Module 1

• Sexually Healthy and Personally Empowered Adolescents
• Adolescence is the period when boys and girls undergo enormous physical and psychological changes to become adults - a natural and healthy period in life
• Many adolescents go through this period experiencing sexual and reproductive health problems like unwanted pregnancy as a consequence of early, unsafe or unprotected sex
• Adolescence is a time of sexual exploration and expression. As their bodies change and mature, many adolescents develop an interest in sex and begin to have sexual relations
• The consequences of unprotected sex in adolescents include too early and unwanted pregnancy, and sexually transmitted infections, including HIV
• When an adolescent girl becomes pregnant, she is at risk of complications during pregnancy and delivery. Her baby is also at risk of health problems, even death. As a consequence of early childbearing, adolescent mothers are often unable to continue schooling and fulfill their aspirations and dreams in life
• Adolescent fathers also face some of the issues that adolescent mothers do. They face the challenges of early fatherhood and the outcomes of lack of emotional maturity to handle relationships
• The lack of knowledge and skills, poor access to contraceptive methods, and vulnerability to coerced sex put adolescents at high risk of unwanted pregnancies and sexually transmitted infections and irreversible or life-long social consequences
• The 2013 Young Adult Fertility and Sexuality Study (YAFS4) reported that in the past decade, the proportion of older adolescent females (15-19 years old) who have begun childbearing doubled. This is primarily because of the rise in the number of both male and female adolescents (15-19 years old) who engaged in premarital sex [ one (1) in every three (3)] and whose sexual activities are mostly unprotected against unwanted pregnancy and sexually transmitted infections including HIV
• Percent of adolescents (10-19) who have begun childbearing


  • 6.3% in 2002
  • 13.6% in 2013
• Percent of adolescents (10-19) who have engaged in pre-marital sex


  • 23.2% in 2002
  • 32% in 2013
• At the time of first sexual contact, adolescents often lack knowledge about sexuality and reproduction. Generally, their first sexual engagement is unprotected which places them at risk of getting sexually transmitted infections (STIs) and unwanted pregnancy
• Young people are vulnerable to HIV infection because of risky sexual behavior, substance abuse, and lack of access to information and prevention services. Many young people do not know that HIV is a threat to them but many do not know how to protect themselves from acquiring HIV infection
• Among the most affected young populations in the country today are young males who have sex with males, young males who have sex with both males and females, young sex workers, and young persons who inject drugs. Their sexual initiation starts during adolescence. Furthermore, they have low knowledge about HIV and low perception of risks of having HIV infection. Finally, they have poor access to HIV information and services
• Adolescent girls usually lack the power, confidence, and skills to refuse to have sex. Girls are most often raised to become submissive females, while boys are encouraged to be more aggressive
• Among the most affected young populations in the country today are young males who have sex with males, young males who have sex with both males and females, young sex workers, and young persons who inject drugs. Their sexual initiation starts during adolescence. Furthermore, they have low knowledge about HIV and low perception of risks of having HIV infection. Finally, they have poor access to HIV information and services.
• Sexual violence


  Sexual abuse, coercion, and rape
• Adolescent girls usually lack the power, confidence, and skills to refuse to have sex. Girls are most often raised to become submissive females, while boys are raised to become dominant males. These gender roles and norms make it difficult for a girl to say no to sex.
• Sexual violence can result in unwanted pregnancy and STIs including HIV, in addition to long lasting psychological consequences.
• Youth's Reasons for Having Sex


  • Wanted to happen that time
  • Did not want but went along with it
  • Did not plan but happened anyway
  • Happened against will
• Percentage Whose First Sexual Intercourse was Forced Against Their Will

  • <15
  • 15-19
  • 20-24
  • 25-29
  • 30-49
• When the SHAPE Adolescents module was first developed and used, the proportion of adolescent females 15 to 19 years old who have begun childbearing was 6.9 percent. Twenty years later, this figure doubled to 13.7 percent (YAFS 2013).
• The United Nations Population Fund or UNFPA reported in 2012 that the Philippines had the highest number of adolescent pregnancies in Southeast Asia which has reached the epidemic level.
• The Department of Health (DOH) reported that from 2011 to 2015 the number of new HIV infection among adolescents has increased by 230 percent. HIV infection is mostly passed on through male to male sex (58%) and males who have sex with both males and females (26%).
• Today's adolescents are digitally wired - they own a cellular phone, use the internet, and have a social networking and email accounts.
• Today's adolescents do not only need information about sexuality and reproduction. They also need skills that allow them to make informed and responsible decisions about their body and relationships, as well as develop attitude that promotes respect for fellow human being regardless of size, shape, color, social status, religion, culture, sexuality, and gender identity within the context of significant factors that affect their growth and development such as technology and globalization.
• The Responsible Parenthood and Reproductive Health Law (Republic Act 10354) was enacted in 2012. The law aims to ensure universal access to reproductive health services including adolescent sexual and reproductive health (ASRH) information and services. It specifically mandates the provision of age- and development-appropriate reproductive health education to young people.
• The YAFS4 provides strong evidence that sexual and reproductive health education for today's youth requires a more responsive approach – one that strongly addresses their social context, health and lifestyle, and sexual behavior.
• Social Context


