Publication: Australasian Medical Journal (Online) Author: Rashmi Date published: January 1, 2011 Dear Editor, In spite of chapters

on reproduction in text books, children turn to peers on media to gather information on sexuality. Education in human sexuality is required in our schools as this need is currently not being addressed adequately in our society1.70% of high school students leant about sex from friends. Misconceptions about anatomy, childbirth, HIV were common.1 74% of students wanted information about sexuality in lower secondary schools. There were misconceptions on menstruation in Zimbabwe with 23% reporting it was an illness.2Knowledge deficits were found in India. All students argued the need to teach young children about human sexuality.3 After approval of Ethics committe of J.J.M.Medical College Davangere, India around 30 students were randomly picked from different part of state attending the state congress and were contacted personally by 2 authors at different times and were asked for informed consent. 9 students of them refused to talk about sex and 21 volunteered with verbal consent. Interview's occurred in private rooms. The interviewers (R), (A.M) (M.B) were standardized with the method of asking, to get more of information & writing the students say verbatim in 2 days training. A semi structured open ended questionnaire was used to get their knowledge. If the answers were unclear interviewer asked for further clarification & summarized the response for children to verify. Four categories were identified and presented below. 1. Sexual Knowledge: All children felt that they have little knowledge about sex. 3 boys (14%) form city with good educated parents felt that they have adequate knowledge about sex. The reproduction knowledge "how a child is born and what are acts responsible for women to get pregnant" was known by 10 (49%) children majority among them were from city with parents of good educational background. Majority of village children never knew reproduction. 3 of the girls (33%) said marriage was responsible for women to get pregnant. One of the village boy felt kissing was reason for child birth. 3 children (14%) having uneducated parents knew the word intercourse but they inter predated it differently- "Touching of male & female urine" said a girl. "Touching private parts & sleeping together without clothes" said another, "Doing some act which I am not sure" said one boy. Sexual intercourse is felt as guilt by 7 kids (33%) who were from village. 2. Knowledge of Sex organ and their functions: 3 boys (28%) didn't know how child comes out of mother's womb. 5 girls (50%) thought child come out of mother's umbilicus. None of the boys knew about menstrual cycle nor age of menarche. 50% of girls felt bad blood moving out of body during menstrual flow. All the boys felt masturbation causes weakness. Girls were unaware of masturbation

3. Information on sex: 45% of girls felt "Giving birth to child is mother, so enjoyment by sex is by girls".45% of girls said "Rapists are males so pleasure from sex will be to men". 60% of boys said "Women instigate sex, so are commercial sex workers. So pleasure from sex is to women". 20% of boys said "Men need to give pleasure to women so women are those who enjoy sex". Almost all were ready to talk freely about sex with their peers. 8 children (32%) discuss about sex with friends, 16% of children (3 girls) wanted to discuss with mother & 2% wanted to discuss with doctors. Except 2 students all other felt that they don't have complete sex education. All the children wanted more information and they needed it in school. Majority wanted the sex education to be separately taught to girls & boys. Almost all felt doctors should give them information about sex. 4. Experience of sex: None of children had any experience of any kind of sexual act. All of them felt 18 was right age for sex. 40% of children felt 20-25 yrs was right age to have sexual experience. Some girls were very particular that they should settle in academic carrier to have sex. Sex was considered as fun, enjoyment & family building process. Girls specially felt a part of family building, process emotional support or an act intended to be between husband and wife or a partner whom they should share their life with. All boys felt sex as part of fun and enjoyment Young people do have lot of misconceptions about sex so they should be provided with more information on sexual health. Students also have urge in knowing more about sex due to fear of HIV/AIDS. References 1) Saksena S, Saldanha's ," Impact of a course on human sexuality and adolescence" Indian Journal of Pediatrics 2003, 70, (3) 203-c 2) Mbizvo MT et al " Reproductive biology knowledge and behavior of teenagers in East, central and southern Africa" the Zimbabwe case study" Cent Africa J Med. 1995 Nov. 41(11):346-54 3) Handa A " Sex education for adolescents" Nursing Journal of India 1995 Aug:86(8) 173-7 Author affiliation: Corresponding Author: Dr. Rashmi Email: csrashmi@yahoo.com, dr.rashmi.kundapur@gmail.com Author affiliation: Sincerely, Rashmi1, Anurupa.M.S2, Meghna Bhat3,Mahabhalaraj,2 VijayKumar.B2

1=Dept of Community Medicine, K.S.Hegde Medical Academy Mangalore, India 2= Dept of Community Medicine J.J.M.Medical College Davangere, India 3= Indiana University School of medicine, Indiapolis, Indiana

