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  1. 1

    HIV and young transgender people.

    Armstrong A; Baer J; Baggaley R; Verster A; Oyewale T

    Geneva, Switzerland, World Health Organization [WHO], 2015. 36 p.

    Key populations at higher risk of HIV include people who sell sex, men who have sex with men (MSM), transgender people and people who inject drugs. Young people who belong to one or more of these key populations – or who engage in activities associated with these populations – are made especially vulnerable to HIV by factors including widespread discrimination, stigma and violence, combined with the particular vulnerabilities of youth, power imbalances in relationships and, sometimes, alienation from family and friends. These factors increase the risk that they may engage – willingly or not – in behaviours that put them at risk of HIV, such as frequent unprotected sex and the sharing of needles and syringes to inject drugs. This brief aims to inform discussions about how best to provide health services, programmes and support for young transgender people. It offers a concise account of current knowledge concerning the HIV risk and vulnerability of young transgender people; the barriers and constraints they face to appropriate services; examples of programmes that may work well in addressing their needs and rights; and approaches and considerations for providing services that both draw upon and build the strengths, competencies and capacities of these young people.
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  2. 2

    Implementing comprehensive HIV and STI programmes with transgender people: practical guidance for collaborative interventions.

    United Nations Development Programme [UNDP]; IRGT: A Global Network of Transgender Women and HIV; United Nations Population Fund [UNFPA]; University of California, San Francisco. Center of Excellence for Transgender Health; Johns Hopkins Bloomberg School of Public Health; World Health Organization [WHO]; Joint United Nations Programme on HIV / AIDS [UNAIDS]; United States Agency for International Development [USAID]

    New York, New York, UNDP, 2016 Apr. 212 p.

    This publication provides guidance to programme designers, implementers, policymakers and decision-makers on how to meaningfully engage adolescents in the AIDS response and in broader health programming. It also demonstrates why adolescents and youth are critical in efforts to end the AIDS epidemic by 2030. The publication additionally highlights what steps should be taken to implement programmes and policies that improve adolescent health outcomes (including for HIV) at the national, regional and global levels.
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  3. 3
    Peer Reviewed

    Sexual health in the International Classification of Diseases (ICD): implications for measurement and beyond.

    Chou D; Cottler S; Khosla R; Reed GM; Say L

    Reproductive Health Matters. 2015 Nov; 23(46):185-92.

    This paper examines different dimensions of sexual health as related to the measurement of sexual health indicators and the proposed changes in the International Classification of Diseases to address issues related to sexuality and sexual health with an aim of informing health policy-making and programming. The lack of mechanisms for monitoring and evaluating sexual health outcomes has impeded the development of policies and programmes that support sexual health. The potential impact of changes to the ICD-11 is major and far-reaching given that the ICD is used by countries to define eligibility and access to health services and to formulate relevant policies and laws, and is used by health professionals as a basis for conceptualizing health conditions, treatments and outcomes. Improving the measurement of sexual health-related indicators builds the evidence base on scientific knowledge of sex, sexuality, sexual health and rights. As we stand on the cusp of the post-2015 era and the development agenda transitions to the Sustainable Development Goals, a unique opportunity presents itself to further consider how sexual health is defined, conceptualized, and monitored.
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  4. 4
    Peer Reviewed

    Countdown for health to the post-2015 UN Sustainable Development Goals.

    Brolan CE; Hill PS

    Medical Journal of Australia. 2015 Apr 6; 202(6):289-90.

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  5. 5
    Peer Reviewed

    Silencing women's sexuality: global AIDS policies and the case of the female condom.

    Peters AJ; van Driel FT; Jansen WH

    Journal of the International AIDS Society. 2013; 16(1):18452.

