young people to resist unwanted sexual pressure or reinforce the intention to practice safer sex, including the correct and consistent use of condoms and contraceptives

 

6.3 HIV and AIDS Stigma, Treatment, Care and Support

 

Learning Objectives for Level I (5-8 years)

Identify the basic needs of people living with HIV

Key Ideas:

•    All people need love and affection

•    People living with HIV can give love and affection and can contribute to society

•    People living with HIV have rights and deserve love, respect, care and support

•    There are medical treatments that help people live positively with HIV

Learning Objectives for Level II (9-12 years)

Describe the emotional, economic, physical and social challenges of living with HIV

Key Ideas:

• HIV and AIDS affect family structure, family roles and responsibilities

• Finding out one’s HIV status can be emotionally challenging

• Disclosing one’s HIV status can have negative consequences, including rejection, stigma, discrimination and violence

• Stigma, including self-stigma, can prevent people fromaccessing and using treatment, care and other support services

• The emotional, health, nutritional and physical needs of children orphaned or made vulnerable by AIDS may require particular attention

• People living with HIV experience changes in their viral loads (the amount of HIV circulating in their bodies) which can impact the risk of transmitting of HIV

• Treatment for HIV is a life-long commitment, and can often come with side effects and other challenges and may require careful attention to nutrition

• Children and young people can also benefit from treatment, although careful attention is required during puberty to ensure proper dosage and adherence

Learning Objectives for Level III (12-15 years)

Explain the importance and key elements of living positively with HIV

Key Ideas:

•    Sexuality education programmes for people living with HIV can support them to practice safer sex and to communicate with their partner(s)

•    People living with HIV should be able to express their love and feelings and to marry or enter into long-term commitments and to start a family, if they choose to do so

•    Support groups and mechanisms typically exist for people living with HIV

•    Discrimination against people on the basis of their HIV status is illegal

Learning Objectives for Level IV (15-18 years)

Describe the concept and causes of stigma and discrimination in relation to people living with HIV

Key Ideas:

• Stigma and discrimination against individuals and communities can impede access to education, information and services, and can heighten their vulnerability

• People living with HIV are often powerful advocates for their own rights, which can be enhanced through support from others

• People living with HIV can be important educators and mobilizers of young people because of their own experience and they can provide guidance and support to young people

References

UNAIDS. 2008. 2008 Report on the global AIDS epidemic. Geneva: UNAIDS.

UNAIDS. 2006. Scaling up access to HIV prevention, treatment, care and support. The next steps. Geneva: UNAIDS.

Curricula, training manuals, guidelines and standards

CDC. 2008. Healthy Youth! National Health Education Standards 1-8, CDC School Health Education Resources. Atlanta: CDC.

Deutsch, C. et al. 2005. Standards for Peer Education Programmes: Youth Peer Education Network. New York: UNFPA and Family Health International.

Education International and WHO. 2001. Training and Resource Manual On School Health and HIV/AIDS Prevention. Brussels: Education International (EI) and the World Health Organization (WHO).

IPPF. 2006. IPPFFramework for Comprehensive Sexuality Education. London: International Planned Parenthood Federation.

IPPF. 1997. IPPF Charter Guidelines on Sexual and Reproductive Rights. London: International Planned Parenthood Federation.

Jamaica Ministry of Education and Youth and Caribbean Consulting Group. 2007. Health and Family Life Education Curriculum Grades 1-6. Caribbean Consulting Group. Brooklyn: Caribbean Consulting Group.

Jamaica Ministry of Education and Youth and Caribbean Consulting Group. 2007. Health and Family Life Education Curriculum Grades 7-9. Brooklyn: Caribbean Consulting Group.

Mercy Corps. November 2007. Commitment to Practice: A Playbook for Practitioners in HIV, Youth and Sport. Portland: Mercy Corps.

New York City Department of Education. 2005. HIV/AIDS Curriculum Overview. New York: New York City Department of Education.

PATH. 2006. Tuko Pamoja: A Guide for Talking with Young People about their Reproductive Health. Nairobi: Programme for Appropriate Technology in Health.

Senderowitz, J., Kirby, D. 2006. Standards for Curriculum-Based Reproductive Health and HIV Education Programmes. Washington, DC: Family Health International.

SIECUS. 2006. Establishing National Guidelines for Comprehensive Sexuality Education: Lessons and Inspiration from Nigeria. New York: SIECUS.

SIECUS. 2000. Developing Guidelines for Comprehensive Sexuality Education. New York: SIECUS.

State of New Jersey Department of Education. 2006. New Jersey Core Curriculum Content Standards for Comprehensive Health and Physical Education. Trenton: State of New Jersey Department of Education.

Svenson, G. R. 1998. European Guidelines for Youth AIDS Peer Education, Malmo. Brussels: European Commission.

UNAIDS. 2007. Practical Guidelines for Intensifying HIV Prevention: Towards Universal Access. Geneva: UNAIDS.

UNESCO. 2005. Reducing HIV/AIDS Vulnerability Among Students in the School Setting: A Teacher Training Manual. Bangkok: UNESCO.

UNESCO IBE. 2006. Manual for Integrating HIV and AIDS Education in School Curricula. Geneva: International Bureau of Education/UNESCO.

Online articles and PowerPoint presentations

Asian Pacific Resource and Research Centre for Women. 2005. Arrows for Change: Women's, Gender and Rights Perspectives in Health Policies and Programmes. Vol. 11 Bumper Issue. Kuala Lumpur: ARROW.

Chingandu, L. 2008. Multiple Concurrent Partnerships: The story of Zimbabwe—Are small houses a key driver? Zimbabwe: Southern Africa HIV and AIDS Information Dissemination Service. http://www.comminit.com/en/node/278405/38

Chinvarasopak, W. 2008. Teachers and Sex: Uneasy Bedfellows? The Experience of the Teenpath Project, PowerPoint presentation at the International AIDS Conference, Mexico City, August 3-8, 2008. http://www.aids2008.org/Pag/ppt/TUSAT2403.ppt

Delaney, M. G. 2008. Prevention through Education, PowerPoint presentation at the 1st Meeting of Ministers of Health and Education to Stop HIV in Latin America and the Caribbean, Mexico City, August 1, 2008. http://www.aids2008.org/Pag/ppt/TUSAT2404.ppt

Exchange Magazine. 2008. Gender Violence, HIV and AIDS. Exchange on HIV/AIDS, sexuality and gender. No. 3. Amsterdam: Royal Tropical Institute. http://www.kit.nl/smartsite.shtml?ch=FAB&id=10488&IssueID=3&Year=2008

Family Health International. 2007. New Websites Make Information About Youth More Accessible. Durham: Family Health International. http://www.fhi.org/NR/rdonlyres/e6k4h7j3p5euhcx43e55pdtsqqx2746tzd2hots7j5iyr6p v4cnbhjoqwyf6dc64ebf6yredaqhazf/YL23e.pdf

Hearst, N. 2007. AIDS Prevention in Generalized Epidemics: What Works? Senate Testimony, December 11, 2007. http://help.senate.gov/Hearings/2007_12_11/Hearst.pdf

IRIN Plus News. 2008. South Africa: SexEducation—The Ugly Stepchild in Teacher Training, IRIN Plus News, 22 May 2008. http://www.plusnews.org/Report.aspx?ReportId=78357 .

