Adolescent sexuality is a stage of human development in which adolescents experience and explore sexual feelings.
Sexual health is an essential part of good overall health and wellbeing. Sexuality is a part of human life and human development.
Good sexual health implies not only the absence of a disease, but the ability to understand and weigh the risks, responsibilities, outcomes and impacts of sexual actions, to be knowledgeable of and comfortable with one’s’ body and to be free from exploitation and coercion, whereas good sexual health is significant across the life span, It is critical in adolescent health.
Adolescence signifies the onset of physical sexual maturation and reproductive capacity, young people have a need and a right to know about their own bodies and to be educated and informed about their sexual health, yet they face many social, political and community barriers to receiving and gaining access to the right information.
Definition of Terms
Incest: Incest refers to sexual activity or marriage between individuals who are closely related by blood, such as siblings or between parents and children.
Pedophilia: Pedophilia is a psychiatric disorder characterized by an adult’s sexual attraction to prepubescent children.
Necrophilia: Necrophilia involves a sexual attraction to corpses.
Voyeurism: Voyeurism is the practice of gaining sexual pleasure from observing others without their knowledge or consent. This behaviour can extend to observing others engaging in sexual activities.
Sadomasochism (S&M): Sadomasochism involves the enjoyment of both giving and receiving pain or humiliation as part of sexual activity. This can include practices like bondage, dominance, submission, and role-playing.
Asexuality: Asexuality is a sexual orientation characterized by a lack of sexual attraction or interest in sexual activity. Asexual individuals may still experience romantic attraction.
Polyamory: Polyamory is the practice of having multiple consensual romantic or sexual relationships simultaneously, with the knowledge and consent of all involved parties.
Pansexuality: Pansexuality refers to the attraction to individuals regardless of their gender or gender identity. Pansexual individuals may be attracted to people regardless of whether they identify as male, female, or non-binary.
Sapiosexuality: Sapiosexuality is the attraction to intelligence. Individuals who identify as sapiosexual are attracted to intelligence and intellectual qualities in others.
Transgender: Transgender refers to individuals whose gender identity differs from the sex assigned to them at birth. Transgender people may identify as male, female, or non-binary.
Cisgender: Cisgender refers to individuals whose gender identity aligns with the sex assigned to them at birth. For example, someone assigned female at birth who identifies as a woman is cisgender.
Bisexuality: Bisexuality is the attraction to individuals of both the same and different genders. Bisexual individuals may experience romantic or sexual feelings for people of various gender identities.
Heterosexuality: Heterosexuality is the romantic or sexual attraction between individuals of the opposite gender. It is the most commonly recognized sexual orientation.
Homosexuality: Homosexuality is the romantic or sexual attraction between individuals of the same gender. People who identify as homosexual are often referred to as gay (men) or lesbian (women).
Awareness about Sexuality
This is a matter of public concern in Uganda. The common belief that adolescents are more involved in sexual activities now compared to traditional societies is supported by evidence. The early age at which young people start engaging in sexual activities in Uganda has been verified through various means. Sexual activity during adolescence can be a personal choice or involuntary. The average age for the first consensual sexual experience is 16 years for women aged 20-49 and 17.6 years for men aged 24-54.
Levels of Awareness in Adolescents
- Level 1 – No awareness: Many adolescents are either ignorant or have a “who cares” attitude towards high-risk sexual behaviour. They are not yet aware enough to change their behaviour and are exposed to high risks as a result. This type of adolescent may be classified at Level 1 of awareness.
- Level 2 – Some awareness: Young people at level two are those who have some self-knowledge of risky situations and behaviours but are not ready to take action. Thus, they are exposed to unwanted pregnancy and infections.
- Level 3 – Relatively aware: Young people at level three are conscious of their risky sexual behaviours and are ready to take action, but do not do so because of factors like peer pressure.
- Level 4 – Fully aware: Young people in this stage have a high level of knowledge and awareness and have also undergone attitude and behavioural changes. Such young people are actively involved in fighting risky sexual behaviours.
Building Healthy Relationships
- Relationship: Relationship refers to a connection, dealing, or association between individuals.
- Friendship: Friendship refers to a relationship between people who know and like each other, characterized by kind and pleasant behaviour.
- Romantic Relationship: A romantic relationship signifies a loving association between two people, appealing to the imagination and influencing emotions.
- Sexual Relationship: A sexual relationship is an intimate connection involving sex between individuals in love.
Steps of Building Healthy Relationships
- Initiating Contact: Actual contact is made with the purpose of getting together and knowing each other..
- Mutual Interest: Each person believes the other is interested in them.