    Introduction: The female condom is the only evidence-based AIDS prevention technology that has been designed for the female body; yet, most women do not have access to it. This is remarkable since women constitute the majority of all HIV-positive people living in sub-Saharan Africa, and gender inequality is seen as a driving force of the AIDS epidemic. In this study, we analyze how major actors in the AIDS prevention field frame the AIDS problem, in particular the female condom in comparison to other prevention technologies, in their discourse and policy formulations. Our aim is to gain insight into the discursive power mechanisms that underlie the thinking about AIDS prevention and women's sexual agency. Methods: We analyze the AIDS policies of 16 agencies that constitute the most influential actors in the global response to AIDS. Our study unravels the discursive power of these global AIDS policy actors, when promoting and making choices between AIDS prevention technologies. We conducted both a quantitative and qualitative analysis of how the global AIDS epidemic is being addressed by them, in framing the AIDS problem, labelling of different categories of people for targeting AIDS prevention programmes and in gender marking of AIDS prevention technologies. Results: We found that global AIDS policy actors frame the AIDS problem predominantly in the context of gender and reproductive health, rather than that of sexuality and sexual rights. Men's sexual agency is treated differently from women's sexual agency. An example of such differentiation and of gender marking is shown by contrasting the framing and labelling of male circumcision as an intervention aimed at the prevention of HIV with that of the female condom. Conclusions: The gender-stereotyped global AIDS policy discourse negates women's agency in sexuality and their sexual rights. This could be an important factor in limiting the scale-up of female condom programmes and hampering universal access to female condoms.
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  6. 6

    Keys to youth-friendly services: Celebrating diversity.

    International Planned Parenthood Federation [IPPF]

    London, United Kingdom, IPPF, 2011 Oct. [12] p.

    Young people are not a single homogenous group, but a diverse population whose sexual and reproductive health needs are complex, shifting and varied. Youth-friendly service delivery should be based on an understanding of and respect for each person's unique social, cultural and economic identity.
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  7. 7

    Keys to youth-friendly services: Adopting a sex positive approach.

    International Planned Parenthood Federation [IPPF]

    London, United Kingdom, IPPF, 2011 Mar. [8] p.

    Sexuality is a fundamental aspect of human life that refers to gender roles and identities, sexual orientation, intimacy and pleasure. Open, free expression of sexuality is central to every individual's well-being. Accepting these realities is the starting point for adopting a sex-positive approach to youth-friendly sexual and reproductive health services.
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  8. 8
    Peer Reviewed

    Sexual and reproductive rights at the United Nations: frustration or fulfilment?

    Miller AM; Roseman MJ

    Reproductive Health Matters. 2011 Nov; 19(38):102-18.

    Over the past 20 years, advocates have gained formal recognition for some rights in sexuality and reproduction and established the application of human rights standards to sexual and reproductive health issues more generally. However, careful reflection on the state of norm development across sexuality and reproduction as a field reveals fractures and stagnation in the development of standards, and a lack of synergy among advocates and between frameworks for similar rights. This paper seeks to stimulate a more careful accounting for these realities. It examines the formal processes and rules guiding standard-setting, in light of the different intellectual and ideological genealogies of sexual and reproductive rights. We use (homo)sexual orientation and abortion as case studies of current high-profile human rights standard-setting, with specific attention to the contemporary state of human rights law-making in the United Nations today. By placing these two issues in conjunction, we seek to make visible relationships between the vicious political debates in the UN on abortion and sexual orientation, and the multiple and sometimes divergent statements of independent experts and expert bodies in the UN human rights system on these and other sexual and reproductive rights issues. We offer no answers but seek to highlight the need for more investigation and self-reflection by advocates and scholars on how these forces operate and how to work with them. Copyright (c) 2011 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.
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  9. 9

    Girls decide: Choices on sex and pregnancy.

    International Planned Parenthood Federation [IPPF]

    London, United Kingdom, IPPF, 2011 Jan. [28] p.

    Girls Decide: Choices on Sex and Pregnancy explores innovative projects for girls and young women that offer great potential for making a difference on a large scale. These projects empower girls and young women, and affect all areas of their development, by implementing a positive approach towards their sexual and reproductive health and rights. When girls and young women understand that their sexual identities, feelings, emotions, sexual behaviour and aspirations are legitimate and respected, they are empowered. When they have access to the knowledge and the opportunities to make choices about relationships, sexuality and pregnancy, and when communities and societies give girls and young women the space and support they need to become confident, decision-making individuals, everyone benefits. It is time for policy- and decision-makers, educators, service providers and community leaders to re-think strategies for girls and young women: invest in, protect and promote policies, programmes, services and research that incorporate a positive approach to their choices around all aspects of sex, sexuality and pregnancy.
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  10. 10

    IPPF / youth manifesto.

