Sexual Rights Research Articles

New evidence on adolescent sexual and reproductive health and rights from the West and Central African region.

The African Journal of Reproductive Health is pleased to publish these compendiums of original research in this special edition that document new findings in adolescent sexual and reproductive health and rights from the West and Central African region (WCA). While sub-Saharan Africa has some of the worst indicators of sexual and reproductive health and rights (SRHR) in the world, the indicators are more daunting in the WCA region. To date, the WCA is recognized to have the highest rates of unwanted pregnancy, unsafe abortion, and human immunodeficiency virus (HIV) and other sexually transmissible infections, as well as the lowest contraceptive prevalence rates among adolescents worldwide.1 Despite the high rate of adverse adolescent reproductive health outcomes in WCA, there has been limited documentations of the socio-cultural and economic circumstances that perpetuate these adverse consequences. There have also been no purposefully designed interventions that provide strong scientific evidence for developing strategies to reverse the trend.

Traditional socio-cultural practices and early pregnancies in Togo: Between social norms and violation of adolescent rights.

This article shows how certain traditional socio-cultural practices that influence the root causes of teenage pregnancy violate the rights of adolescents. The data came from the action-research entitled "Multisectoral and transformative approaches to rites and initiations for adolescent sexual and reproductive health rights", conducted by the Togolese Association for Family Welfare (ATBEF) in May 2022. The option is made for a qualitative approach. The information collected was recorded on dictaphones and then transcribed from the local languages of collection into French. Content analysis was used to write the research report. The results reveal that these practices, which are still prevalent in the localities of the study, and which exert pressure on adolescent girls, are also products of violations of many girls' rights.

Knowledge and practice of health workers on sexual and reproductive health and rights and gender-based violence: Evidence from three municipalities in Senegal.

Adolescents in low- and middle-income countries face numerous developmental, sexual and reproductive health (SRHR) challenges, including exposure to multidimensional violence. Dealing with gender-based violence (GBV) is of great importance and health personnel are key players. The objective of this work was to study the knowledge and practices of health personnel on SRHR and gender-based violence in Guédiawaye, Kaolack and Kolda communities in Senegal. A descriptive and analytical cross-sectional study was conducted, which consisted of health professionals (general practitioners and specialists, nurses, and midwives) and community health workers (community relays, bajenu gox, matrons). All health facilities in the three communities were included. Data analysis consisted of univariate analysis and logistic regression modeling to investigate the factors associated with the knowledge and practice of health personnels. An alpha risk of 5% was taken. A total of 78 health professionals and 128 community actors were included in the study. More than half of the health personnel (56.3%) had good knowledge of policies, standards and protocols relating to sexual and reproductive health services for women (adolescents) and about 60% on conventions and laws. The level of knowledge was good among 51% of respondents and good practices among 54.9%. The factors associated with good knowledge were the municipality in which the profession was practiced, and the effects of training received in the social construction of gender. The factors associated with the practices were knowledge of policies, standards and protocols through training, training received in the provision of family planning services, and in medico-psychosocial management of cases of sexual violence. We conclude that the knowledge of stakeholders (health professionals and community health workers) about sexual and reproductive health and gender-based violence is important for better service provision and good management of cases of gender based violence.

Gender differences in adolescents' perceptions of condom use in Ebonyi State, Southeast Nigeria.

This paper assessed gender differences and perceptions towards condom use among in-school adolescents in Ebonyi State, Nigeria. This was a cross-sectional study undertaken in six local government areas in Ebonyi State, Nigeria. Data were collected using a structured questionnaire and summarised using frequencies and proportions. Chi-square test and binary logistic regression were used in the analysis. The level of statistical significance was a p-value of <0.05. Findings showed that a significantly higher proportion of male respondents (58.8%) had a good perception of condom use when compared to female respondents (45.8%). Gender, level of schooling, and working for pay had significant associations with good perceptions of condom use, while the significant predictors in the logistic regression model were gender, level of schooling, and working for pay. Interventions that promote the sexual and reproductive health and rights of adolescents and those that empower women with relevant skills by addressing unequal gender power relations in relationships should be prioritized.

Health aspects of the presidential election in the United States.

The prospect of a Biden-Trump rematch had raised concerns. The argument of Trump on the older age of Biden led to a boomerang effect when the latter was replaced by the much younger Kamala Harris whose mixed African and Asian ancestry should lead to her support on international issues. Swing voters might be attracted by her potential as the first female president. Assertive on the politically controversial issue of abortion, Kamala Harris already spent a substantial part of her vice-presidency on women issues. Her promotion of sexual and reproductive rights during the presidential campaign augurs well for restoring those priorities on the American political agenda.

