Interest in the reproductive health of adolescents continues to grow throughout the world. One of the factors responsible for this interest is the sheer number of young persons worldwide. For example, nearly half of the global population is less than 25 years old. Addressing the reproductive health information and service needs of this population poses significant challenges for policy makers and service providers especially those working in poor resource settings.
The fact that adolescents and other young persons are disproportionately affected by the reproductive health morbidity such as abortion, sexually transmitted infections (STI) including HIV/AIDS draws attention to the need of appropriate interventions. Adolescents account for a significant proportion of unsafe abortions globally. According to the World Health Organization (WHO) at least one-third of all women seeking hospital-care for abortion complications are under the age of 20 years. Adolescents are also one of the groups hard hit by HIV/AIDS.
Over half of all new HIV infections in Africa in 2005 were among young persons aged 14–25 years with the worst hit being young women. These data underscore the need to target adolescents with appropriate interventions that address not only the contextual factors such as gender roles and poverty that place them at risk but also individual factors including lack of access to knowledge, inadequate communication and life skills that adolescents need to negotiate safe sex. Ten to fifteen years ago the number of new reported sexually transmitted infections (STI) fell in several countries in Western Europe.
The reasons for this are not known, but it has been suggested that the increased awareness of HIV contributed to this decline. This suggestion is supported by the fact that several reports have indicated changes in sexual behaviour and attitudes both among populations at high risk for HIV, like men who have sex with men (MSM), and among the general population. Through the recent years there have been seen a rise in STIs in Western and Eastern Europe that may stem, among others, from an increase in high-risk sexual attitudes and behaviour.
This is supported by data obtained from men who have sex with men (MSM) and from adult heterosexual populations. Data on sexual behaviour and attitudes in young healthy populations and historical data allowing longitudinal studies of changes in these features are few. However, it is of utmost importance that the changes in sexual behaviour and attitudes are monitored closely, preferably at short time intervals, in order for public health professionals to duly cater for trends when planning preventive and prophylactic measures.
The purpose of the present paper is to report the changes in sexual behaviour among healthy adolescents in high school. Of particular interest is to determine if changes in attitude towards the use of condoms and safe sex practices is broadly consistent with the observed decline and subsequent increase in reported STIs, which was done by comparing data from three identical cross-sectional surveys on sexual behaviour and contraception conducted.
Evidence of unmet need is reflected in the fact that some adolescents and other young persons lack adequate knowledge and understanding of the reproductive process, that many harbor misconceptions such as the belief that mosquitoes can transmit HIV infection, and false claims that use of contraceptives can cause infertility.