    International Planned Parenthood Federation [IPPF]. Youth Committee

    [London, United Kingdom], IPPF, 1998. [2] p.

    The IPPF / youth manifesto outlines the goals developed by the Youth Committee of IPPF. The goals include: access to information and education on sexuality and SRH services for young people, youth must be able to be active citizens in their society, and young people must be able to have pleasure and confidence in relationships and all aspects of sexuality.
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  11. 11
    Peer Reviewed

    Looking for sex in all the wrong places.

    Camargo KR Jr; Mattos RA

    Global Public Health. 2008; 3(S2):92-104.

    The purpose of this paper is to present an analysis of how issues on sexuality are captured by the World Bank's economic rationality, producing a sanitised discourse which, through its silences, further contributes to a normalised view of sexuality. Given the Bank's authority to determine what kinds of health and development programmes are established in the developing world, it is in a unique position to influence approaches to issues of gender and sexuality. An analysis of the Bank's documents reveals, however, that rather than addressing these fundamental components of some of the most pressing health emergencies of our time, its economic rationality and technocratic viewpoint has effectively silenced and sanitised the discourse on sexuality, thereby limiting what sexuality and gender-related issues can be tackled in the context of Bank sponsored programmes, and constraining efforts to advance fundamental sexual rights. Nevertheless, unexpected and paradoxical results may arise from that process, which, thus, does not necessarily lead to the furthering of a comprehensive conservative agenda. (author's)
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  12. 12

    Sex politics: reports from the Front Lines.

    Parker E; Petchesky R; Sembler R

    [Rio de Janeiro], Brazil, Sexuality Policy Watch, [2006]. 412 p.

    Sex Politics: Reports from the Front Lines is a comparative study of the politics of sexuality, sexual health and sexual rights in eight countries and two global institutions. Over the past few decades, sexuality has become the focal point for political controversy and a key domain for social change. Issues such as protecting sexual freedoms and enhancing access to resources that promote sexual health are among the SPW's central concerns. The documents that are included in Sex Politics are based on research that has been carried out between 2004 and 2007 on sexuality and politics in Brazil, Egypt, India, Peru, Poland, South Africa, Turkey, Vietnam, the United Nations and the World Bank. These case studies are framed, at the outset, by an introductory chapter on sexual rights policies across countries and cultures that seeks to describe some of the conceptual architecture as well as the collaborative process that was used in developing these studies, and at the end, by a crosscutting analysis of the local and global politics of sex and reproduction that seeks to offer a preliminary analysis of at least some of the issues that emerge from a comparative reading of the diverse case studies included in this work. (excerpt)
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  13. 13
    Peer Reviewed

    Male circumcision, in so many words.

    Gruskin S

    Reproductive Health Matters. 2007 May; 15(29):49-52.

    INTEREST in male circumcision as an HIV prevention intervention is focused on the promise it holds to reduce the risk of HIV infection for men engaged in heterosexual, vaginal intercourse. Following an international consultation on 6-8 March 2007, WHO and UNAIDS released "Conclusions and Recommendations" on the policy and programmatic implications of the existing data on male circumcision and HIV prevention. This is a welcome step in what will inevitably be a long process to ensure male circumcision is appropriately implemented as part of the response to HIV. Beyond simply the offer of the service, if male circumcision is to be an effective strategy over the long term, these conclusions and recommendations will need to be translated into guidelines and adapted and adopted at national and local level. Policies and programmes will need to be developed, and appropriate monitoring and evaluation systems created. In doing so, the devil, as they say, will be in the details. Some issues to be considered as this process moves forward are outlined below. (excerpt)
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  14. 14

    Married adolescents: no place of safety.

    World Health Organization [WHO]; United Nations Population Fund [UNFPA]

    Geneva, Switzerland, WHO, 2006. 35 p.