IRIN Plus News. 2008. Mind Your Language: A Short Guide to HIV/AIDS Slang, IRIN Plus News, 18 June 2008. http://www.irinnews.org/Report.aspx?ReportId=78809

IRIN Plus News. 2008. Kenya: More Education Equals Less Teen Pregnancy and HIV, IRIN Plus News, 25 July. http://www.irinnews.org/report.aspx?ReportID=79456

Kaiser Daily Health Policy Report. 2008. HIV/AIDS Hinders Children's Access to Education, UNDP Official Says. Kaiser Daily Health Policy Report, June 16 2008. http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=52746

Kaiser Daily HIV/AIDS Report. 2008. HIV/AIDS Campaign Launched In Tanzania To Address Issues of Multiple Sex Partners. Global Challenges, October 27, 2008. http://www.medicalnewstoday.com/articles/127122.php

Kamugisha, N.E. 2007. An Improved School Environment Contributes to Quality Adolescent Sexual and Reproductive Health. PowerPoint presentation, Kampala, Uganda: Straight Talk Foundation. http://www.jhsph.edu/gatesinstitute/_pdf/policy_practice/adolhealth/presentations/.../3C_Namayanja_ Improved%20School%20Environment.pdf

Kirby, D. 2008. Abstinence and Comprehensive Sex/HIV Education Programmes: Their Impact on Behaviour in Developed and Developing Countries. Powerpoint presentation at the International AIDS Conference, Mexico City, August 3-8, 2008. http://www.aids2008.org/Pag/ppt/TUSY0301.ppt

Knerr, W., Philpott, A. 2008. Global Mapping of Pleasure: A directory of organizations, programmes, media and people who eroticize safer sex. Oxford: The Pleasure Project. http://www.thepleasureproject.org/content/File/ Global%20Mapping%20of%20Pleasure_2nd%20Ed_lo%20res(1).pdf

Maticka-Tyndale, E. 2008. Sustainability of Gains Made in a Primary School HIV Prevention Programme in Kenya into the Secondary School Years. PowerPoint presentation at the Investing in Young People's Health and Development Conference, Abuja, Nigeria, April 27-29. http://www.jhsph.edu/gatesinstitute/_pdf/policy_ practice/adolhealth/presentations/.../3C_Maticka-Tyndale_2ary%20school%20Kenya.pdf

Mulama, S. 2007. The Sexuality Education Needs of Teacher Trainees in Kenya. Lagos: Africa Regional Sexuality Resource Centre. http://www.arsrc.org/downloads/sldf/FinalReport%20Stella%20Mulama2006.pdf

Phamotse, P. 2008. HIV & AIDS and the Education Sector in Lesotho. PowerPoint presentation delivered by Chris Castle at the International AIDS Conference, Mexico City, August 3-8, 2008. http://www.aids2008.org/Pag/ppt/TUSAT2402.ppt

Philemon, L. 2008. Multiple Concurrent Partnerships Make HIV/AIDS A Quagmire. Guardian/IPP Media, 24 October. http://kurayangu.com/ipp/guardian/2008/10/24/125038.html

Star Schools Project. http://starschool.brimstone.net/ (accessed June 30, 2008).

UN. 2008. New Report Says Some Cultural Factors Influencing Spread of AIDS Are Specific to Africa. Press release. New York: United Nations. http://www.thebody.com/content/world/art47245.html

UNESCO. 2005. Adolescence Education: Newsletter for policy makers, programme managers and practitioners. Vol. 8, No. 1. http://www.unescobkk.org/fileadmin/user_upload/arsh/AEN/AEN_June05.pdf.

UNICEF Children and HIV and AIDS http://www.unicef.org/aids/index_introduction.php.


Appendices

Appendix I

International conventions and agreements relating to sexuality education

United Nations Committee on the Rights of the Child. CRC/GC/2003/4, 1 July 2003. General Comment 4: Adolescent health and development in the context of the Convention on the Rights of the Child (CRC)8

“The Committee calls upon States parties to develop and implement, in a manner consistent with adolescents' evolving capacities, legislation, policies and programmes to promote the health and development of adolescents by (...) (b) providing adequate information and parental support to facilitate the development of a relationship of trust and confidence in which issues regarding, for example, sexuality and sexual behaviour and risky lifestyles can be openly discussed and acceptable solutions found that respect the adolescent's rights (art. 27 (3));” (CRC/GC/2003/4, para. 16)

“Adolescents have the right to access adequate information essential for their health and development and for their ability to participate meaningfully in society. It is the obligation of States parties to ensure that all adolescent girls and boys, both in and out of school, are provided with, and not denied, accurate and appropriate information on how to protect their health and development and practise healthy behaviours. This should include information on the use and abuse, of tobacco, alcohol and other substances, safe and respectful social and sexual behaviours, diet and physical activity.” (CRC/GC/2003/4, para 26)

United Nations Committee on Economic, Social and Cultural Rights. E/C.12/2000/4, 11 August 2000. Substantive issues arising in the implementation of the international covenant on economic, social and cultural rights. General Comment 149

“The Committee interprets the right to health, as defined in article 12.1, as an inclusive right extending not only to timely and appropriate health care but also to the underlying determinants of health, such as [...] access to health-related education and information, including on sexual and reproductive health.” (E/C.12/2000/4, para. 11)

“By virtue of article 2.2 and article 3, the Covenant proscribes any discrimination in access to health care and underlying determinants of health, as well as to means and entitlements for their procurement, on the grounds of race, colour, sex, language, religion, political or other opinion, national or social origin, property, birth, physical or mental disability, health status (including HIV/AIDS), sexual orientation and civil, political, social or other status, which has the intention or effect of nullifying or impairing the equal enjoyment or exercise of the right to health.(...)” (E/C.12/2000/4, para. 18)

“To eliminate discrimination against women, there is a need to develop and implement a comprehensive national strategy for promoting women’s right to health throughout their life span. Such a strategy should include interventions aimed at the prevention and treatment of diseases affecting women, as well as policies to provide access to a full range of high quality and affordable health care, including sexual and reproductive services. A major goal should be reducing women’s health risks, particularly lowering rates of maternal mortality and protecting women from domestic violence. The realization of women's right to health requires the removal of all barriers interfering with access to health services, education and information, including in the area of sexual and reproductive health. It is also important to undertake preventive, promotive and remedial action to shield women from the impact of harmful traditional cultural practices and norms that deny them their full reproductive rights.” (E/C.12/2000/4, para. 21)

United Nations Convention on the Rights of Persons with Disabilities. A/61/611, 6 December, 2006. Article 25 - Health10

“States Parties recognize that persons with disabilities have the right to the enjoyment of the highest attainable standard of health without discrimination on the basis of disability. States Parties shall take all appropriate measures to ensure access for persons with disabilities to health services that are gender-sensitive, including health-related rehabilitation. In particular, States Parties shall:

(a) Provide persons with disabilities with the same range, quality and standard of free or affordable health care and programmes as provided to other persons, including in the area of sexual and reproductive health and population-based public health programmes... ”

International Conference on Population and Development (ICPD) Programme of Action (POA)11

“All countries should strive to make accessible through the primary health-care system, reproductive health to all individuals of appropriate ages as soon as possible and no later than the year 2015. Reproductive health care in the context of primary health care should, inter alia, include: family-planning counselling, information, education, communication and services; education and services for prenatal care, safe delivery and post-natal care, especially breast-feeding and infant and women’s health care; prevention and appropriate treatment of infertility; abortion as specified in paragraph 8.25, including prevention of abortion and the management of the consequences of abortion; treatment of reproductive tract infections; sexually transmitted diseases and other reproductive health conditions; and information, education and counselling, as appropriate, on human sexuality, reproductive health and responsible parenthood.” (ICPD POA, para. 7.6)

“Innovative programmes must be developed to make information, counselling and services for reproductive health accessible to adolescents and adult men. Such programmes must both educate and enable men to share more equally in family planning and in domestic and child-rearing responsibilities and to accept the major responsibility for the prevention of sexually transmitted diseases. Programmes must reach men in their workplaces, at home and where they gather for recreation. Boys and adolescents, with the support and guidance of their parents, and in line with the Convention on the Rights of the Child, should also be reached through schools, youth organizations and wherever they congregate. Voluntary and appropriate male methods for contraception, as well as for the prevention of sexually transmitted diseases, including AIDS, should be promoted and made accessible with adequate information and counselling.” (ICPD POA, para. 7.9)