Gender and adolescent sexual and reproductive health and rights in West and Central Africa: New evidence and emerging gaps.

The West and Central Africa (WCA) region is a natural resource-rich, 24-country, contiguous area with a population of nearly 500 million people. The median age for the region is currently 18 years and approximately one-third of its population is aged between 10 and 24 years. If current demographic trends in the region persist, its population will reach 1.5 billion by 2050. At that time, WCA will not only have the largest number of young people globally, but it will also be the only part of the world whose population of young people will continue to increase1. Many countries in the region are also or have recently been involved in armed conflicts, which have devastated infrastructure, displaced people, stifled development, and more importantly, resulted in myriad deaths and morbidities.

Knowledge gaps related to HIV and condom use for preventing pregnancy: a cross-sectional study among migrants in Sweden

BackgroundInformation and knowledge of sexual and reproductive health and rights (SRHR) plays a crucial role in promoting safe sexual practices among young migrants. We aimed to assess the sociodemographic factors of migrants associated with knowledge of condoms and the prevention, treatment, and transmission of HIV to highlight the need for SRHR information, including comprehensive sexual health education.MethodsA cross-sectional survey was conducted (2018–2019) among migrants at Swedish language schools and high schools across Sweden. The survey included questions about knowledge of condom use for preventing pregnancy and HIV treatment and transmission. Descriptive statistics were calculated, and multivariable logistic regression analyses were performed to assess the responses to the knowledge questions and sociodemographic characteristics.ResultsOut of 3430 respondents (median age: 35, interquartile range: 20), approximately 39% were unaware that condoms can prevent unplanned pregnancies. Only 58% of the respondents knew that condoms reduce the risk of contracting HIV. About 77% were unaware of HIV treatment, and 52% reported not knowing that a woman with HIV could transmit the virus to her baby during pregnancy or breastfeeding. Incorrect knowledge about condom use to prevent unwanted pregnancy was associated with several factors: younger age (15–19 years) adjusted odds ratio (aOR) 1.35; 95% confidence interval (CI), 1.02–1.79); female respondents (aOR: 1.68; 95% CI 1.36–2.07); lack of previous sexual health education (aOR: 2.57; 95% CI 2.11–3.13); low level of education (aOR: 1.30; 95% CI 1.04–1.61). Originating from the Americas, European, or sub-Saharan African regions was associated with a 34–42% decreased likelihood of incorrect knowledge that condoms can reduce the risk of HIV infection compared to respondents from the Middle East and North Africa (MENA). More than half (64%) of respondents reported needing more SRHR information.ConclusionsWe found significant knowledge gaps on HIV and condom use for preventing pregnancy among migrants in Sweden. Comprehensive sexual health education in language schools, along with information to newly arrived migrants from diverse regional backgrounds and targeted sexual health services to younger individuals, women, and those who lack sexual health education, are needed to address these information gaps and provide crucial SRHR education and information.

Using Modern Contraception While Wanting a Child: What Does Contraceptive Over-Use Mean for the Human Rights-Based Approach in Burkina Faso? Insights from PMA2020 Data

(1) Background: Sustainable development goal 5.6 calls for “universal access to sexual and reproductive health and reproductive rights” to fulfil sexual and reproductive practices. The capability approach helps refine the analysis of contraceptive use by going beyond the dichotomous view of contraceptive use as use/non-use to focus on women’s freedom to choose what they have good reason to value. Using the case of Burkina Faso, we probe more deeply into whether contraceptive use reflects real progress in women’s reproductive rights to realize the fertility projects they value. (2) Methods: We use PMA2020 data collected in Burkina Faso between December 2018 and January 2019. The survey included 3329 women with a participation rate of 97.7%. The PMA2020 female core questionnaire solicits information on fertility and contraceptive behavior, much like the DHS. We asked a series of specific questions about cognitive and psychosocial access relating to FP. We examined bivariate associations between our outcome measure “contraceptive behavior” and a set of independent variables. We also used logistic regression models to evaluate associations with endowments/conversion and capability factors and current functioning by focusing on overuse (i.e., use of contraceptives despite desiring pregnancy within the next 12 months). (3) Results: Women who said their ideal number of children was “up to God” had the highest level of overuse, which was also higher among women living in communities with medium acceptance of contraception and greater support for fertility. Women who have higher and middle levels of information tend to engage less in overuse than those with lower information levels. (4) Conclusions: We conclude that overuse (contraceptive use when desiring a child soon) may reveal a lack of rights, as it is associated with a lack of information about contraceptives and women’s inability to conceive an ideal number of children. Efforts should be made to enhance women’s level of contraceptive information.