    Marriage is widely regarded as a place of safety to shelter from the risks of adolescence. In many parts of the developing world, parents and policy makers see marriage as a walled garden where cultural and family values protect young girls from defilement and stigma. Particularly in poorer and rural areas, there is pressure on parents to marry off their daughters while they are very young before they become an economic liability. Millions of girls reluctantly enter into marriage while they are still children, just sexually mature but unready in every other way for this profound change in their lives. Typically, an adolescent bride knows little of her new husband or new life, has little control over her destiny and is unaware of the health risks that she faces. When an adolescent girl starts a sexual relationship with a man 10 years older than she is, he may be sexually experienced. If he is infected with a sexually transmitted infection (STI) or with HIV, a marriage certificate offers no protection. In the context of the AIDS pandemic, it is a chilling fact that the majority of unprotected sex between an un-infected adolescent girl and an infected older man takes place within marriage with the blessing of parents and community. Neither AIDS nor STIs respect marriage as a place of safety. (excerpt)
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  15. 15

    Statement by Regional Director Carmen Barroso at the 36th Session of the Commission on Population and Development, United Nations, New York, 2 April 2003.

    Barroso C

    New York, New York, International Planned Parenthood Federation [IPPF], Western Hemisphere Region [WHR], 2003 Apr 2. [3] p.

    In a speech before the 36th Session of the U.N. Commission on Population and Development in New York on 2 April 2003, Carmen Barroso, Regional Director of IPPF/WHR, emphasized the paramount importance of comprehensive sexuality education for young people, and urged the United Nations to give it much greater attention in its future program of work in the area of population. (excerpt)
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  16. 16

    SIECUS PEPFAR country profiles: focusing in on prevention and youth. Mozambique.

    Sexuality Information and Education Council of the United States [SIECUS]

    New York, New York, SIECUS, [2006]. [10] p. (SIECUS PEPFAR Country Profiles: Focusing in on Prevention and Youth)

    The Republic of Mozambique is home to approximately 9 million people. Mozambicans consist almost exclusively of indigenous tribal groups, with 50% holding traditional, indigenous beliefs, 30% holding Christian beliefs, and 20% holding Muslim beliefs. After nearly five centuries under Portuguese control, Mozambique gained its independence in 1975. Since then, the country has struggled with violent conflict and natural disasters. Between 1977 and 1992 up to one million Mozambicans died from famine and fighting in conflicts between the Front for the Liberation of Mozambique (FRELIMO) and Mozambique National Resistance (RENAMO). In 1992, a UN-negotiated peace agreement ended this lengthy civil war between the parties, but the countryside was left riddled with landmines. In 1990, a new constitution provided for multi-party elections and a free market economy following a move away from Marxism. Today, Mozambique is a democratic republic. In 2005, current President Armando Guebuza, who was a member of FRELIMO's armed wing, was elected by popular vote for a five-year term. His presidency follows that of Joaquim Chissano, also a member of FRELIMO, who stepped down after 18 years in office. The next elections will take place in 2009. (excerpt)
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  17. 17

    Sexual health -- a new focus for WHO.

    World Health Organization [WHO]. Special Programme of Research, Development and Research Training in Human Reproduction; World Health Organization [WHO]. Department of Reproductive Health and Research

    Progress in Reproductive Health Research. 2004; (67):1-8.

    In this issue of Progress, we look at some of the matters that need to be addressed in order to improve sexual health. The first article considers what is meant by sexual health, and what external forces have a significant impact on sexual health in the population. On page 4, the article on promoting sexual health discusses what actions are needed in other sectors —education, legislation, etc.—in order to create a supportive environment for promotion of sexual health. The article on page 5 outlines experiences so far in integrating sexual health into primary health care services, while the remaining two articles look at two specific issues that have a tremendous direct impact on sexual health—traditional sexual practices and violence related to sexuality and gender. (excerpt)
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  18. 18

    Gender, sexuality and harmful sexual practices.

    World Health Organization [WHO]. Department of Reproductive Health and Research

    Progress in Reproductive Health Research. 2005; (67):6.

    In many parts of the world, certain sexual practices, such as dry sex, douching, and warming and stretching of the labia, are common. However, the epidemiological impact, and the social and cultural meanings of these practices, are not well understood. With the emergence of the HIV pandemic, there has been renewed interest in the role these practices might play in facilitating transmission of HIV, as well as in their potential impact on the effectiveness and acceptability of new products such as microbicides. In addition, it is increasingly recognized that such practices could also compromise the efficacy of some contraceptive methods. Recent studies of rituals associated with sexual initiation in sub-Saharan Africa indicate a greater prevalence of such practices than had previously been documented. However, there is a need for more in-depth research on sexual practices, to explore the full context of both belief and practice, particularly in the context of HIV. (excerpt)
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  19. 19
    Peer Reviewed

    Promoting sexual health and responsible sexual behavior: an introduction.

