Comprehensive sexuality education

Definition

Com­pre­hen­sive sex­u­al­ity edu­ca­tion gives young peo­ple accu­rate, age-appro­pri­ate infor­ma­tion about sex­u­al­ity and their sex­ual and repro­duc­tive health, which is crit­i­cal for their health and sur­vival. Com­pre­hen­sive sex­u­al­ity edu­ca­tion equips and empow­ers young peo­ple to pro­tect them­selves from HIV and other sex­u­ally trans­mit­ted dis­eases. Com­pre­hen­sive sex­u­al­ity edu­ca­tion pro­grammes should be based on an estab­lished cur­ricu­lum; sci­en­tif­i­cally accu­rate; tai­lored for dif­fer­ent ages; com­pre­hen­sive; and should be dif­fer­en­ti­ated from sex edu­ca­tion. Given the inter­sec­tion­al­ity of HIV risk fac­tors and bar­ri­ers to its pre­ven­tion and treat­ment, there is grow­ing recog­ni­tion that com­pre­hen­sive sex­u­al­ity edu­ca­tion prac­tices must address the needs of young peo­ple & key pop­u­la­tions and struc­tural dri­vers of sex­ual and repro­duc­tive health. This can be achieved by ensur­ing cul­tur­ally appro­pri­ate, com­mu­nity dri­ven engage­ment which is tai­lored for a sub-group. Top­ics cov­ered by com­pre­hen­sive sex­u­al­ity edu­ca­tion include fam­i­lies and rela­tion­ships; respect, con­sent and bod­ily auton­omy; anatomy, puberty and men­stru­a­tion; con­tra­cep­tion and preg­nancy; sex­u­ally trans­mit­ted infec­tions, includ­ing HIV; and oth­ers.

Evi­dence con­sis­tently shows that high-qual­ity sex­u­al­ity edu­ca­tion deliv­ers pos­i­tive health out­comes, with life­long impacts. Young peo­ple are more likely to delay the onset of sex­ual activ­ity–and when they do have sex, to prac­tice safer sex–when they are bet­ter informed about their sex­u­al­ity, sex­ual health and their rights. Yet research shows that the major­ity of ado­les­cents lack the knowl­edge required to make deci­sions about their sex­ual and repro­duc­tive health respon­si­bly, leav­ing them vul­ner­a­ble to coer­cion, HIV infec­tion, and unin­tended preg­nancy.

Inter­na­tional agree­ments reflected in the Lan­guage Com­pendium include com­mit­ments to address this gap by “accel­er­at­ing efforts to scale up sci­en­tif­i­cally accu­rate, age-appro­pri­ate com­pre­hen­sive edu­ca­tion, rel­e­vant to cul­tural con­texts, that pro­vides ado­les­cent girls and boys and young women and men, in and out of school, con­sis­tent with their evolv­ing capac­i­ties, with infor­ma­tion on sex­ual and repro­duc­tive health and HIV pre­ven­tion, gen­der equal­ity and women’s empow­er­ment, human rights, phys­i­cal, psy­cho­log­i­cal and puber­tal devel­op­ment and power in rela­tion­ships between women and men.” Prece­dents in the Lan­guage Com­pendium also rec­og­nize that com­pre­hen­sive sex­u­al­ity edu­ca­tion helps “build self-esteem and informed deci­sion-mak­ing, com­mu­ni­ca­tion and risk reduc­tion skills and develop respect­ful rela­tion­ships,” enabling young peo­ple and oth­ers at risk “to pro­tect them­selves from HIV infec­tion.”

Precedents

2021 Global AIDS Strategy 2021-2026

• “A lack of edu­ca­tion and eco­nomic oppor­tu­ni­ties and insuf­fi­cient or nonex­is­tent access to com­pre­hen­sive sex­u­al­ity edu­ca­tion also increase women and girls’ vul­ner­a­bil­ity to HIV. Research evi­dence con­firms that com­ple­tion of sec­ondary edu­ca­tion can help pro­tect girls against HIV acqui­si­tion, while also yield­ing broader social and eco­nomic ben­e­fits. Com­pre­hen­sive sex­u­al­ity edu­ca­tion helps improve young peo­ple’s knowl­edge about HIV and coun­ters mis­in­for­ma­tion about sex­ual and repro­duc­tive health. A grow­ing body of data has val­i­dated numer­ous, inter­sec­toral, gen­der-trans­for­ma­tive inter­ven­tions. Impor­tant, though still inad­e­quate, invest­ments by the Global Fund, the United States Pres­i­dent’s Emer­gency Plan for AIDS Relief (PEP­FAR), UN Women, UNICEF and other part­ners are sup­port­ing the empow­er­ment, mobi­liza­tion and lead­er­ship of women liv­ing with HIV, women from key pop­u­la­tions, and ado­les­cent girls and young women.” (para­graph 150)