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Throughout the hands of time, religious affiliations have taught that sexual intercourse should not come before the act of marriage, and therefore pregnancy is a sacred act and bond between man and wife. Since the establishment of this teaching, those beliefs have become the norm for American society. Sex before marriage is considered sinful and dirty to many Americans, no matter what religious affiliation they may be. Pregnancy before marriage, then, is looked upon like that of, say, a leather boot maker in India's Caste System. These beliefs, then, have driven the strong idea that teaching about contraception as a form of sex education in American schools is morally incorrect, and therefore abstinence is the only acceptable form of sex education that students should be taught. Abstinence as the only form of sex education is a Utopian way of teaching sex education, but sad to say, we are living far from Utopia. As great as America is, there is also undoubtedly a vast number of negative things that go on as well - theft, rape, murders, and yes, teenagers who have raging hormones. To say that teenagers don't need to be sexually active is a very true statement, but tell that to a teenager who is in the midst of a steamy "make-out" session with their "main squeeze" on a Friday night and things are getting more and more serious with each passing minute - I doubt they'll agree. In fact, the statistics prove that they won't agree. According to www.pregnantteenhelp.org, America has the highest rate of teen pregnancy and births in the Western industrialized world; this racks up an estimated seven billion dollars annually. What may be even more heinous is the fact that 1/3 or teenage girls will get pregnant during their teen years. Let me reiterate that - one third of teenage girls will get pregnant; that is around 750,000 girls a year. More than two-thirds of those girls will not graduate high school. One could argue that the reason for such scary statistics is the fact that boys and girls alike are not being taught the cold hard facts - what to do when they get in a situation where their minds check out and and their very strong hormones check in. If there was a nation-wide sex education program instilled that promoted abstinence, but taught contraception as well, there would be a significant change in those statistics. It doesn't come down to what the Bible teaches - if girls have created a seven billion dollar industry because they are having sex with no knowledge whatsoever, and girls are not graduating from high school because they don't know how to use a condom when sex sounds enticing on a Friday night, something needs to change. Sure, sex isn't necessary, but it is going to happen. To say that every teenager should just put their hormones away until they are married is unrealistic - and unfair. Coming from Utah, I see what the sole teaching of abstinence does to people. Growing up in a predominately Mormon faith-based state, it is interesting to see how early people get married not because they are ready, but because they want to explore sexual activities. Upon exploration, girls have multiple children very rapidly and become captives of the laundry room and the

changing table at age nineteen. Not only is this cycle increasing our population in a very rapid (and scary) fashion, but it is also taking young, talented girls away from helping to stimulate Utah's businesses and economy. One might argue that had those girls been able to freely explore sexual activities with the knowledge of more than just a solely abstinent-based method of teaching, they might be out contributing to the economy or excelling in college rather than breastfeeding children. The same holds true for non-married, non-Mormon pregnant teenagers. Had they had the knowledge they needed in middle and high school about contraception, and how to prevent themselves from getting ever-growing sexually transmitted infections, they might too be in the work force stimulating our industries, heading our companies, and becoming milestone thinkers for a greater tomorrow. Yes, there are a handful of girls in America who know that abstinence is the safest way to not get pregnant, and it is a fine message to instill, but isn't America built on the idea that everyone should have equal opportunity? Prevention comes from knowledge of the facts. Some girls don't have the tools to learn the facts, which easily jeopardizes the opportunities that American teenagers all deserve. The government needs to be in charge of making girls aware. The only way that can be done is if students learn about alternative forms of prevention. According to www.advocatesforyouth.org, "Research has identified highly effective sex education and HIV prevention programs that affect multiple behaviors and/or achieve positive health impacts. Behavioral outcomes have included delaying the initiation of sex as well as reducing the frequency of sex, the number of new partners, and the incidence of unprotected sex, and/or increasing the use of condoms and contraception among sexually active participants.Long-term impacts have included lower STI and/or pregnancy rates." Yet, "No highly effective sex education or HIV prevention education program is eligible for federal funding because mandates prohibit educating youth about the benefits of condoms and contraception." Research like this shows that abstinence-only education is not helping anything. In fact, research from the same website shows that eighty percent of abstinence programs funded by the U.S. Department of Health and Human Services contained "misleading, false, or distorted information about reproductive health." This information included false information about the effectiveness of contraceptives and the risks of abortion, religious beliefs and stereotypes about girls and boys they deemed as scientific fact, and medical and scientific errors of fact. Furthermore, it was found in a study that, following a course of abstinent-only sex education, 40 percent of the pupils had an increase in sexual activities. So why is it that MTV and thirty second Trojan condom commercials are giving teenagers more information about sex and STI's than our own government? Not only will the government not give us information that is sought, but they label this information as morally wrong. As Woody Allen said, "Love is the answer, but while you are waiting for the answer, sex raises some pretty good questions." Whether you want to accept it or not, all teenagers try to find the path to fall in love, and it would be quite the naivet to think that sex is not going to appear on that path somewhere. It isn't a matter of "if", but a matter of "when" - and more importantly, a matter of "what": what tools will they have to be safe and cautious, if any? From the teenage perspective, I urge you to rethink the guidelines of sexual education and to stress the importance

of safe sex, not just abstinence. The future of millions of teenagers is in your hands - you can give us the knowledge to become successful, and now you know how.
By Katie H, http://www.letters2president.org/issues/Sex%20Education

