Reproductive Health of Young Adults PART I

1. Reproductive Health of Young AdultsPART I DR KANURPIYA CHATURVEDI DR . KANURPIYA CHATURVEDI

2. Reproductive Health Issues of Young Adults Topics to be covered • Why focus on young adults • Characteristics of young adults • Reproductive health risks and consequences • STI/HIV risks and consequences DR . KANURPIYA CHATURVEDI

3. Why Focus on the Reproductive Health of Young Adults *1 of every 4 persons worldwide is between ages 10 and 24 years * Youth are a great potential resource DR . KANURPIYA CHATURVEDI

4. Risks: Unintended and too-early pregnancy STIs, including HIV/AIDS Unsafe abortion Sexual violence and unwanted sexual activity Consequences: Medical Psychological Social Economic Reproductive Health Risks and Consequences for Young Adults DR . KANURPIYA CHATURVEDI

5. About half of all new HIV infections are among youth HIV/AIDS Risk for Youth • HIV/AIDS epidemic among youth remains largely invisible to adults • Stopping HIV/AIDS requires working with youth in a comprehensive way • Young women are several times more likely to get infected than young men DR . KANURPIYA CHATURVEDI

6. Age Marital status Gender norms Sexual activity School status Childbearing status Economic/social status Rural/urban Peer pressure Political/cultural Factors Affecting the Reproductive Health Needs of Young Adults DR . KANURPIYA CHATURVEDI

7. Gender Affects the Reproductive Health of Youth • Expectations of sexual activity of boys and girls • Views regarding responsibility for contraception • Social consequences of pregnancy • Degree of risk for HIV/AIDS infection • Cultural acceptance of harmful behaviors and practices • Client-provider interactions Gender involves roles and relationships that are determined by society and culture. Gender affects: DR . KANURPIYA CHATURVEDI

8. Young Adults and Contraceptive Use • Few married youth use contraceptives before first birth • After becoming sexually active, unmarried youth delay use of contraceptives about a year • Common reasons for non-use of contraceptives among unmarried youth: • did not expect to have sex • lacked information about contraception • lacked access to contraceptives DR . KANURPIYA CHATURVEDI

9. Limited Contraceptive Use: Characteristics of Youth • Tend not to plan ahead or anticipate consequences • Think they are not at risk • Feel invulnerable • Lack confidence or motivation to use • Embarrassed or not assertive • Lack power and skill to negotiate use • Social or cultural expectations or beliefs DR . KANURPIYA CHATURVEDI

10. Limited Contraceptive Use: Barriers to Access Lack of access to services or methods: • Clinics not designed to be inviting to youth • Providers reluctant to serve unmarried youth • Laws/policy may prohibit provision to unmarried youth Youth may: • Lack transportation to clinic or money for contraceptives or services • Fear judgment or discovery • Be concerned about having pelvic exam DR . KANURPIYA CHATURVEDI

11. Psychological and Social Consequences of Pregnancy for Unmarried Youth • Social stigmas for unmarried mothers and children • Limited education • Fewer career or job opportunities • Heavy economic burden • Depression, loss of self-confidence and lack of hope • Consequences more severe for young women than men • Children of young parents may face psychological, social and economic obstacles DR . KANURPIYA CHATURVEDI

12. Maternity Care Prenatal Care: • To educate young women on proper pregnancy care and assess risk for complications Delivery: • To monitor for possible complications Prenatal and postpartum: • To provide information on contraception, breastfeeding, child-care skills and child health DR . KANURPIYA CHATURVEDI

13. Risk of Unsafe Abortion Each year at least 2 million young women worldwide have unsafe abortions mainly due to: • Inaccessibility or costs of safe services • Self-induced methods • Unskilled or non-medical providers • Delay in seeking procedure past first 3 months of pregnancy family planning can reduce unsafe abortion DR . KANURPIYA CHATURVEDI

14. Consequences of Unsafe Abortion 3 out of 5 women seeking hospital care for unsafe abortion complications in Africa, Asia and Latin America are under age 20 Complications: Infection Hemorrhage Injury to reproductive organs Intestinal perforations Toxic reactions to drugs Can result in: Infertility Death Psychological trauma Negative social reactions DR . KANURPIYA CHATURVEDI

15. Youth at High Risk for STIs/HIV High STI risk • Primary factors are behavioral: • Non-use or incorrect • use of condoms • Little knowledge • of STIs • Failure to seek treatment • Multiple partners or partners with multiple partners DR . KANURPIYA CHATURVEDI

16. Consequences of STIs, Including HIV Curable STIs: Mostly bacterial Can lead to PID and infertility Harmful medical, psychological, and social consequences Incurable STIs: Viral Can lead to chronic disease or death (HIV/AIDS) DR . KANURPIYA CHATURVEDI

17. Risks and Consequences of Sexual Abuse Rape, sexual assault, involuntary prostitution can result in: • Physical injury • Unintended pregnancy • STIs • Psychological trauma • Increased likelihood of high-risk sexual behavior DR . KANURPIYA CHATURVEDI

18. Summary and Next Steps Young adults face high risks of pregnancy and STIs • Young adults need information, skills, and access to services • Policy-makers and providers need to know how and where to reach youth, and what contraceptive and STI/HIV services are needed DR . KANURPIYA CHATURVEDI

19. How to Reach Young Adults • Topics to be covered • Who provides information and services to young adults • What reproductive health information is needed by young adults • Where services for young adults are best provided DR . KANURPIYA CHATURVEDI

20. Youth Involvement Is Critical • Involve perspective of target audience • Work with youth, rather than for youth • Draw on youth’s energy, hope, eagerness to learn and resilience • Youth “should be involved from the start as full partners….” • World Health Organization, 2001 DR . KANURPIYA CHATURVEDI