“The objectives are: (a) To promote adequate development of responsible sexuality, permitting relations of equity and mutual respect between the genders and contributing to improving the quality of life of individuals; (b) To ensure that women and men have access to the information, education and services needed to achieve good sexual health and exercise their reproductive rights and responsibilities.” (ICPD POA, para. 7.36)

“Support should be given to integral sexual education and services for young people, with the support and guidance of their parents and in line with the Convention on the Rights of the Child, that stress responsibility of males for their own sexual health and fertility and that help them exercise those responsibilities. Educational efforts should begin within the family unit, in the community and in the schools at an appropriate age, but must also reach adults, in particular men, through non-formal education and a variety of community-based efforts. (ICPD POA, para. 7.37)

“In the light of the urgent need to prevent unwanted pregnancies, the rapid spread of AIDS and other sexually transmitted diseases, and the prevalence of sexual abuse and violence, Governments should base national policies on a better understanding of the need for responsible human sexuality and the realities of current sexual behaviour.” (ICPD POA, para. 7.38)

“Recognizing the rights, duties and responsibilities of parents and other persons legally responsible for adolescents to provide, in a manner consistent with the evolving capacities of the adolescent, appropriate direction and guidance in sexual and reproductive matters, countries must ensure that the programmes and attitudes of health-care providers do not restrict the access of adolescents to appropriate services and the information they need, including on sexually transmitted diseases and sexual abuse. In doing so, and in order to, inter alia, address sexual abuse, these services must safeguard the rights of adolescents to privacy, confidentiality, respect and informed consent, respecting cultural values and religious beliefs. In this context, countries should, where appropriate, remove legal, regulatory and social barriers to reproductive health information and care for adolescents.” (ICPD POA, para. 7.45)

“Countries, with the support of the international community, should protect and promote the rights of adolescents to reproductive health education, information and care and greatly reduce the number of adolescent pregnancies.” (ICPD POA, 7.46)

“Governments, in collaboration with non-governmental organizations, are urged to meet the special needs of adolescents and to establish appropriate programmes to respond to those needs. Such programmes should include support mechanisms for the education and counselling of adolescents in the areas of gender relations and equality, violence against adolescents, responsible sexual behaviour, responsible family-planning practice, family life, reproductive health, sexually transmitted diseases, HIV infection and AIDS prevention. Programmes for the prevention and treatment of sexual abuse and incest and other reproductive health services should be provided. Such programmes should provide information to adolescents and make a conscious effort to strengthen positive social and cultural values. Sexually active adolescents will require special family-planning information, counselling and services, and those who become pregnant will require special support from their families and community during pregnancy and early child care. Adolescents must be fully involved in the planning, implementation and evaluation of such information and services with proper regard for parental guidance and responsibilities.” (ICPD POA, para. 7.47)

“Programmes should involve and train all who are in a position to provide guidance to adolescents concerning responsible sexual and reproductive behaviour, particularly parents and families, and also communities, religious institutions, schools, the mass media and peer groups. Governments and non-governmental organizations should promote programmes directed to the education of parents, with the objective of improving the interaction of parents and children to enable parents to comply better with their educational duties to support the process of maturation of their children, particularly in the areas of sexual behaviour and reproductive health.” (ICPD POA, 7.48)

United Nations. A/S-21/5/Add.1, 1 July 1999. Overall review and appraisal of the implementation of the Programme of Action of the International Conference on Population and Development (ICPD + 5)12

“Governments, in collaboration with civil society, including non-governmental organizations, donors and the United Nations system, should: (a) Give high priority to reproductive and sexual health in the broader context of health-sector reform, including strengthening basic health systems, from which people living in poverty in particular can benefit; (b) Ensure that policies, strategic plans, and all aspects of the implementation of reproductive and sexual health services respect all human rights, including the right to development, and that such services meet health needs over the life cycle, including the needs of adolescents, address inequities and inequalities due to poverty, gender and other factors and ensure equity of access to information and services; (c) Engage all relevant sectors, including non-governmental organizations, especially women’s and youth organizations and professional associations, through ongoing participatory processes in the design, implementation, quality assurance, monitoring and evaluation of policies and programmes, in ensuring that sexual and reproductive health information and services meet people’s needs and respect their human rights, including their right to access to good-quality services; Develop comprehensive and accessible health services and programmes, including sexual and reproductive health, for indigenous communities with their full participation that respond to the needs and reflect the rights of indigenous people; [....]” (A/S-21/5/ Add.1, para. 52(a)-(d))

United Nations Fourth World Conference on Women (FWCW) Platform for Action (PFA)13

“The human rights of women include their right to have control over and decide freely and responsibly on matters related to their sexuality, including sexual and

reproductive health, free of coercion, discrimination and violence. Equal relationships between women and men in matters of sexual relations and reproduction, including full respect for the integrity of the person, require mutual respect, consent and shared responsibility for sexual behaviour and its consequences.” (FWCW PFA, para. 96)

“Actions to be taken by Governments, international bodies including relevant United Nations organizations, bilateral and multilateral donors and non-governmental organizations [...] (k) Give full attention to the promotion of mutually respectful and equitable gender relations and, in particular, to meeting the educational and service needs of adolescents to enable them to deal in a positive and responsible way with their sexuality;” (FWCW PFA, para. 108(k) and A/S-21/5/Add.1, para. 71®)

“Actions to be taken by Governments, in cooperation with non-governmental organizations, the mass media, the private sector and relevant international organizations, including United Nations bodies, as appropriate [...] (g) Recognize the specific needs of adolescents and implement specific appropriate programmes, such as education and information on sexual and reproductive health issues and on sexually transmitted diseases, including HIV/AIDS, taking into account the rights of the child and the responsibilities, rights and duties of parents as stated in paragraph 107 (e) above;” (FWCW PFA, para. 107(g))

United Nations. A/RES/S-26/2, 2 August 2001. General Assembly Special Session on HIV/AIDS, Declaration of Commitment on HIV/AIDS 14

“We, the Heads of State and Government and Representatives of Heads of State and Government, solemnly declare our commitment to address the HIV/ AIDS crisis by taking action as follows [...] By 2003, develop and/or strengthen strategies, policies and programmes, which recognize the importance of the family in reducing vulnerability, inter alia, in educating and guiding children and take account of cultural, religious and ethical factors, to reduce the vulnerability of children and young people by: ensuring access of both girls and boys to primary and secondary education, including on HIV/AIDS in curricula for adolescents; ensuring safe and secure environments, especially for young girls; expanding good quality youth-friendly information and sexual health education and counselling service; strengthening reproductive and sexual health programmes; and involving families and young people in planning, implementing and evaluating HIV/AIDS prevention and care programmes, to the extent possible;” (para. 63)

More general references may also include:

•    The 2000 Education for All (EFA) Dakar Framework for Action15 stresses in one of its six goals that youth-friendly programmes must be made available to provide the information, skills, counselling and services needed to protect young people from the risks and threats that limit their learning opportunities and challenge education systems, such as schoolage pregnancy and HIV and AIDS.

•    EDUCAIDS16, the UNAIDS initiative for a comprehensive education sector response to HIV and AIDS that is led by UNESCO, recommends that HIV and AIDS curricula in schools “begin early, before the onset of sexual activity”, “build knowledge and skills to adopt protective behaviours and reduce vulnerability”, and “address stigma and discrimination, gender inequality and other structural drivers of the epidemic”.

•    The World Health Organization17 (WHO, 2004) concludes that it is critical that sexuality education be started early, particularly in developing countries, because girls in the first classes of secondary school face the greatest risk of the consequences of sexual activity, and beginning sexuality education in primary school also reaches students who are unable to attend secondary school. Guidelines from the WHO Regional Office for Europe call on Member States to ensure that education on sexuality and reproduction is included in all secondary school curricula and is comprehensive.18

•    UNAIDS19 has concluded that the most effective approaches to sexuality education begin with educating young people before the onset of sexual activity.20 UNAIDS recommends that HIV prevention programmes: be comprehensive, high quality and evidence-informed; promote gender equality and address gender norms and relations; and include accurate and explicit information about safer sex, including correct and consistent male and female condom use.