Child welfare workers’ understanding of young people’s sexual health when conducting assessments due to substance use problems

Young people with substance use problems often have an early sexual debut, an increased risk of sexually transmitted infections and unplanned pregnancies, and a high risk of experiencing sexual violence. At the same time, according to the national action plan on sexual and reproductive health and rights (SRHR), the social services in Sweden have an important role in addressing sexual health in various contexts, such as in child welfare investigations. Therefore, this study has investigated how Swedish child welfare workers understand and relate to sexual health issues in child welfare investigations regarding young people with substance use problems. Following a strategic sampling, 15 child welfare workers were interviewed. The interviews were examined with a thematic content analysis with results showing that sexual health issues represented an area where knowledge was lacking. This was largely connected to that the child welfare workers had not been taught about SRHR in their bachelor’s degree nor in their continued education within the child welfare system. As a result of this, they often developed their own individual, professional approach for assessing sexual health matters, guided by the principle of “not investigating more than necessary”. When addressing sexual health in their assessment work, the child welfare workers primarily focused on risk, vulnerability and exposure. Not assessing young peoples’ sexual health was seen as protecting the right to confidentiality and privacy. In summary, this meant that young people with a problematic substance use were seldom given opportunities to talk about their sexual health, and especially not about positive sexual experiences related to their substance use.

Climate change and sexual and reproductive health and rights research in low-income and middle-income countries: a scoping review

IntroductionThis study aimed to provide an overview of the research landscape and to identify research gaps linking climate change events and sexual and reproductive health and rights (SRHR) in low-income...

“Defend your children, they can be taken by two gay men”: A scoping review of the conflating and diversionary discourses used in same-sex marriage debates

The use of direct popular votes such as plebiscites, referendums, and postal surveys to determine the right of same-sex couples to marry have proliferated in recent years, particularly across the Global North. By including the public in the decision-making process, serious debates have been fermented about the morality of lesbian, gay, bisexual, transgender, and queer (LGBTQ+) rights. Based on a scoping review of the available English language literature, this paper maps the key findings from 24 peer reviewed studies to offer a cross-national analysis of conflating and diversionary discourses used by pro- and anti-SSM advocates. This paper finds that despite ostensibly being about LGBTQ + sexual rights, these debates commonly conflate SSM with other unsubstantiated ‘threats’, categorised here as operating across the global, national, and individual levels. The findings suggest that SSM debates consistently conflated the issue with international human rights discourses, alongside notions of ‘race’, gender, family, and reproduction as a strategy to garner public opinion. This study reveals a complex network of discourses where the rights of LGBTQ + people are continuously harnessed for political agendas extending beyond the specific efforts to legislate SSM. This paper concludes with the limitations of this review and possible directions for future research.

Pornography, sexual privacy and copyright

This article proposes a new paradigm in the consideration of privacy in pornographic works in copyright enforcement actions. It focuses particularly on attempts to threaten individuals with copyright infringement action based on a speculative invoicing model. We approach this issue from the perspective of the right to sexual privacy of alleged infringers, which, as we argue, is particularly pertinent for pornographic works. The courts in England and Wales have broadly recognised the role of individual privacy and embarrassment caused to alleged infringers in the leading cases of Golden Eye and subsequently in Mircom, but the law remains unclear with no real recognition of, or meaningful mechanisms in place to address, the underlying issues. The article points out that this is due to a fundamental lack of appreciation of sexual privacy at a conceptual level in the context of consumption of pornography in the internet age, and consequent failure to consider this in copyright enforcement proceedings. We argue that the law should achieve a balance between the right holder's interest and the sexual privacy of alleged infringers, and copyright enforcement actions need to be approached with this in mind. This calls for a fundamental reconceptualisation of the right to privacy, and we call upon the courts to recognise and balance the sexual privacy rights of the alleged infringers of copyright in pornographic works with the interests of the right holders in certain copyright enforcement actions to achieve fair and equitable outcomes.

