Sex And The Youth

PHILIPPE Talavera is the director of Ombetja Yehinga, an organisation that works to limit the spread of HIV amongst the youth. Recently, Talavera called for family planning services in Namibia to accommodate teenagers under 18 years of age. Specifically, Talavera advocates for the provision of hormonal contraceptives, the pill and injection, for teenage girls (‘A pill too hard to swallow?’, The Namibian, August 18 2009). I do not doubt his proposal was made in good faith, but it unfortunately it leaves out several considerations concerning the health of adolescents.

In spite of his call for the provision of contraceptives to female teenagers, he does not specify a minimum age for use of hormonal contraceptives. He also fails to provide any evidence from the public health literature to support his assertion that teenage girls are responsible enough to use the pill correctly and thereby take charge of their reproductive health, as any person over the age of 18. Though I am not a physician, I am sure that hormonal contraceptives must have an age restriction. Talavera must furnish evidence that such contraceptives will not cause bodily harm to young women or interfere with their incipient hormonal cycles.From the article it is clear Talavera wants teenagers to be recognised as sexual beings by providers of health services. However, the real issue at stake for young people life or death, sero-positivity or sero-negativity for HIV. Access to hormonal contraceptives may not necessarily contribute to decline in HIV infection amongst adolescents. A study in Cameroon women aged 15-49 found that users of hormonal contraceptives had a higher HIV prevalence compared to non-users. Though hormonal contraceptives do not appear to alter a woman’s physiology such that she is more vulnerable to HIV infection, they may influence her negotiating power when it comes to safe sex (‘Hormonal Contraception, Sexual Behaviour and HIV prevalence among women in Cameroon’, BMC Women’s Health, 2008). Once the risk of pregnancy is gone, a man has one less reason to use a condom. Civil society representatives should thoroughly research the potential consequences of a public health intervention for HIV transmission before advocating for its implementation. However, Talavera is right to be concerned about the youth. In spite of the risk of HIV infection, men between the ages of 15-19 represent the largest proportion of men who engage in unprotected sex in Namibia (Demographic and Health Survey, 2006-07). Hence, civil society organisations have a cardinal role in pushing the government to increase condom use amongst the youth. Pancho MulongeniVia e-mail