Appendix II

Interview schedule and methodology

The consultant interviewed key stakeholders/informants to document best practice with developing and implementing formal school-based sexuality education programmes and curricula in developing countries, particularly in sub-Saharan Africa. However, information about developing particularly innovative approaches existing in Europe and North America has also been included.

In general,

A)    Key informants were initially contacted by phone and/or email, and interviews were requested.

B)    Once they agreed to participate, and gave their informed consent, they were emailed a semistructured interview guide so that they could prepare in advance, or choose to type up their responses.

C)    Arrangements were made to call the respondents at an agreed upon date and time.

D)    Respondents were contacted, questions were asked during a semi-structured phone or face-to-face interview, and their responses were then recorded, transcribed and compiled as background information for development of the working draft of the International Technical Guidance on Sexuality Education.

A total of 11 in-depth interviews were conducted with a set of pre-determined questions using a semistructured interview guide. The tool was developed to help document best practice with developing and implementing formal school-based sexuality education programmes and curricula. Interview questions on the semi-structured questionnaire were intentionally designed to be open-ended, and interviews with key informants were loosely structured to encourage free flow of information and ideas, and to maximise focus on their area(s) of specialisation, while eliciting their feedback and response.

Eight of the interviews were completed by phone, and one by a face-to-face interview. Two of the informants preferred writing their responses instead of the phone interview, and two informants submitted written responses as supplemental information to their phone interviews. The phone interviews ranged in duration from one half hour to two and a half hours.

In addition, four more informal interviews were conducted with informants not on the key informant contact list because they were thought to have particular insight and/or experience that might be helpful. They included: Novia Condell, UNICEF Jamaica; Shirley Oliver-Miller, Independent Adolescent Reproductive and Sexual Health Consultant; Bill Finger and Karah Fazekas of Family Health International (FHI). Although helpful, information provided was more limited in scope; thus, their responses were not transcribed and compiled with the other key informant interviews.

Semi-structured interview questionnaire schedule

1.    What has been your experience with developing and implementing sexuality education programmes in schools or in the formal education sector?

2.    What has presented challenges?

3.    What has been successful; what has worked?

4.    What are the most important elements of quality sexuality education programmes?

5.    What is the best way for Ministries of Education to work with schools to get them to promote and implement comprehensive sexuality education approaches?

6.    How can we move schools and communities towards comprehensive sexuality education verses abstinence-only-until-marriage approaches?

7.    What is (are) the best school-based sexuality education programme(s) you know about?

8.    How should the programme be taught (what are the entry points) in schools (e.g., as a separate subject, along with a carrier subject, or integrated throughout the curriculum)?

9.    What is the best process (or most promising practises) for ministries of education to undertake when developing and implementing a sexuality education programmes in schools?

10.    What is important to include in an International Technical Guidance document for ministers and policy-makers that will help them implement quality programmes?

Appendix III

People contacted and key informant details

Name, Title and Affiliation

Country/Region

Area(s) of Expertise

Maria Bakaroudis Independent Consultant

Malawi

Research and technical support

Sanja Cesar

Programme Manager, Centre for Education, Counselling and Research

Croatia

Implementation and advocacy

Esther Corona

Mexican Association for Sex Education and World Association for Sexual Health

Mexico and Latin America

Implementation and advocacy

Akinyele Dairo UNFPA

Sub-Saharan Africa

Implementation and technical support

Nike Esiet

Executive Director, Action Health, Inc. (AHI)

Nigeria

Implementation and advocacy

Christopher Graham Jamaica Ministry of Education

Jamaica and the Caribbean

Implementation and advocacy

Helen Mondoh

Professor of Education, Egerton University

Kenya

Implementation and research

Lisa Mueller

Programme for Appropriate Technology in Health (PATH)

Botswana, China, Ghana and the United Republic of Tanzania

Implementation and technical support

Tajudeen Oyewale UNICEF

Nigeria

Research and implementation

Jenny Renju

Liverpool School of Tropical Medicine, National Institute for Medical Research Tanzania

United Republic of Tanzania

Implementation and advocacy

Appendix IV

List of participants

in the UNESCO global technical consultation on sex, relationships and HIV/STI education, 18-19 February 2009, San Francisco, USA

Prateek Awasthi
UNFPA
Sexual and Reproductive Health Branch
Technical Division
220 East 42 nd Street
New York, New York 10017, USA
http://www.unfpa.org/adolescents/

Arvin Bhana
Child, Youth, Family & Social Development Human Sciences Research Council (HSRC)
Private Bag X07 Dalbridge, 4014, South Africa
http://www.hsrc.ac.za/CYFSD.phtml

Chris Castle
UNESCO
Section on HIV and AIDS
Division for the Coordination of UN Priorities in Education
7, place de Fontenoy 75352 Paris, France
http://www.unesco.org/aids

Dhianaraj Chetty
Action Aid International
Post Net suite # 248
Private bag X31 Saxonwold 2132
Johannesburg, South Africa
http://www.actionaid.org/main.aspx?PageID=167

Esther Corona
Mexican Association for Sex Education/World Association for Sexual Health (WAS)
Av de las Torres 27 B 301
Col Valle Escondido, Delegación Tlalpan México
14600 D.F., Mexico
esthercoronav@hotmail.com
http://www.worldsexology.org/

Mary Guinn Delaney
UNESCO
Santiago Enrique Delpiano 2058 Providencia Santiago, Chile
http://www.unesco.org/santiago

Nanette Ecker
nanetteecker@verizon.net
http://www.siecus.org/

Nike Esiet
Action Health, Inc. (AHI)
17 Lawal Street
Jibowu, Lagos, Nigeria
http://www.actionhealthinc.org/

Peter Gordon
Basement Flat
27a Gloucester Avenue
London NW1 7AU, United Kingdom

Christopher Graham
HIV and AIDS Education Guidance and Counselling Unit,
Ministry of Education
37 Arnold Road Kingston 5, Jamaica

Nicole Haberland
Population Council USA One
Dag Hammarskjold Plaza New York, NY 10017, USA
http://www.popcouncil.org/

Sam Kalibala
Population Council Kenya
Ralph Bunche Road
General Accident House, 2nd Floor
P.O. Box 17643-00500, Nairobi, Kenya
http://www.popcouncil.org/africa/kenya.html

Douglas Kirby
ETR Associates 4 Carbonero Way,
Scotts Valley, CA 95066, USA
http://www.etrassociates.org/

Wenli Liu
Research Center for Science Education
Beijing Normal University #19, Xinjiekouwaidajie Beijing, 100875, China

Elliot Marseille
Health Strategies International
1743 Carmel Drive #26 Walnut Creek, CA 94596, USA

Helen Omondi Mondoh
Egerton University
P.O BOX 536 Egerton-20115, Kenya

Prabha Nagaraja
Talking About Reproductive and Sexual Health Issues (TARSHI)
11, Mathura Road, 1st Floor, Jangpura B New Delhi 110014, India
http://www.tarshi.net/

Hans Olsson
The Swedish Association for Sexuality Education
Box 4331, 102 67 Stockholm, Sweden
http://www.rfsu.se/

Grace Osakue
Girls' Power Initiative (GPI)
Edo State 67 New Road, Off Amadasun Street,
Upper Ekenwan Road, Ugbiyoko,
P.O.Box 7400, Benin City, Nigeria
http://www.gpinigeria.org/

Jo Reinders
World Population Foundation
Vinkenburgstraat 2A 3512 AB Utrecht, Holland
http://www.wpf.org/