PL 442/17 de Marielle Franco: conflitos e contingências entre movimento feminista e antiaborto

The attack on sexual and reproductive rights is carried out in a strategic and constant manner. In this article, the objective is to analyze the discourse used in these attacks, through the speeches of parliamentarians during the voting on Bill 442/17, by Marielle Franco, in the City Council of Rio de Janeiro, in 2023. Thus, through listening to the records of the voting and bibliographic material, it was possible to observe the discursive resources and the mode of operation of anti-abortion groups. It is worth noting that, in this work, we chose not to make these political figures visible, and therefore, the transcriptions of speeches by councilors in favor of these groups were identified by numbering rather than by names.

Em defesa das crianças? A instrumentalização da democracia no discurso antigênero

This article seeks to analyze, through the Content Analysis of parliamentary speeches and videos of leaderships and religious public figures, the discourse on the so-called "gender ideology" in the Brazilian House of Representatives between 2015 and 2019. In order to prevent the advancement of sexual and reproductive rights and spread traditional morality in education, the lexicon of democracy is used as a tool and Christian values receive a secular camouflage. Therefore, the de-democratizing political-religious action is legitimized in the public arena, enabling, as a consequence, the precariousness of lives and the perpetuation of inequalities and violence faced by historically subalternized groups, such as trans people, cisgender women and sexual dissidents.

“It's very much part of this movement to undermine democracy”: A qualitative study of European Union level opposition strategies against reproductive health and rights

Despite increasing contestations of agreed global commitments on sexual and reproductive health and rights (SRHR), our understanding of strategies of opposition in global health policymaking remains limited. This article explores the opposition to SRHR at the European level focusing on the decision-making institutions of the European Union (EU). The central research questions ask i) how SRHR opposition actors seek to influence EU institutions and ii) what challenges their actions pose for health policymaking at the EU level. Our empirical focus is based on the qualitative method of framework analysis, with data collected from multiple sources, including documentary data on European Parliamentary debates, Council conclusions of the European Union, reports of nongovernmental organisations, and key informant interviews. Our study is in line with observations on globally coordinated efforts to restrict access to SRH services. This is a challenge for specific forums and countries, but as well for European Union's wider internal and external policies. We present a toolbox of strategies and actors operational at the European Union level. Our findings on opposition to SRHR indicate that it can be seen as a political tool that is part of a broader anti-democratic movement. Understanding strategies of anti-SRHR opposition is important for health policymakers as it shapes debates and the achievement of universal health coverage (UHC).

Forbidden Conversations: A Comprehensive Exploration of Taboos in Sexual and Reproductive Health.

This scoping review aims to comprehensively explore the landscape of taboos and their impact on sexual and reproductive health. Titled "Forbidden Conversations," it delves into the intricate web of societal, cultural, and religious norms that have contributed to the elusive and often stigmatized nature of sexual and reproductive health topics. The review navigates through the multifaceted dimensions of these taboos, shedding light on their impact on individuals, communities, and public health while advocating for a paradigm shift toward open, inclusive, and informed dialogue. The analysis within this review spans a decade, capturing the most recent and relevant literature to map the landscape of taboos in sexual and reproductive health. It explores the persistent societal apprehensions and subsequent stigmatization surrounding topics such as menstruation, contraception, fertility, sexual orientation, and gender identity. The review contextualizes the multifaceted challenges presented by these prevailing norms by tracing historically rooted taboos and their evolution across different cultures and contexts. The scoping review identifies the profound implications of these taboos on public health, highlighting how they contribute to disparities in access to healthcare, perpetuate misinformation, and infringe upon the fundamental rights of individuals. It addresses the challenges in sexual education, emphasizing how these taboos impede comprehensive understanding and enforcement of sexual and reproductive health rights among adolescents and young adults. The intersectional approach taken in this review situates these taboos within broader systems of inequality, emphasizing the compounded impact they have on marginalized populations. Through this comprehensive exploration, the review aims to provide actionable insights and identify existing research, policy, and practice gaps. It seeks to lay the foundation for future initiatives that advocate for destigmatization, empowerment, and equity in sexual and reproductive health. Ultimately, "Forbidden Conversations" aims to steer the conversation toward openness and inclusivity while advocating for unbiased, comprehensive sexual and reproductive healthcare with dignity for all individuals.