2021 CSW Report on women and HIV/AIDS

• “Age-appro­pri­ate, com­pre­hen­sive sex­u­al­ity edu­ca­tion for ado­les­cents both in and out of school is a proven strat­egy, con­tribut­ing to reduc­tions in gen­der-based vio­lence, increased use of con­tra­cep­tion, decreased num­bers of sex­ual part­ners and delayed ini­ti­a­tion of sex­ual inter­course.” (para­graph 29)

2021 Political declaration on HIV and AIDS

• “Com­mit­ting to accel­er­at­ing efforts to scale up sci­en­tif­i­cally accu­rate, age- appro­pri­ate com­pre­hen­sive edu­ca­tion, rel­e­vant to cul­tural con­texts, that pro­vides ado­les­cent girls and boys and young women and men, in and out of school, con­sis­tent with their evolv­ing capac­i­ties, with infor­ma­tion on sex­ual and repro­duc­tive health and HIV pre­ven­tion, gen­der equal­ity and women’s empow­er­ment, human rights, phys­i­cal, psy­cho­log­i­cal and puber­tal devel­op­ment and power in rela­tion­ships between women and men, to enable them to build self-esteem and informed deci­sion-mak­ing, com­mu­ni­ca­tion and risk reduc­tion skills and develop respect­ful rela­tion­ships, in full part­ner­ship with young per­sons, par­ents, legal guardians, care­givers, edu­ca­tors and health-care providers, in order to enable them to pro­tect them­selves from HIV infec­tion.” (para­graph 60(g))

2018 HRC Resolution on human rights in the context of HIV and AIDS

• “Calls upon States to accel­er­ate efforts to scale up sci­en­tif­i­cally accu­rate, age-appro­pri­ate com­pre­hen­sive edu­ca­tion, rel­e­vant to cul­tural con­texts, that pro­vides ado­les­cent girls and boys and young women and men, in and out of school, con­sis­tent with their evolv­ing capac­i­ties, with infor­ma­tion on sex­ual and repro­duc­tive health, sex­u­al­ity and HIV pre­ven­tion, gen­der equal­ity and women’s empow­er­ment, human rights, and phys­i­cal, psy­cho­log­i­cal and puber­tal devel­op­ment.” (para­graph 15)

2016 Resolution on Women, the Girl Child and HIV and AIDS

• “Calls upon gov­ern­ments to accel­er­ate efforts to scale up sci­en­tif­i­cally accu­rate age-appro­pri­ate com­pre­hen­sive edu­ca­tion, rel­e­vant to cul­tural con­texts, that pro­vides ado­les­cent girls and boys and young women and men, in and out of school, con­sis­tent with their evolv­ing capac­i­ties, with infor­ma­tion on sex­ual and repro­duc­tive health and HIV pre­ven­tion, gen­der equal­ity and women’s empow­er­ment, human rights, phys­i­cal, psy­cho­log­i­cal and puber­tal devel­op­ment and power in rela­tion­ships between women and men, to enable them to build self-esteem, informed deci­sion-mak­ing, com­mu­ni­ca­tion and risk reduc­tion skills and develop respect­ful rela­tion­ships, in full part­ner­ship with young per­sons, par­ents, legal guardians, care­givers, edu­ca­tors and health-care providers, in order to enable them to pro­tect them­selves from HIV infec­tion.” (para­graph 11)

• “Urges gov­ern­ments to elim­i­nate gen­der inequal­i­ties and gen­der-based abuse and vio­lence, increase the capac­ity of women and ado­les­cent girls to pro­tect them­selves from the risk of HIV infec­tion, prin­ci­pally through the pro­vi­sion of health care and ser­vices, includ­ing, inter alia, sex­ual and repro­duc­tive health care, as well as full access to com­pre­hen­sive infor­ma­tion and edu­ca­tion, ensure that women can exer­cise their right to have con­trol over, and decide freely and respon­si­bly on, mat­ters related to their sex­u­al­ity, includ­ing their sex­ual and repro­duc­tive health, free of coer­cion, dis­crim­i­na­tion and vio­lence, in order to increase their abil­ity to pro­tect them­selves from HIV infec­tion, and take all nec­es­sary mea­sures to cre­ate an enabling envi­ron­ment for the empow­er­ment of women and strengthen their eco­nomic inde­pen­dence and, in that con­text, reit­er­ates the impor­tance of the role of men and boys in achiev­ing gen­der equal­ity.” (para­graph 9)