Sara Seims
Population Program
The William and Flora Hewlett Foundation
2121 Sand Hill Road Menlo Park, CA 94025, USA
http://www.hewlett.org/Programs/Population/

Ekua Yankah
UNESCO
Section on HIV and AIDS
Division for the Coordination of UN Priorities in Education
7, place de Fontenoy 75352 Paris, France
http://www.unesco.org/aids

Appendix V

Bibliography of resources

This bibliography of teaching materials was developed to accompany the International Technical Guidance on Sexuality Education. It is composed of existing, high quality sexuality education curricula, curriculum guides and teacher training manuals from around the world. The bibliography is intended to serve as a practical reference for curriculum developers, programme planners, school principals and teachers. The resources were selected based on the following criteria established at an expert technical consultation in February 2009:

•    Contributes towards comprehensive sexuality education curricula, curriculum guides or teacher training manuals

•    Evaluated or recommended by experts

•    Recently published (1998-2009) with accurate, up-to-date information reflecting latest “state-of-the-art” knowledge

•    Targeted to learners or educators, particularly at the primary and secondary school level, but also including the tertiary level

•    Available in English, French, Spanish or Portuguese

Updated versions of this resource list and their annotations can be found on the UNESCO HIV and AIDS Education Clearinghouse website http://hivaidsclearinghouse.unesco.org.

Note: The inclusion of resources in this bibliography does not represent an endorsement by UNESCO and the other UN partner organizations involved in the development of the International Technical Guidance.

Guidelines and Guiding Principles

Common ground: principles for working on sexuality

Produced by: Talking About Reproductive and Sexual Health Issues (TARSHI)

Date: 2001

Access: To order a copy, please contact tarshiweb@tarshi.net or tarshi@vsnl.com

From evidence to action: advocating for comprehensive sexuality education

Produced by: International Planned Parenthood Federation (IPPF)

Date: 2009

Access: Can be downloaded online from www.ippf.org/en/Resources/Guides-toolkits/From+evidence+to+actio

n+advocating+for+comprehensive+sexuality+education.htm

(Free Adobe Acrobat Reader® software required.)

Guidelines for comprehensive sexuality education in Nigeria

Produced by: Action Health Incorporated and Sexuality Information and Education Council of the United States (SIECUS)

Date: 1996

Access: Can be downloaded online from www.siecus.org/_data/global/images/nigerian_guidelines.pdf (Free Adobe Acrobat Reader® software required.)

Guidelines for comprehensive sexuality education: kindergarten through 12th grade

Produced by: National Guidelines Task Force and Sexuality Information and Education Council of the United States (SIECUS)

Date: 2004, 3rd edition

Access: Can be downloaded online from www.siecus.org/_data/global/images/guidelines.pdf (Free Adobe Acrobat Reader® software required.)

IPPF framework for comprehensive sexuality education

Produced by: International Planned Parenthood Federation (IPPF)

Date: 2006

Access: Can be downloaded online from

www.ippf.org/NR/rdonlyres/CE7711F7-C0F0-4AF5-A2D5-1E1876C24928/0ZSexuality.pdf (Free Adobe Acrobat Reader® software required.)

Jamaican guidelines for comprehensive sexuality education: pre-school through age 24

Produced by: Jamaican Task Force Committee for Comprehensive Sexuality Education (Jamaica Family Planning Association (FAMPLAN Jamaica) and Sexuality Information and Education Council of the United States (SIECUS)

Date: 2008

Access: Can be downloaded online from www.siecus.org/_data/global/images/Jamaica%20Guidelines.pdf (Free Adobe Acrobat Reader® software required.)

Manual for integrating HIV and AIDS education in school curricula

Produced by: United Nations Educational, Scientific and Cultural Organization (UNESCO) International Bureau of Education (IBE)

Date: 2006

Access: Can be ordered (in hard copy or on CD-ROM) free of charge from ibeaids@ibe.unesco.org or downloaded online in five different languages.

English: www.ibe.unesco.org/fileadmin/user_upload/HIV_and_AIDS/publications/IBE_CurrManual_3v_en.pdf French: www.ibe.unesco.org/fileadmin/user_upload/HIV_and_AIDS/publications/IBE_CurrManual_3v_fr.pdf Spanish: www.ibe.unesco.org/fileadmin/user_upload/HIV_and_AIDS/publications/Manual_SP.pdf Russian: www.ibe.unesco.org/fileadmin/user_upload/_temp_/Manual_complete_RUreduced.pdf

Arabic: www.ibe.unesco.org/fileadmin/user_upload/_temp_/Manuel_complet_ARbis.pdf (Free Adobe Acrobat Reader® software required.)

National health education standards: achieving excellence

Produced by: Joint Committee on National Health Education Standards and American Cancer Society Date: 2007, 2nd edition

Access: To order a printed book (at the cost of US$29.95), a CD-ROM ($19.95) or a downloadable PDF ($9.95) visit: https://www.cancer.org/docroot/PUB/PUB_0.asp?productCode=F2027.27 or www.cdc.gov/HealthyYouth/ SHER/standards/index.htm

Right from the start: guidelines for sexuality issues (birth to five years)

Produced by: Early Childhood Sexuality Education Task Force and Sexuality Information and Education Council of the United States (SIECUS)

Date: 1998

Access: Can be downloaded online from www.siecus.org/_data/global/images/RightFromTheStart.pdf (Free Adobe Acrobat Reader® software required.)

Sex education at schools

Produced by: Austrian Ministry of Education and Cultural Affairs Date: 1994

Access: The document is only available online in German. It can be downloaded from www.bmukk.gv.at/ schulen/unterricht/prinz/Unterrichtsprinzipien_Se1597.xml (Free Adobe Acrobat Reader® software required.)

Standards for curriculum-based reproductive health and HIV education programs

Produced by: Family Health International (FHI)

Date: 2006

Access: Can be ordered free of charge from youthnetpubs@fhi.org or downloaded online from www.fhi.org/NR/rdonlyres/ea6ev5ygicx2nukyntbvjui35yk55wi5lwnnwkgko3to uyp3a33aiczutoyb6zhxcnwiyoc37uxyxgZsexedstandards.pdf (Free Adobe Acrobat Reader® software required.)

Tell Me More! Children’s rights and sexuality in the context of HIV/AIDS in Africa

Produced by: Save the Children, Sweden and Swedish Association for Sexuality Education (RFSU)

Date: 2007

Access: The English version can be downloaded online from www.savethechildren.net/alliance/resources/hiv_ aids/2007_SCSweden_TellMeMore.pdf (Free Adobe Acrobat Reader® software required.)

Concept sex education for youths: sex education, contraception and family planning

Produced by: Federal Centre for Health Education (Die Bundeszentrale für gesundheitliche Aufklärung, BZgA) Date: 1999

Access: This publication can be downloaded from www.bzga.de/?uid=0cdce7ce03172b7fba028de802bec1fd& id=medien&sid=72&ab=20.

(Free Adobe Acrobat Reader® software required.)

It can also be obtained free of charge from the following address: BZgA, D-51101 Cologne, Germany or by email: order@bzga.de. Order number: 13006070.

The contemporary management of growing up and sexual maturation: the role of the primary school in Kenya

Produced by: Helen O. Mondoh, Lois W. Chiuri, Johnson M. Changeiywo and Nancy O. Omar Date: 2006

Access: Can be obtained from the following address: QUESTAFRICA, c/o FORMAT, POB 79, Village Market, 00621 Nairobi, Kenya. Phone: + 254 (20) 675 2866 or by email: questafrica@gmail.com or jeffers@questafrica.org.

