• Topic: Advocacy
• Article on Advocacy

Almost 1 billion people are between ages 10 and 19—one-sixth of the world's total population (8). Most sexual activity among young people takes place within marriage. A minority of unmarried young men and women are sexually active, typically episodically and infrequently (158). Premarital sexual experience has become more common, however, as the age at first marriage has risen and age at puberty has fallen (82).

Substantial numbers of young men and women have their first sexual experience outside marriage. In sub-Saharan Africa surveys show that, by age 20, on average 38% of women had sex for the first time before marriage. In Latin America and the Caribbean an estimated 28% did so (8) (see Figure, left). Elsewhere, few surveys have asked whether first sex before age 20 was before or after marriage.

Consequences. Young men often face peer pressures to take sexual risks—for example, visiting sex workers and not using condoms. Risk-taking often has fatal consequences. Half of all people who have become infected with HIV became infected between ages 15 and 24. Currently, about one-third of all people with HIV are ages 15 to 24 (232).

Having an unintended pregnancy often hastens or even forces marriage at a young age. While data are unavailable for Asia, in sub-Saharan Africa and Latin America births to unmarried adolescents are common; in many countries, one-third of the births to women ages 15 to 19 occur among unmarried women (8).

Many unintended pregnancies and STIs occur because few young people use condoms or any other contraception the first time that they have sex. The most common reason that young people give for not using contraception is that they did not expect to have sex; the second most reported reason is that they did not know about contraception (158).

Because life-long attitudes and behavior patterns form during youth, addressing the needs of young people will have positive consequences for them now and throughout their lives. Young people need to learn about sexuality and reproductive health from everyone in a position to provide accurate information and counseling—family planning and other health care providers as well as parents, teachers, peers, and the mass media (116). Peers and the entertainment media are particularly powerful influences on young people. They can provide models of healthy behavior (115).

Sex education. Sex education programs help young people remain healthy. Most studies find that sex education does not encourage young people to be promiscuous. In fact, of 53 studies of various sex education programs reviewed by UNAIDS, 22 found that sex education delayed the onset of sexual activity, reduced the number of sexual partners, or reduced unplanned pregnancy and STI rates. Another 27 found that a sex education program neither increased nor decreased sexual activity. Only three studies reported increases in sexual behavior associated with receiving sex education (232).

For many unmarried young people, sexual abstinence may be a good choice. Studies have not found, however, that programs advocating only abstinence have reduced levels of sexual activity among young people (56, 109, 168).