    Coleman E

    Journal of Sex Research. 2002 Feb; 39(1):[11] p..

    We are at a unique juncture in history and have a rare opportunity to develop global, national, and community strategies to promote sexual health for the new century. This opportunity has been created by the fact that the world is experiencing a new sexual revolution and a public health imperative. Much like the sexual revolution of the 1960s and 1970s, it is a revolution fueled by incredible scientific advances, as well as dramatic social and economic change. We also face a myriad of sexual health problems, which is creating an enormous burden on societies. These two factors are putting pressure on health ministries to develop comprehensive approaches to sexual health promotion. The last major attempt at developing global strategies for promoting sexual health was fueled by the previous sexual revolution of the 1960s and 1970s. In 1975, the World Health Organization (WHO) produced a document Education and Treatment in Human Sexuality: The Training of Health Professionals. This historic document called upon societies around the world to develop the necessary sexuality education, counseling, and therapy to promote sexual health and to provide the necessary training for health professionals. This document also served as a stimulus for the development of the field of sexology and sexual resources centers throughout the world. (excerpt)
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  20. 20

    Working with men for HIV prevention and care.

    Joint United Nations Programme on HIV / AIDS [UNAIDS]

    Geneva, Switzerland, UNAIDS, 2001 Oct. [43] p. (UNAIDS Best Practice Collection - Key Material; UNAIDS/01.64 E)

    Engaging men as partners is a critical component in AIDS prevention and care as, in many contexts, men are the decision-makers in matters related to reproductive and sexual health. As reflected in the theme of the World AIDS Campaign of 2000-Men Make a Difference-men's roles and responsibilities in relation to the health of their female partners have a significant bearing on the course of the epidemic. The work of UNAIDS in this field has three broad objectives: motivating men and women to talk more openly about sex, sexuality, drug used and HIV/AIDS; encouraging men to take greater care of themselves, their partners and families; and promoting programmes that respond to the needs of both men and women. It is important that work with men and boys should not seek to replace work with women and girls, but rather complement it. Parallel programmes for men and boys are crucial in ensuring that men protect not only their own health but also the health of their families. By working in partnership with men, rather than apportioning blame, it is hoped that men can finally begin to be seen as part of the solution rather than part of a problem. Twelve projects were selected because they demonstrated such a perspective and represented a diverse range of interventions with men. It was believed that an analysis of their strategies and lessons learned would generate common ground on men's needs, associated with HIV/AIDS and their general health, and would provide insights into effective approaches for working with men. (excerpt)
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  21. 21

    A cultural approach to HIV / AIDS prevention and care. Country assessment summary report. Handbook for culturally appropriate project design. Information / education / communication capacity building, networking, data collection and research.

    UNESCO. Cultural Policies for Development Unit; Joint United Nations Programme on HIV / AIDS [UNAIDS]

    Paris, France, UNESCO, Cultural Policies for Development Unit, 2000. 186 p. (Studies and Reports, Special Series No. 10; CLT.2000/WS/10; CLT.2000/WS/16)

    This document presents the two major achievements of Year I of the current UNESCO/UNAIDS joint project “A Cultural Approach to HIV/AIDS Prevention and Care”. This phase of the project was meant to identify the interactions between cultures and the HIV/AIDS issue and to adjust prevention and care accordingly. The first part is devoted to the Summary Report of 16 country assessments and shorter county papers carried out in Southern Africa, the Caribbean and South-East Asia. Assessment activities were twofold: 1) Review of the institutional action to date, in as much as it considers cultural aspects in prevention and care programs and projects; 2) In-depth case investigations of people’s reactions concerning the risk and the need for them to change their sexual and non-sexual behaviours accordingly, in relation with their cultural references and resources. (excerpt)
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  22. 22

    Shifting to a sexual and reproductive health approach: challenges for family planning providers.