Growing up and sexual maturation among the Luo of Kenya: removing barriers to quality education

Produced by: Helen Mondoh, Lois W. Chiuri, Nancy O. Omar, Johnson M. Changeiywo Date: 2006

Access: Can be ordered from: QUESTAFRICA, c/o FORMAT, POB 79, Village Market, 00621 Nairobi, Kenya. Phone: + 254 (20) 675 2866 or by email: questafrica@gmail.com or jeffers@questafrica.org

Intervention mapping (IM) toolkit for planning sexuality education programs: using intervention mapping in planning school-based sexual and reproductive health and rights (SRHR) education programs

Produced by: World Population Foundation (WPF) and Maastricht University Date: 2008

Access: Can be downloaded online from www.wpf.org/documenten/20080729_IMToolkit_July2008.pdf (Free Adobe Acrobat Reader® software required.)

More information and hard copies of the document can be obtained from: World Population Foundation (WPF), Vinkenburgstraat 2A, 3512 AB Utrecht, The Netherlands. Tel: +31 (30) 23 93 888; Email: j.leerlooijer@wpf.org

RAP-Tool

Produced by: Youth Incentives Programme, Rutgers Nisso Groep Date: 2007

Access: The tool can be downloaded online from www.youthincentives.org/Downloads (Free Adobe Acrobat Reader® software required.)

Tool to assess the characteristics of effective sex and STD/HIV education programs

Produced by: Healthy Teen Network and ETR Associates Douglas Kirby, Lori A. Rolleri and Mary Martha Wilson Date: 2007

Access: The tool can be downloaded online from: www.healthyteennetwork.org/vertical/Sites/%7BB4D0CC76-CF78-4784-BA7C-5D0436F6040C%7D/uploads/%7BAC34F932-ACF3-4AF7-AAC3-4C12A676B6E7%7D.PDF (Free Adobe Acrobat Reader® software required.)

A hard copy of this tool can also be ordered for US$10 at: www.healthyteennetwork.org/index.asp?Type=B_ PR&SEC=%7B2AE1D600-4FC6-4B4D-8822-F1D5F072ED7B%7D&DE=%7BB3E92693-FE7D-4248-965F-6AC3471B1E28%7D

A Sexatlas for schools. Sexuality and personal relationships: a guide for the planning and implementation of teaching programmes in this area for primary, junior secondary and senior secondary schools

Produced by: Swedish Association for Sexuality Education (RFSU)

Date: 2004

Access: The guide can be downloaded online from:

English: www.rfsu.se/upload/PDF-Material/sexatlas%20engelska.pdf French: www.rfsu.se/upload/PDF-Material/atlas_sexuel_des_ecoles.pdf (Free Adobe Acrobat Reader® software required.)

Sexualities: exploring sexualities as a cultural phenomena

Produced by: Swedish Association for Sexuality Education (RFSU)

Date: 2001

Access: To order the book, please contact: RFSU, Box 4331, 102 67 Stockholm, Sweden.

Phone: + 46 (0)8 692 07 00; Fax: + 46 (0)8 653 08 23; Email: info@rfsu.se

Teacher Training Guides

Basics and beyond: integrating sexuality, sexual and reproductive health and rights.

A manual for trainers

Produced by: Talking About Reproductive and Sexual Health Issues (TARSHI)

Date: 2006

Access: To order a copy, please contact tarshiweb@tarshi.net or tarshi@vsnl.com

Comprehensive sexuality education: trainers’ resource manual

Produced by: Action Health Incorporated Date: 2003

Access: The document can be ordered for free from Action Health Incorporated publications by sending an email to: library@actionhealthinc.org

Learning about living: the electronic version of FLHE. North Nigeria, Version 1.1. Teachers Manual 2009

Produced by: One World UK; Butterfly Works; Action Health Incorporated and the Nigerian Educational Research and Development Council (NERDC)

Date: 2009

Access: The electronic version is available at: www.learningaboutliving.org/north For more information about this programme, please email: info@learningaboutliving.org

National Family Life and HIV Education: teachers guide in basic science and technology

Produced by: Nigerian Educational Research and Development Council (NERDC) with the support of UNICEF Date: 2006

Access: To order a copy, contact: NERDC Headquarters, Lokoja - Kaduna Road, Sheda,

P.M.B. 91 Federal Capital Territory, Abuja, Nigeria. Or visit www.nerdcnigeria.org

Curricula

Activity book: Beacon Schools

Produced by: Health Communication Partnership (HCP), Ethiopia Date: 2005

Access: Can be downloaded online from the Johns Hopkins Bloomberg School of Public Health’s Center for Communication Programs:

English www.jhuccp.org/legacy/countries/ethiopia/PLETH178.pdf Amharic www.jhuccp.org/legacy/countries/ethiopia/PLETH179.pdf Oromifa www.jhuccp.org/legacy/countries/ethiopia/PLETH180.pdf (Free Adobe Acrobat Reader® software required.)

Becoming a responsible teen (BART): an HIV risk-reduction program for adolescents

Produced by: ETR Associates and Janet S. St. Lawrence Date: 2005, revised edition

Access: The manual can be ordered for US$54.95 from ETR Associates online at http://pub.etr.org/ or by mail: ETR Associates, 4 Carbonero Way, Scotts Valley, CA 95066, USA. Phone: +1 (800) 321-4407;

Fax: +1 (800) 435-8433. Two optional videos Seriously Fresh and Are You With Me? can be ordered for $65 each from Select Media Publishing online at www.selectmedia.org or by mail: Select Media, Inc.,

POB 1084, Harriman, NY 10926, USA.

Chela

Produced by: Phoenix Publishers Ltd., Helen O. Mondoh, Owen McOnyango, Lucas A. Othuon, Violet Sikenyi and Johnson M. Changeiywo

Date: 2006

Access: To order the books, visit www.phoenixpublishers.co.ke/order.php or write to Phoenix Publishers Ltd., Kijabe Street, Nairobi, POB 18650-00500, Kenya.

Choose a future! Issues and options for adolescent boys and girls in India

Produced by: The Centre for Development and Population Activities (CEDPA)

Date: 2004 and 2003, updated edition

Access: More information on the programme can be obtained from the Centre for Development and Population Activities (CEDPA), 1133 21st Street NW, Suite 800, Washington DC 20036, USA.

Phone: + 1 (202) 939-2612; Fax: + 1 (202) 332-4496; www.cedpa.org or from CEDPA/India, C-1 Hauz Khas, New Delhi - 110016, India; Email: agogoi@cedpaindia.org

Draw the line/respect the line: setting limits to prevent HIV, STD and pregnancy

Produced by: Center for AIDS Prevention Studies/University of California and ETR Associates Date: 2003

Access: The manuals can be ordered for US$21 each from ETR Associates online at http://pub.etr.org/ or by mail: ETR Associates, 4 Carbonero Way, Scotts Valley, CA 95066, USA. Phone: + 1 (800) 321-4407;

Fax: + 1 (800) 435-8433.

Facilitating school-based co-curricular activities on HIV and AIDS. Students and teachers learning for an HIV free generation

Produced by: Federal Ministry of Education, Nigeria and Action Health Incorporated Date: 2007

Access: For enquiries please contact: library@actionhealthinc.org Family life and HIV education for junior secondary schools

Produced by: Action Health Incorporated (in partnership with the Lagos State Ministry of Education, Nigeria). Published by Spectrum Books Limited.

Date: 2007

Access: The documents can be ordered free of charge from Action Health Incorporated publications by sending an email to: library@actionhealthinc.org

Focus on youth: an HIV prevention program for African-American youth

Produced by: ETR Associates Date: 2009

Access: Can be ordered for US$59.95 from ETR Associates online at http://pub.etr.org/

or by mail: ETR Associates, 4 Carbonero Way, Scotts Valley, CA 95066, USA. Phone: +1 (800) 321-4407;

Fax: +1 (800) 435-8433.