2016 Political Declaration on HIV and AIDS

• “Com­mit to accel­er­at­ing efforts to scale up sci­en­tif­i­cally accu­rate, age-appro­pri­ate com­pre­hen­sive edu­ca­tion, rel­e­vant to cul­tural con­texts, that pro­vides ado­les­cent girls and boys and young women and men, in and out of school, con­sis­tent with their evolv­ing capac­i­ties, with infor­ma­tion on sex­ual and repro­duc­tive health and HIV pre­ven­tion, gen­der equal­ity and women’s empow­er­ment, human rights, phys­i­cal, psy­cho­log­i­cal and puber­tal devel­op­ment and power in rela­tion­ships between women and men, to enable them to build self-esteem and informed deci­sion-mak­ing, com­mu­ni­ca­tion and risk reduc­tion skills and develop respect­ful rela­tion­ships, in full part­ner­ship with young per­sons, par­ents, legal guardians, care­givers, edu­ca­tors and health-care providers, in order to enable them to pro­tect them­selves from HIV infec­tion.” (para­graph 62(c))

2011 Political Declaration on HIV and AIDS

• “Pledge to elim­i­nate gen­der inequal­i­ties and gen­der-based abuse and vio­lence, increase the capac­ity of women and ado­les­cent girls to pro­tect them­selves from the risk of HIV infec­tion, prin­ci­pally through the pro­vi­sion of health care and ser­vices, includ­ing, inter alia, sex­ual and repro­duc­tive health, as well as full access to com­pre­hen­sive infor­ma­tion and edu­ca­tion, ensure that women can exer­cise their right to have con­trol over, and decide freely and respon­si­bly on, mat­ters related to their sex­u­al­ity, includ­ing their sex­ual and repro­duc­tive health, free of coer­cion, dis­crim­i­na­tion and vio­lence, in order to increase their abil­ity to pro­tect them­selves from HIV infec­tion, and take all nec­es­sary mea­sures to cre­ate an enabling envi­ron­ment for the empow­er­ment of women and to strengthen their eco­nomic inde­pen­dence, and, in this con­text, reit­er­ate the impor­tance of the role of men and boys in achiev­ing gen­der equal­ity.” (para­graph 53)

2006 Political Declaration on HIV/AIDS

• “Pledge to elim­i­nate gen­der inequal­i­ties, gen­der-based abuse and vio­lence; increase the capac­ity of women and ado­les­cent girls to pro­tect them­selves from the risk of HIV infec­tion, prin­ci­pally through the pro­vi­sion of health care and ser­vices, includ­ing, inter alia, sex­ual and repro­duc­tive health, and the pro­vi­sion of full access to com­pre­hen­sive infor­ma­tion and edu­ca­tion; ensure that women can exer­cise their right to have con­trol over, and decide freely and respon­si­bly on, mat­ters related to their sex­u­al­ity in order to increase their abil­ity to pro­tect them­selves from HIV infec­tion, includ­ing their sex­ual and repro­duc­tive health, free of coer­cion, dis­crim­i­na­tion and vio­lence; and take all nec­es­sary mea­sures to cre­ate an enabling envi­ron­ment for the empow­er­ment of women and strengthen their eco­nomic inde­pen­dence; and in this con­text, reit­er­ate the impor­tance of the role of men and boys in achiev­ing gen­der equal­ity.” (para­graph 30)

2001 Declaration of Commitment on HIV/AIDS

• “By 2005, ensure that at least 90 per cent, and by 2010 at least 95 per cent of young men and women aged 15 to 24 have access to the infor­ma­tion, edu­ca­tion, includ­ing peer edu­ca­tion and youth-spe­cific HIV edu­ca­tion, and ser­vices nec­es­sary to develop the life skills required to reduce their vul­ner­a­bil­ity to HIV infec­tion, in full part­ner­ship with young per­sons,par­ents, fam­i­lies, edu­ca­tors and health-care providers” (para­graph 53)

Expert precedents

2022 OHCHR Annual Report on Human Rights and HIV/AIDS

• “Rec­om­mend that States ensure that com­pre­hen­sive sex­u­al­ity edu­ca­tion pro­grammes are age-appro­pri­ate, evi­dence-based and sci­en­tif­i­cally accu­rate at all lev­els of edu­ca­tion, includ­ing com­pre­hen­sive infor­ma­tion on sex­ual and repro­duc­tive health and rights, respon­si­ble sex­ual behav­iour, pre­ven­tion of early preg­nancy and sex­u­ally trans­mit­ted dis­eases, includ­ing HIV” (para­graph 29(d))

2022 Report of the Independent Expert on SOGI: Law of Inclusion

• “The pro­vi­sion and recep­tion of com­pre­hen­sive gen­der and sex­u­al­ity edu­ca­tion is legally pro­tected under arti­cle 19 of the Uni­ver­sal Dec­la­ra­tion of Human Rights and arti­cle 19 of the Inter­na­tional Covenant on Civil and Polit­i­cal Rights.” (para­graph 54)