- Acceptance: Each person learns to accept one another for who they truly are.
- Conflict Resolution: Disagreements occur, and the comfort level grows between partners.
- Complementing Each Other: Partners learn to complement each other in their strengths and weaknesses.
- Building Trust: Trust is established, reducing feelings of jealousy.
Differences Between Love and Infatuation
- Love can be described as a feeling of intense affection for another person.
- Infatuation is the state of being completely carried away by unreasoning passion or love; addictive love. Infatuation usually occurs at the beginning of a relationship when sexual attraction is central.
Healthy Ways of Ending a Relationship
- Clear Decision: Make a clear decision about whether to end the relationship or not.
- Acknowledgment of Hurt: Acknowledge that someone will likely be hurt, and you may feel sadness yourself.
- Commitment to Decision: Once the decision is made, stick to it.
- Truthful Communication: Be truthful but kind about why you are ending the relationship.
- Appropriate Setting: Choose an appropriate place and time to break up.
- Avoiding Blame: Try not to blame your partner for the break, focusing on mutual understanding.
Factors Influencing Adolescent Engagement in Sexual Activity
Lack of Knowledge on Outcome of Sexual Activity: Many adolescents might not fully understand the potential consequences of engaging in sexual activities, including the risk of unintended pregnancies and sexually transmitted infections.
- Incest: Inappropriate sexual relationships within the family.
- Defilement: Unlawful sexual activity with a minor.
- Rape: Forced non-consensual sexual intercourse.
Poverty: Economic hardships may push adolescents into risky behaviours, including engaging in transactional sex.
Lack of Essential Skills
- Assertiveness: The ability to express one’s needs and desires confidently.
- Self-awareness: Understanding one’s emotions, values, and motivations.
- Negotiation Skills: Ability to communicate and reach agreements.
- Value Clarification: Clearly defining personal values.
- Self-esteem: Confidence in one’s worth and abilities.
- Decision Making: The capacity to make informed choices.
Alcohol and Substance Use: Substance abuse can impair judgment and increase the likelihood of engaging in risky sexual behavior.
Peer Pressure: Influence from friends or peer groups can play a significant role in adolescents’ decisions regarding sexual activity.
- Slums: Living in challenging urban environments.
- Influence of Media: Exposure to explicit content in electronic and print media.
- Rapid Urbanization: Changing social dynamics due to urban growth.
Lack of Recreational Activities: Insufficient constructive activities may lead adolescents to seek excitement through risky behaviours.
Insecurity: Living in environments with high levels of insecurity may contribute to seeking comfort or escape through sexual activities.
Emotional Factors: Adolescents may engage in sex as a way of dealing with emotional challenges, seeking validation, or expressing affection.
Civil Strife: Conflict and instability in the community can disrupt social norms, impacting adolescents’ behaviour.
Financial Considerations: Economic disparities may drive some adolescents to engage in transactional sex for financial gains.
Revenge: Seeking revenge or retaliating against perceived wrongs can be a motivation for engaging in risky behaviour.
Consequences of Adolescent Engagement in Sex
- Complications: Risks associated with teenage pregnancies, including health issues for both mother and baby.
- Induced Abortions: The potential consequences of unsafe abortion practices.
- Premature Childbirth: Increased risk of complications for both mother and child.
- VVF (Vesicovaginal Fistula): A severe condition often associated with childbirth.
Sexually Transmitted Infections/HIV/AIDS
- Increased vulnerability to infections with potential life-long health consequences.
- Impaired reproductive capabilities as a result of early and unprotected sexual activity.
Cancer of Cervix
- Long-term health risks, including the potential development of cervical cancer.
- Anxiety, Depression, Guilt, Self-condemnation, Shame, Fear: Psychological challenges arising from early sexual experiences.
- Dropping Out of School: Impact on educational pursuits.
- Truancy: Irregular attendance and engagement.
- Stigmatization: Negative societal perceptions.
- Forced Marriage: Pressure to marry due to early pregnancy.
- Stunted Growth for Adolescent Mothers: Health impacts on both mother and child.
- Reduced Employment Chances and Low Social Status: Long-term societal implications.
Measures to Prevent Adolescent Engagement in Sex
- Promotion of Positive Cultural Practices: Reinforcing cultural values that discourage early sexual activity.
- Advocating for Virginity/Abstinence: Encouraging young people to abstain from sexual activity until they are emotionally and mentally prepared.
- Life Skills Promotion: Providing adolescents with essential life skills, including communication, decision-making, and critical thinking, to navigate challenges effectively.
- Comprehensive Sex Education: Implementing educational programs that equip adolescents with accurate information about sexual health and relationships.