    Cullins V; Becker J; Farrell BL; Twyman P; Barone M

    Global HealthLink. 2000 Mar-Apr; 102:[2] p..

    A shift has been occurring in the family planning field from a focus on demographic goals and contraceptive prevalence to a more client-centered focus and recognition of the broader sexual and reproductive health (SRH) needs of clients. The 1994 International Conference on Population and Development’s Programme of Action and the 1995 United Nations Fourth World Conference on Women in Beijing have fueled rapid shifts in programs and policies toward a broader SRH approach, with particular emphasis on prevention of HIV and other sexually transmitted infections (STIs). Integration of HIV/STI prevention in family planning programs has been seen as important because family planning programs reach large numbers of sexually active people, and are often the only contact that women have with the health-care system. Although family planning programs are in a unique position to provide HIV/STI prevention services, many still concentrate almost entirely on contraceptive acceptance. (excerpt)
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  23. 23

    Declaration of intentions of the IPPF European Network, Brussels, 27 June 2003.

    International Planned Parenthood Federation [IPPF]. European Network

    Choices. Sexual and Reproductive Health and Rights in Europe. 2003 Autumn; 35.

    Reaffirms the human rights basis of sexual and reproductive rights and the need to preserve, guarantee and expand these rights for all peoples in Europe and around the world; underlines its commitment to prioritise the human rights approach to sexuality and reproduction in all activities of the federation; recalls that sexual and reproductive rights are already the subject of international human rights law, jurisprudence, treaties and conventions; reaffirms that the IPPF Charter on Sexual and Reproductive Health and Rights outlining 12 rights provides the framework for work in progressing towards the full recognition of sexual rights as human rights; welcomes the recognition of other civil society groups of the human rights basis of their specific work in sexuality, reproduction, health and equality. (excerpt)
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  24. 24

    Gender perspectives in reproductive health practices in Thailand: a synthesis of research findings.

    Sirirassamee B; Sethaput C; Yoddumnern-Attig B

    Nakhonpathom, Thailand, Mahidol University, Institute for Population and Social Research [IPSR], 2003 Jan. vii, 130 p. (IPSR Publication No. 274; UNFPA Project THA/99/P02)

    This document synthesizes research findings from 17 regional research studies on gender issues and reproductive health. Funded by UNFPA, these projects covered all four major regions of Thailand with the aim of building a more accurate picture of the degree to which gender norms and roles exert a strong influence on sexuality, reproductive health (RH) behaviour, and RH/family planning service delivery. Results from these projects have revealed a persistent double standard in Thai society, as socially constructed gender norms strongly govern men's and women's behaviours especially in terms of those that are acceptable when dealing with each other. Most notably, men have a higher degree of decision-making power regarding sexuality, reproductive health decision-making and practices. For example, men make the decision about whether or not to use a condom, which they will provide for themselves or their girlfriends. Consequently, they play a more dominant role while women play a passive one, which reduces women's negotiating power. Gender norms also block women from having access to proper information and health care, which places them at greater risk of reproductive health problems. Moreover, while overall accurate knowledge about sexually transmitted infections (STIs) among both men and women is rather low, men know much more than their female counterparts about STIs. In terms of health seeking behaviours, unmarried men and women prefer local convenience stores or other non-professional services, because they offer a higher degree of privacy with no risk of condemnation that might arise from visits to public health service delivery points. Based on the results of the studies, a package of future strategies and research investigations is recommended covering such levels as adolescents themselves (individual), schools, mass media, health services, communities and society. (author's)
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  25. 25

    Behavioral interventions for the prevention of sexual transmission of HIV. [Intervenciones conductuales para la prevención de la transmisión sexual del VIH]

    Institute of Medicine. International Forum for AIDS Research

    Washington, D.C., Institute of Medicine, International Forum for AIDS Research, [1992]. 8 p.

    The fourth meeting of the International Forum for AIDS Research was organized around three overall objectives: a) to consider a model for categorizing behavioral interventions; b)to share information about current behavioral intervention programs in which IFAR members are involved; and c) to foster discussion about the adequacy of present strategies. The meeting began with an analytical phase that explored aspects of methodology, followed with presentations on selected programs, and concluded with a generic case study exercise that highlighted different social scientific perspectives on producing change in human behavior. (excerpt)
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