Many factors have been found to influence teen sexual knowledge, attitudes, and behaviors. For example, parent-child communication has been linked to greater sexual knowledge and more conservative sexual attitudes (Fisher, 1986). Similarly, of researchers that have measured relations between closeness and sexuality, most have found that parent-adolescent relationships, mother-daughter in particular, made an impact on adolescent sexual behavior (e.g., Fox, 1981; Miller & Fox, 1987). Sexual education programs in schools have generally had positive effects on adolescent sexual knowledge (Finkel & Finkel, 1985; Melchert & Burnett, 1990), but have also been found not to influence adolescents' sexual attitudes (Finkel & Finkel, 1985) or behaviors (Maslach & Kerr, 1983). One study reported that neither the presence nor absence of contraceptive education in a sample of high school students was correlated with the students' contraceptive behaviors (Taylor, Wang, Jack & Adame, 1989), whereas another reported that a school-based sex education program seemed to have a positive effect on the students' condom use (Kvalem, Sundet, Rivo, Eilertsen & Bakketeig, 1996). The impact of peers has also been explored. Generally, adolescents reported greater sexual activity when they believed that their friends were also sexually active, whether or not they really were (Brooks-Gunn & Furstenberg, 1989), and when they had older siblings modeling sexually active behavior (East, Felice, & Morgan, 1993; Rodgers & Rowe, 1988). Also, it has been reported that students who identify peers as a source of education are no less knowledgeable about sexual topics than were those who named parents as a source (Handelsman, Cabral & Weisfeld, 1987).

by Cheryl L. Somers, Jamie H. Gleason

http://findarticles.com/p/articles/mi_qa3673/is_4_121/ai_n28860272/ After examining these results, it seems unlikely that more education directly leads to more behavior and more liberal attitudes. A more likely explanation is that some of the sexual outcome factors are occurring among teenagers before the sex education factors are occurring. It is possible that, for example, as teenagers become more sexually active, they either turn to various sources for information to help them cope with their new behaviors, or parents, schools, and other sources begin to notice the developing sexuality and recognize the need to address it. Prior literature has shown that although most families report that they want to be the ones to educate their teens about sexuality, very few actually follow through (e.g., White & DeBlassie, 1992). Many reasons have been offered, including that parents are not comfortable themselves, they do not have the correct information to disseminate to their teens,

and many do not believe that their teens are sexually active when, indeed, the teens are involved in sexual activity. There has also been indication that parents, for example, do not address sexual topics until after their teens have initiated sexual activity (Somers & Paulson, in press). It is likely that schools and professionals are also not addressing the needs of children and adolescents at appropriate developmental periods.

Implications of this set of findings are that adults in teens' lives need to be made more aware of the developmental trajectories common for sexual activity. Not only do they need to be taught to recognize the onset of sexual interest and behavior, but they need to be given the tools to be able to address sexual topics in a developmentally appropriate way (e.g., information that is appropriate for children at each age level, given what is known about cognitive and emotional capacities at each developmental level). The negative finding from schools is most likely due to the fact that school sex educations programs generally under-address teenagers needs, and often focus on biological topics rather than socio-sexual topics. Constraints faced by school systems are significant. However, teenagers are more likely to benefit from multidimensional sex education that would address their unique experiences and help them to make safe decisions. A common debate among educators, researchers, and parents involves the issue of who should be responsible for sexual education for adolescents. However, an additional explanation of the current results is that source of sex education may not be what matters most. Perhaps the focus should shift from who should teach sex education to an emphasis on methods used to teach it. Collectively, those significant findings seem to suggest that the information students receive from different sources may be either contradictory, less than accurate, or untimely. It is possible that the content and accuracy of information are greater contributors to teens' sexual knowledge, attitudes, and behaviors. This is a possibility that needs to be further examined in new research. A major limitation of this study was that the category entitled "professionals" was minimally endorsed by the participants, suggesting that very few adolescents had received sex education on any of these topics from non-family, non-school professionals like physicians and nurses. It is important for future research to explore whether this group of practitioners can have a significant impact on sexual outcomes. Their professional status may help to successfully influence teens' sexual outcomes, and it may appeal to teens that these professionals are relatively independent of the teens' family and school lives. Due to the close involvement of parents and school personnel in teens' daily activities, teens may perceive them as more aversive sources from which to receive information. Therefore, while family and school influence is most important, this sector may offer significant benefits to the process and outcomes of sex education. Another limitation is that a relatively small percentage of variance was predicted in each of the statistically significant analyses. Therefore, a large proportion of influence on sexual knowledge, attitudes, and behaviors is unknown, and the aforementioned interpretations are made somewhat cautiously. The authors recognize the preliminary nature of this study and encourage further exploration of this topic.