2016 General Comment No.22 on the Right to Sexual and Reproductive Health

• “States are obliged to ensure that ado­les­cents have full access to appro­pri­ate infor­ma­tion on sex­ual and repro­duc­tive health, includ­ing fam­ily plan­ning and con­tra­cep­tives, the dan­gers of early preg­nancy and the pre­ven­tion and treat­ment of sex­u­ally trans­mit­ted dis­eases, includ­ing HIV/AIDS, regard­less of their mar­i­tal sta­tus and whether their par­ents or guardians con­sent, with respect for their pri­vacy and con­fi­den­tial­ity.” (para­graph 44)

1999 General Recommendation No.24 on women and health

• “States par­ties should ensure, with­out prej­u­dice or dis­crim­i­na­tion, the right to sex­ual health infor­ma­tion, edu­ca­tion and ser­vices for all women and girls, includ­ing those who have been traf­ficked, even if they are not legally res­i­dent in the coun­try. In par­tic­u­lar, States par­ties should ensure the rights of female and male ado­les­cents to sex­ual and repro­duc­tive health edu­ca­tion by prop­erly trained per­son­nel in spe­cially designed pro­grammes that respect their right to pri­vacy and con­fi­den­tial­ity.” (para­graph 18)

Evidence

2021 State of World Population

• “Oppo­nents of com­pre­hen­sive sex­u­al­ity edu­ca­tion often con­tend that it pro­motes sex­ual activ­ity, yet stud­ies show that this is incor­rect. Rather, evi­dence indi­cates that this edu­ca­tion, when pro­vided to inter­na­tional stan­dards, improves young peo­ple’s knowl­edge and con­sti­tutes a cru­cial and cost-effec­tive strat­egy for pre­vent­ing unin­tended preg­nancy and sex­u­ally trans­mit­ted infec­tions, includ­ing HIV. Some stud­ies show it may actu­ally help delay ado­les­cents’ sex­ual debut.” (p. 12)

2020 Evidence Review of the UNAIDS Strategy 2016-2021

• “Com­pre­hen­sive sex­u­al­ity edu­ca­tion has been shown to improve HIV-related knowl­edge and encour­age safer sex­ual behav­iours. It is also rel­a­tively inex­pen­sive: one mul­ti­coun­try eval­u­a­tion found that com­pre­hen­sive sex­u­al­ity edu­ca­tion need avert only 4% of pro­jected HIV infec­tions to be cost-sav­ing. Other behav­ioural inter­ven­tions also have pos­i­tive out­comes in spe­cific con­texts. Short-term HIV pre­ven­tion cam­paigns in schools have been found to be effec­tive in reduc­ing sex­ual rela­tions with older higher-risk part­ners, as well as teenage preg­nan­cies. Com­bined behav­ioural and struc­tural inter­ven­tions using gen­der-trans­for­ma­tive HIV pre­ven­tion approaches are effec­tive in chang­ing sex­ual behav­iours and in pre­vent­ing HIV in some set­tings.” (pp. 53)

• “There is encour­ag­ing progress in the pro­vi­sion of com­pre­hen­sive sex­u­al­ity edu­ca­tion, with 80% of coun­tries sur­veyed report­ing the exis­tence of sup­port­ive poli­cies or strate­gies. Most coun­tries in Asia and the Pacific (21 of 25) have national HIV strate­gies that refer to the role of edu­ca­tion, while most coun­tries in west­ern and cen­tral Asia have for­mal poli­cies on life skills-based HIV sex­u­al­ity edu­ca­tion. Health min­is­ters in Latin Amer­ica and the Caribbean have com­mit­ted to nation­wide school-based sex­u­al­ity and HIV edu­ca­tion. Although poli­cies on com­pre­hen­sive sex­u­al­ity edu­ca­tion are increas­ingly aligned with national norms, the trans­la­tion of these poli­cies into actual pro­grammes lags in many set­tings, which adds to young peo­ple’s vul­ner­a­bil­ity to HIV.” (pp. 54–55)

2016 Prevention Gap Report

• “In sub-Saha­ran Africa, sur­vey data from 35 coun­tries show that only 36% of young men and 30% of young women cor­rectly iden­ti­fied ways of pre­vent­ing the sex­ual trans­mis­sion of HIV and rejected major mis­con­cep­tions about HIV trans­mis­sion. In 23 coun­tries out­side of sub-Saha­ran Africa, just 13.8% of young men and 13.6% of young women had cor­rect and com­pre­hen­sive knowl­edge about HIV.” (p. 71)