Good things for young people: reproductive health education for primary schools

Produced by: MEMA kwa Vijana (Tanzanian Ministries of Health and Education, the Tanzania National Institute for Medical Research (NIMR), the African Medical and Research Foundation (AMREF) and the London School of Hygiene and Tropical Medicine (LSHTM))

Date: 2004

Access: Can be downloaded online as follows:

Teacher's Guide for Standard 5: www.memakwavijana.org/pdfs/Teachers-Guide-Std-5-English.pdf Teacher's Guide for Standard 6: www.memakwavijana.org/pdfs/Teachers-Guide-Std-6-English.pdf Teacher's Guide for Standard 7: www.memakwavijana.org/pdfs/Teachers-Guide-Std-7-English.pdf Teacher's Resource Book: www.memakwavijana.org/pdfs/Teachers-Resource-Book.pdf (Free Adobe Acrobat Reader® software required.)

For details of how to obtain the Swahili language version, contact Annabelle.South@lshtm.ac.uk

Let us protect our future. A comprehensive sexuality education approach to HIV/STDS and pregnancy

prevention

Produced by: Select Media

Date: 2009

Access: Forthcoming in autumn 2009

Making proud choices! A safer-sex approach to HIV/STDs and teen pregnancy prevention

Produced by: Select Media, Loretta Sweet Jemmott; John B. Jemmott, and Konstance A. McCaffree Date: 2006, 3rd edition

Access: The basic package of the document can be ordered for US$145.00 (the complete package including the four optional videos costs $535.00) from Select Media Publishing online at http://selectmedia.org/customer-service/evidence-based-curricula/making-proud-choices/ or by mail: Select Media, Inc., POB 1084, Harriman, NY 10926, USA.

My future is my choice

Produced by: The Youth Health and Development Programme, UNICEF, Government of Namibia, University of Maryland School of Medicine Date: 1999 and 2001

Access: The documents can be downloaded online from www.unicef.org/lifeskills/index_14926.html (Free Adobe Acrobat Reader® software required.)

National Family Life and HIV Education Curriculum for junior secondary schools in Nigeria

Produced by: Nigerian Educational Research and Development Council (NERDC), Federal Ministry of Education of Nigeria, Universal Basic Education (UBE) and Action Health Incorporated Date: 2003

Access: The document can be downloaded online from www.actionhealthinc.org/publications/downloads/ jnrcurriculum.pdf (Free Adobe Acrobat Reader® software required.)

Our future: sexuality and life skills education for young people Produced by: International HIV/AIDS Alliance Date: 2007

Access: The three books can be ordered free of charge from mail@aidsalliance.org or downloaded online from:

www.aidsalliance.org/graphics/secretariat/publications/Our_Future_Grades_4-5.pdf

www.aidsalliance.org/graphics/secretariat/publications/Our_Future_Grades_6-7.pdf

www.aidsalliance.org/graphics/secretariat/publications/Our_Future_Grades_8-9.pdf

(Free Adobe Acrobat Reader® software required.)

Our whole lives: sexuality education

Produced by: Unitarian Universalist Association of Congregations (UUA)

Dates: 1999 and 2000

Access: The manuals can be ordered at a cost of between US$40 and $75 each from UUA bookstore online at www.uua.org/religiouseducation/curricula/ourwhole/ or by mail: Unitarian Universalist Association of Congregations, 25 Beacon Street, Boston, MA 02108, USA. Phone: +1 (617) 742-2100;

Fax: +1 (617) 723-4805.

Project H: working with young men series

Produced by: Instituto Promundo, Pan American Health Organization (PAHO) and World Health Organization (WHO)

Date: 2002

Access: The manuals can be ordered free of charge from promundo@promundo.org.br

or downloaded online from

(Free Adobe Acrobat Reader® software required.)

English: www.promundo.org.br/396?locale=en_US Spanish: www.promundo.org.br/352?locale=pt_BR Portuguese: www.promundo.org.br/396?locale=pt_BR

Program M. Working with young women: empowerment, rights and health

Produced by: Instituto Promundo, Salud y Género, ECOS (Comunicagao em Sexualidade), Instituto PAPAI and World Education Date: 2008

Access: A hard copy of the manual can be ordered free of charge from: promundo@promundo.org.br It can also be downloaded online from:

English: www.promundo.org.br/materiais%20de%20apoio/publicacoes/MANUAL%20M.pdf

Portuguese: www.promundo.org.br/materiais%20de%20apoio/publicacoes/TrabalhandocomMulheresJovens.

pdf

(Free Adobe Acrobat Reader® software required.)

The video can be ordered from: www.rumo.com.br/sistema/home.asp?IDLoja=10093. A clip is available at: www.promundo.org.br/354

The Red Book. What you want to know about yourself (10-14 years)

The Blue Book. What you want to know about yourself (15+ years)

Produced by: Talking about Reproductive and Sexual Health Issues (TARSHI)

Date: 2005 and 1999

Access: The booklets can be downloaded online from www.tarshi.net/publications/publications_sexuality_ education.asp (Free Adobe Acrobat Reader® software required.)

Reducing the risk: building skills to prevent pregnancy, STD and HIV

Produced by: ETR Associates and Richard P. Barth Date: 2004, 4th edition

Access: The Trainer’s Manual (US$42.95), the Student Workbook, in English or Spanish (set of five, $18.95) and the Activity Kit ($39) can be ordered from ETR Associates online at http://pub.etr.org/ or by mail: ETR Associates, 4 Carbonero Way, Scotts Valley, CA 95066, USA. Phone: + 1 (800) 321-4407; Fax: +1 (800) 4358433.

Safer choices: preventing HIV, other STD and pregnancy

Produced by: Karin K. Coyle, Joyce V. Fetro, Richard P. Barth, ETR Associates and Center for Health Promotion Research and Development, University of Texas-Houston, Health Science Center Date: 2007, revised edition

Access: The complete set of Safer Choices manuals, student workbooks and an activity kit can be ordered for US$189.95 through ETR Associates online at http://pub.etr.org/ or by mail: ETR Associates, 4 Carbonero Way, Scotts Valley, CA 95066, USA. Phone: + 1 (800) 321-4407; Fax: + 1 (800) 435-8433. A video/DVD, “Blood Lines”, recommended for use with Level 2, can be purchased for $149. Teacher training for this programme is available in the US through ETR Associates (training@etr.org).

Stepping stones: a training package in HIV/AIDS, communication and relationships skills

Produced by: ActionAid International and Alice Welbourne Date: 1999

Access: The manual can be previewed on www.steppingstonesfeedback.org/?page_id=965 or www. stratshope.org/t-training.htm. It can be ordered at low cost from Teaching Aids at Low Cost (TALC) on www. talcuk.org/books/bs-stepping-stones.htm

Today’s choices

Produced by: Stellenbosch University, Department of Education South Africa and World Population Foundation (WPF)

Date: 2004

Access: The programme is available online at http://arhp.co.za/todays_choices/. It may be copied (downloaded) and printed free of charge.

UDAAN: towards a better future. Training manual for nodal teachers.

Produced by: The Centre for Development and Population Activities (CEDPA), India; Jharkhand State AIDS Control Society and Department of Education, Government of Jharkhand, India Date: 2006

Access: More information on the programme can be obtained from the Center for Development and Population Activities (CEDPA), 1133 21st Street NW, Suite 800, Washington DC 20036, USA. Phone: + 1 (202) 939-2612;

Fax: + 1 (202) 332-4496, or online: www.cedpa.org. Information is also available from CEDPA/India, C-1 Hauz Khas, New Delhi - 110016, India. Email: agogoi@cedpaindia.org

The world starts with me!

Produced by: World Population Foundation (WPF), Butterfly Works and SchoolNet Uganda Date: 2003

Access: A part of the curriculum is available online for free at: www.theworldstarts.org/start/begin.html For more information regarding the curriculum, see: www.wpf.org/documenten/20060809_WSWM_handout. doc or contact World Population Foundation, Vinkenburgstraat 2A, 3512 AB Utrecht, The Netherlands. Tel: +31 (30) 239 38 88. Email: office@wpf.org.

The world starts with me! Adaptations

Indonesia:

-    DAKU! For secondary schools in Indonesia, developed by the World Population Foundation (WPF),

Indonesia, 2006.