Factors Influencing Access to Sexual and Reproductive Health Information among Adolescents Aged 12-19 Years in Mukono Municipality Schools: A Cross-Sectional Study

Background: Adolescent sexual and reproductive health is one of the essential health care services that promote a adolescent’s health. Complications of unwanted pregnancies lead to school dropouts’, disability and mortality. However, many adolescents 12-19 years face barriers to reproductive health information about their health and rights. And are unable to access services needed to protect their health. This study aimed to assess factors influencing access to Sexual and Reproductive Health Information among adolescents aged 12-19 years in Mukono municipality schools, Uganda. Methods: Analytical cross-sectional survey and simple random sampling were used to select 384 participants between July and December 2022 in Mukono municipality. A Self-administered structured was used to collect data. Data was analyzed using descriptive statistics, chi-square test, and a modified Poisson regression model. Results: Findings showed the mean age of participants was 16.1 (S.D + 2) years. The proportion of access to information was 80.27%. Significant factors strongly associated with access to sexual and reproductive health information were being Moslem (OR: 0.284 (0.089-0.912)], going to hospital [OR: 2.350 (1.143-4.828)], distance 3-5 Kms from home to nearest health facility [OR: 0.41 (0.176-0.912)]. Conclusion: Two of every ten participants had access to Sexual Reproductive Health and Rights information. Significant determinants were radio media and print newspapers. Stakeholders should advocate for adolescents’ increased access to healthcare information to avert the upsurge in related diseases. Policy makers should review and monitor new guidelines for Adolescent and School health inclusive of sexuality and reproductive health. Thus, improve health equity for all.

Inclusion Goals: What Sex Education for LGBTQIA+ Adolescents?

According to the World Health Organization and the World Association for Sexual Health (WAS) Declaration of Sexual Rights, sex education aims to provide children and adolescents with comprehensive knowledge, skills, attitudes, and values, promoting equality and nondiscrimination while upholding freedom of thought and expression. However, current school curricula often focus on dichotomous sexual identity and hetero-cis-normative prevention strategies, neglecting the needs of gender minority (GM) and sexual minority (SM) youths. In family settings, discussions typically revolve around sexual risk reduction and basic contraception, omitting relational aspects and components of sexual identity such as orientations and gender expressions. This discrepancy highlights a gap between the official goals of sex education and its practical implementation, reflecting a cultural deficit in familial sex education. This study reviews the scientific literature on sexual health promotion interventions from 2015 to 2024 to identify inclusive approaches that enhance the participation of all youths, not just hetero-cis-normative individuals. The hypothesis is that most interventions primarily serve heterosexual and cisgender youths, indicating a need for more inclusive strategies to achieve better sexual health and educational outcomes. The study also suggests expanding curricula to align with recognized guidelines and the diverse needs of youth.

Child welfare workers’ understanding of gender, sexual orientation and sexual health in assessments of youths with a problematic substance use

ABSTRACT The use of alcohol or illicit substances by youths may be related to sexual motives and experiences. Accordingly, child welfare workers need to address young people’s sexuality in their investigative work. In this study, we have examined the significance of different social categories, namely gender and sexual orientation, when child welfare workers assess young people with a substance use and their related sexual health. Fifteen child welfare workers were recruited through a strategic sampling to participate in semi-structured interviews, which were analysed using thematic content analysis. The results consist of three sub-themes: Sexually vulnerable girls; Boys as perpetrators; and Unseen LGBTQ+ youth. Together, these sub-themes constitute an overarching theme where the heterosexual matrix appears to be the interpretative framework when investigating a problematic substance use. The suggested implications for practice include education in sexual and reproductive health and rights for child welfare workers aiming to achieve an equitable assessment process for all youth with a problematic substance use.

Mapping the Cross-Border Influence of Regional and International Reproductive Rights Cases

Abstract International and regional human rights mechanisms are essential tools for ensuring access to justice for human rights violations and advancing measures of non-repetition, such as domestic law and policy reform. Scholarship on the impacts of these mechanisms have largely centred on the resulting domestic law and policy reform in the countries at issue in these cases and the resulting normative standards human rights bodies have established. The cross-fertilization of these cases among other international and regional human rights mechanisms and domestic courts remains an important but underexplored aspect of how such cases influence progress towards the realization of human rights. Through the lens of four landmark cases on sexual and reproductive health and rights, this article examines the influence of these cases in jurisprudence from across the globe, demonstrating how such decisions have reverberated across borders. These rippling effects of strategic litigation constitute an important impact that should be taken into account when evaluating the influence and efficacy of these mechanisms.