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Q&A: How to Empower Youths to Take Charge of Their Health and Sexuality

Mathilde Bagneres interviews ORIANA LOPEZ URIBE, youth activist for sexual and reproductive health services and information

UNITED NATIONS, Apr 28 2012 (IPS) - Young people aged 15-24 make up a quarter of sexually active individuals, yet they comprise half of new sexually transmitted infections (STIs) infections each year.

A Centres for Disease Control (CDC) study released in March 2008 estimates that one in four young women ages 14 to 19 in the United States are infected with at least one of the most common STIs: human papillomavirus, Chlamydia, herpes simplex virus and trichomoniasis.

At the same time, 75,000 children under the age of 18 lack health insurance and nearly 30,000 people aged 18-24 are uninsured, according to the U.S. Census Bureau.

Compared to the rest of the industrialised world, American teens are less likely to use contraception and have less access to reproductive health services and sex education. These factors help explain why the U.S. has the highest teen pregnancy rate of the industrialised world.

Oriana Lopez Uribe of Mexico began her activism as a volunteer with Mexfam, the Mexican Planned Parenthood Association, where she developed strategies for sexual and reproductive health services and information for youth.

She is currently a program officer at Balance, which promotes sexual and reproductive health services for young people and women at the national, regional and international levels.

IPS correspondent Mathilde Bagneres spoke with Oriana Lopez Uribe about her commitment to sexual and reproductive rights for young people.

Q: Can you tell me more about your work and about the presentation you gave during the commission on population and development at the United Nations (U.N.)? A: I have been an advocate for sexual and reproductive rights for 13 years.

I came to the U.N. to advocate for sexual and reproductive rights. Later, in two panels related to access to comprehensive sexual and reproductive health services, I spoke about the national experience and some of the barriers that young people have to tackle to access health services.

We still have not a very enabling environment for communicating about sexuality issues with our parents. The obligation for parental consent is a barrier for young people because if your family is not very open to sexuality, then it will be very difficult to tell them that you need to go to sexual and reproductive health services.

Lack of confidentiality is also a big issue. There is a lot of discrimination and especially with young and adolescent girls. If they are not married, everyone expects them not to have sexuality.

Due to all this discrimination, health providers have bad attitudes when young women come to their services. They don’t give them the service, or they lecture them about how they should behave. After such treatment, girls are not coming back.

In Mexico, we have specific laws and norms about giving adolescents access to sexual and reproductive health services. But the health providers don’t know the laws. They don’t know that it is their obligation to provide the service. There is a real need to train and inform those health care providers.

Q: What concrete measures and actions could be taken to promote sexual and reproductive rights for young people? Can you share a successful experience? A: One NGO had a successful experience. They built a program to help rural and indigenous adolescents and young women. Those clinics work in the community – they are not outsiders. People working in the clinics are coming from the community; they are really working within the community.

They also provide a space for young people to express themselves, to dance, to paint; so it is not just about diseases. It is a whole program for youth and not just healing services.

The clinics are also integrated clinics, so you can go there and you can get many services such as STI prevention, contraception. You have everything you need in one place. Even some other health related topics like nutrition, psychological help.

The government supported this program, and it was taken into more and more rural areas and marginalised parts of the country with the same components: lots of participation, community work.

Of course, it still needs to be improved, but I think it is a very good experience because it shows how much youth participation needs to be taken in account to develop policies and for the implementation of those policies, the evaluation, the monitoring and at all levels. Youth participation is crucial.

Q: What is the situation regarding sexual and reproductive rights in Mexico and, more particularly, norms regarding abortion? A: Mexico has different states so it is complicated. In general, in Mexico abortion is against the law, but there are some exceptions.

In every state, if the pregnancy is due to rape, you can have a legal abortion or at least that’s what the law says, or if the woman has gynaecological problems, some health issues, if there is a death risk, she can have an abortion.

In certain states you can also have a legal abortion for economic reasons. In Mexico City, without any reason, you can ask for an abortion during the first trimester.

The law says that if you’re a minor, you don’t have to come with your parents – it can be an adult that you trust. But the reality is that the health providers, to protect themselves, don’t think about the teenager in front of them. They ask for parental consent or a legal guardian’s consent, which makes it really hard for young girls because there is still a lot of stigma and discrimination around abortions. It’s very hard to change that.

The ideal would be to say, “She is the one that knows better.” If that pregnancy is not wanted, we need to start trusting women. They know what’s best for them.

Q: What are the greatest sexual health challenges that young people face nowadays? A: Everyone has to start believing, seeing and acknowledging that adolescents and young people have rights. We need to start giving them the ability to make their own choices. We, young people, are able to make decisions.

There is a lot of negativity surrounding and associated with youth – immaturity, drug use, bad sexuality, promiscuity.

I think it is very disempowering to think that an adolescent is a child. We need to stop protecting young people and start empowering them. We need to make them believe in themselves and boost their self- esteem and their capacity to make choices.