-    MAJU! For special education schools for deaf youth in Indonesia, developed by the World Population Foundation (WPF), Indonesia and the Directorate of Special Needs Education (DSE) of the Indonesian Ministry of Education and Culture, 2008.

-    Langhka Pastiku! For special education schools for blind youth in Indonesia, developed by the World Population Foundation (WPF), Indonesia, the Ministry of Special Education in Indonesia and Yayasan Pelita Ilmu (YPI), 2008.

-    SERU! For juvenile correction institutes in Indonesia, developed by the World Population Foundation (WPF), Indonesia.

-    You and me. For kindergarten in Indonesia, developed by the World Population Foundation (WFP), Indonesia and Bernard van Leer Foundation, 2007.

Kenya:

-    The world starts with me! For secondary schools and disadvantaged youth in Kenya, developed by the World Population Foundation (WFP), Centre for Study of Adolescence (CSA) and NairoBits Digital Design School, Nairobi, 2006.

Thailand:

-    The world turns by my hands! For secondary schools in Bangkok, developed by the World Population Foundation (WFP) and the Association for the Promotion of the Status of Women (APSW), 2007.

Viet Nam:

-    Journey to adulthood. For the Teacher Training University Students of Danang University of Education in Viet Nam, developed by the World Population Foundation (WFP) Viet Nam, Danang University of Education, Department of Education and Training Danang and National Institute of Educational Sciences, 2009. (An adaptation for secondary schools is under development.)

Young men as equal partners (YMEP)

Produced by: YMEP-project (a collaboration between Kenyan, Tanzanian, Ugandan, Zambian and Swedish Member Associations of the International Planned Parenthood Federation (IPPF))

Date: 2008, revised edition

Access: The book can be downloaded online from

www.rfsu.se/upload/PDF-Material/YMEPguidebookapril08.pdf

(Free Adobe Acrobat Reader® software required.)

Cover photo
© 2000 Rick Maiman/David and Lucile Packard Foundation, Courtesy of Photoshare © 2009 UNAIDS/O.O’Hanlon © 2006 Basil A. Safi/CCP, Courtesy of Photoshare © 2006 UNAIDS/G. Pirozzi.

p.5 © 2004 Ian Oliver/SFL/Grassroot Soccer, Courtesy of Photoshare p.17 © 2006 Rose Reis, Courtesy of Photoshare

1    Sexuality Education is defined as an age-appropriate, culturally relevant approach to teaching about sex and relationships by providing scientifically accurate, realistic, non-judgmental information. Sexuality Education provides opportunities to explore one’s own values and attitudes and to build decision-making, communication and risk reduction skills about many aspects of sexuality. The evidence review in Volume I section 4 of this document refers to this definition as the criterion for the inclusion of studies for the evidence review.

2     Botswana, Ethiopia, Indonesia, Jamaica, Kenya, Namibia, Nigeria, South Africa, Tanzania, Thailand, USA and Zambia.

3    These included but were not limited to the following sites: SIECUS; Johns Hopkins Bloomberg School of Public Health Center for Communications Program’s The Info Project; International HIV/AIDS Alliance; Family Health International; Institute of Education, University of London; United Nations Educational, Scientific and Cultural Organization (UNESCO); UNESCO International Bureau of Education (IBE); United Nations Population Fund (UNFPA); and International Planned Parenthood Federation (IPPF).

4    “In no case should abortion be promoted as a method of family planning.In circumstances in which abortion is not against the law, such abortion should be safe. In all cases, women should have access to quality services for the management of complications arising from abortion. Post-abortion counselling, education and family-planning services should be offered promptly, which will also help to avoid repeat abortions." ICPD POA, para. 8.25 “In circumstances where abortion is not against the law, health systems should train and equip health-service providers and should take other measures to ensure that such abortion is safe and accessible." Key actions ICPD+5, para. 63iii

5    “In order to promote the health and development of adolescents, States parties are also encouraged to respect strictly their right to privacy and confidentiality, including with respect to advice and counselling on health matters (art. 16). Health-care providers have an obligation to keep confidential medical information concerning adolescents, bearing in mind the basic principles of the Convention. Such information may only be disclosed with the consent of the adolescent, or in the same situations applying to the violation of an adult’s confidentiality. Adolescents deemed mature enough to receive counselling without the presence of a parent or other person are entitled to privacy and may request confidential services, including treatment." CRC Gen Com 4(2003) para. 11. “The realization of the right to health of adolescents is dependent on the development of youth-sensitive health care, which respects confidentiality and privacy and includes appropriate sexual and reproductive health services." CRC Gen Com 4(2003) para. 40b.

6    McCary J.L. 1978. McCary's Human Sexuality. Third Edition. New York: D. Van Nostrand and Company, pp. 150 & 262. Strong, B., DeVault, C. 1988. Understanding Our Sexuality. Second Edition. Eagan MN: West Publishing Company, pp. 179-80. Haas, A., and Haas, K. 1990. Understanding Sexuality. Times Mirror/Mosby College Publishing: St. Louis. p. 207. Francoeur, R.T., Noonan, R.J. (Editors). 2004. The International Encyclopaedia of Sexuality. Volume 5. New York: Continuum Intl Pub Group.

7    “In order to promote the health and development of adolescents, States parties are also encouraged to respect strictly their right to privacy and confidentiality, including with respect to advice and counselling on health matters (art. 16). Health-care providers have an obligation to keep confidential medical information concerning adolescents, bearing in mind the basic principles of the Convention. Such information may only be disclosed with the consent of the adolescent, or in the same situations applying to the violation of an adult's confidentiality. Adolescents deemed mature enough to receive counselling without the presence of a parent or other person are entitled to privacy and may request confidential services, including treatment." CRC Gen Com 4(2003) para. 11. “The realization of the right to health of adolescents is dependent on the development of youth-sensitive health care, which respects confidentiality and privacy and includes appropriate sexual and reproductive health services." CRC Gen Com 4(2003) para. 40b.

8    UN. 2003. United Nations Committee on the Rights of the Child. General Comment 4: Adolescent health and development in the context of the Convention on the Rights of the Child (CRC). CRC/GC/2003/4. New York: UN. See also: UN. 1989. United Nations Convention on the Rights of the Child. New York: UN.

9    UN. 2000. United Nations Committee on Economic, Social and Cultural Rights. Substantive issues arising in the implementation of the international covenant on economic, social and cultural rights. General Comment No. 14. E/C.12/2000/4. New York: UN.

10    UN. 2006. United Nations Convention on the Rights of Persons with Disabilities. A/61/611. New York: UN.

11    UN. 1994. International Conference on Population and Development. Programme of Action. New York: UN.

12    UN. 1999. Overall Review and Appraisal of the Implementation of the Programme of Action of the International Conference on Population and Development. A/S-21/5/Add.1. New York: UN.

13    UN. 1995. United Nations Fourth World Conference on Women. Platform for Action. New York: UN.

14 UN. 2001. United Nations General Assembly Special Session on HIV/AIDS. Declaration of Commitment on HIV/AIDS. . A/RES/S-26/2. New York: UN.

15   UNESCO. 2000. Dakar Framework for Action: Education for All. Meeting Our Collective Commitments. Paris, UNESCO.

16   UNESCO. 2008. EDUCAIDS Framework for Action. Paris: UNESCO.

17    WHO. 2004. Adolescent Pregnancy Report. Geneva: WHO

18    WHO. 2001. WHO Regional Strategy on Sexual and Reproductive Health. Copenhagen: WHO, Regional Office for Europe.

19    UNAIDS. 2005. Intensifying HIV Prevention, supra note 26, at 33. Geneva: UNAIDS.

20    UNAIDS. 1997. Impact of HIV and Sexual Health on the Sexual Behaviour of Young People: A Review Update 27. Geneva: UNAIDS.