- Access to Reproductive Health Services: Ensuring availability and accessibility of reproductive health services for adolescents, including counselling and contraceptives.
- Community Awareness and Involvement: Engaging communities to raise awareness about the consequences of early sexual activity and fostering support networks.
- Mentorship Programs: Establishing mentorship initiatives to guide adolescents and provide positive role models.
- Poverty Alleviation Programs: Addressing economic disparities to reduce vulnerability to transactional sex due to financial hardships.
- Parental Involvement: Encouraging open communication between parents and adolescents to ascertain understanding and guidance.
- Legal Protection: Enforcing and strengthening laws against sexual abuse and exploitation to protect adolescents.
- Psychosocial Support: Offering psychological and emotional support to adolescents dealing with emotional challenges.
- School-Based Programs: Implementing educational initiatives within schools to address sexual health, life skills, and personal development.
- Media Literacy: Promoting media literacy to help adolescents critically evaluate and understand media influences on sexual behavior.
Roles of Health Workers in Managing Adolescents Engaging in Unprotected Sex
Sensitizing the Community on Consequences of Adolescent Sex
- Health workers play a role in educating the community about the potential risks and consequences of adolescent sexual activity, promoting awareness and informed decision-making.
Promotion of Recreation Activities for Adolescents
- Encouraging health-promoting recreational activities helps channel the energy of adolescents positively, reducing idle time that might lead to risky behaviours.
Encouraging Parents to Discuss Sex Issues with Adolescents
- Health workers advocate for open communication between parents and adolescents, emphasizing the importance of discussing sex-related matters to foster understanding and guidance.
- Providing counselling services to adolescents helps address emotional and psychological aspects related to sexual activity, offering support and guidance.
Treatment of Consequences
- Health workers are instrumental in treating the physical and mental health consequences that adolescents may face due to engaging in unprotected sex.
Supply of Condoms and Contraceptives
- Ensuring access to condoms and contraceptives helps reduce the risk of unintended pregnancies and sexually transmitted infections among sexually active adolescents.
Risk Factors Leading Adolescents to Engage in Sex
- Use of Alcohol and Drugs: Substance abuse impairs judgement, leading to increased risk-taking behaviour among adolescents.
- Lack of Comprehensive and Reliable Information: Limited access to accurate sexual and reproductive health information increases the likelihood of engaging in risky sexual behaviour.
- Low Perception of Risk: Adolescents may underestimate the risks associated with early sexual activity, affecting their decision-making and precautionary measures.
- Gender Inequality: Gender disparities contribute to risky sexual practices, influenced by social and cultural expectations.
- Levels of Education: Education plays a crucial role in shaping behaviour, decision-making, and health-seeking behaviour among adolescents.
- Lack of Guidance and Poor Modeling by Parents: Inadequate parental guidance and poor role modelling can create an environment conducive to early sexual initiation.
- Socio-Economic Constraints: Economic challenges may drive adolescents to engage in transactional sex for material gains.
- Single Parent in the Household: Adolescents in single-parent households may face increased risks, with potential implications for their attitudes toward sex.
- External Influence from Peers (Peer Pressures): Peers can significantly impact adolescents’ behavior, especially if they lack guidance and information from other sources.
- Overcrowding in Slums: Living in overcrowded conditions, such as slums, may expose adolescents to various immoral behaviors and influence their decisions.
What Adolescents Can Do to Avoid Engaging in Sexual Activities
Proper Parental Mentoring and Supervision
- Adolescents benefit from parental involvement, guidance, and setting family rules to shape their behaviours positively.
Involvement in Recreational Activities
- Engaging in constructive recreational activities, such as watching educational films, helps occupy adolescents’ time positively.
Staying in School
- Encouraging adolescents to stay in school provides them with opportunities for personal development and increased awareness.
Avoiding Bad Peer Groups
- Adolescents are advised to avoid negative peer influences that may lead them into risky behaviours.
Promoting Sex Education
- Encouraging comprehensive sex education both in and out of schools helps adolescents make informed decisions.
Joining Creative Groups and Healthy Clubs
- Participation in creative groups strengthens a positive environment, offering alternatives to risky behaviours.
Abstaining from Sex
- Health workers advocate for abstinence as a protective measure against the potential consequences of early sexual activity.
Avoiding Substance Use
- Refraining from alcohol and substance use helps maintain clear judgement and decision-making.
Limiting Unnecessary Gifts and Remaining Assertive
- Adolescents are advised to be assertive, learning to say no to situations that may compromise their well-being.
Intensifying Career Guidance and Counseling
- Career guidance and counselling play a vital role in leading adolescents toward positive life choices.