  • Most youth today are never married, more youth who are in a "live-in" arrangement than are formally married
  • Today's youth are studying (36%) or working (24%), others who are either idle (9%) or looking for work (7%)
  • Most of today's youth rely more on the internet rather than on newspaper, television, and radio for entertainment and information
• Health and Lifestyle


  • Young people consider themselves in good health condition, with 16 percent even giving themselves very healthy self-assessment, while 26 percent said they are healthier than average
  • A typical diet of a young Filipino includes instant noodles, chips, grilled street food and carbonated drinks
  • Many adolescents are physically active, about two (2) in three (3) young Filipinos engage in physical exercises and 67 percent do it at least twice a week, more young men than women regularly exercise, but media and technology-related activities dominate young people's leisure choices
• Non-Sexual Risk Behaviors


  • Smoking, drinking, and drug use while on the decline, are precursors to risky sexual behavior among adolescents
  • Reported suicide attempts remained almost constant but actual suicide attempts increased in the past decade, by age and sex
  • Experience of physical violence either as victim or as aggressor, is higher among the 15-19 year olds and among males, the most common aggressors are friends, classmates, romantic or sexual partners, and a parent, or a sibling
  • Among 15-19-year olds, the most common objects of their physical aggression are classmates and friends
  • Harassment using cybertechnology while generally low, remains a significant concern among adolescents
• Sexual Risk Behaviors


  • More youth are having sex before they reach the age of 18 years and before they are married
  • Many of them (78%) do not use protection against unintended pregnancy and STIs
  • Most of them acknowledge their lack of knowledge about sex particularly on the risk of conception
  • Commercial sex remains low and has declined, more men have commercial sex experience, either paying or being paid, most commercial sex activities are unprotected by condom
  • Casual sex is more prevalent among males than females, non-romantic or casual sex is also more common among males, more males report having multiple sexual partners
  • There are sexual risk behaviors specific to males having sex with males and anal sex, other sexual activities are technology-mediated
• Teenage Fertility


  • The proportion of 15-19-year-old females who have begun childbearing doubled in the past decade
  • More teenage mothers are in living-in arrangements and there are also more teenage mothers who never marry
  • Teenage mothers are mostly high school undergraduates and graduates
  • Teenage childbearing and prevalence of premarital sex are highly correlated
  • Most teenagers acknowledge lack of knowledge about sex
• Comprehensive Sexuality Education (CSE)


  An age-appropriate and culturally relevant approach to teaching about sexuality and relationships by providing scientifically accurate, realistic and non-judgmental information
• Minimum Functions of CSE

  • Provide accurate information about topics that stir the curiosity of children and young people, and about which they have a need to know
  • Provide children and young people with opportunities to explore values, attitudes, and norms concerning sexual and social relationships
  • Promote the acquisition of skills (e.g., information-gathering, communication, negotiation, refusal, decision-making, self-management)
  • Encourage children and young people to assume responsibility for their own behavior and to respect the rights of others
• Acquisition of skills


  • Information-gathering
  • Communication
  • Negotiation
  • Refusal
  • Decision-making
  • Self-management
• Encourage children and young people

  To assume responsibility for their own behavior and to respect the rights of others
• Content for an effective CSE program

  • Knowledge of sexual issues such as sexual abuse and sexual coercion, HIV and other STIs, pregnancy and methods of prevention
  • Prevention of risks (e.g., HIV, other STIs, and of pregnancy)
  • Personal values about sexual activity and abstinence
  • Attitudes about self-protection, including use of condoms and contraception
  • Perceptions of peer norms especially about sexual activity, condoms and contraception
  • Self-efficacy to avoid unwanted sexual attention, refuse sexual intercourse, and to use protection
  • Communication with parents or other adults and with potential sexual partners
• The confidentiality of sensitive information should be maintained
• Enables adolescent learners to: a. Acquire accurate information on human sexuality and sexual and reproductive health (SRH) in the context of human rights b. Explore and clarify values, adopt positive attitude towards SRH, and develop self-esteem, and respect for human rights and gender equality c. Develop and practice life skills that allow them to nurture respectful and productive relationship with family members, peers, friends, and romantic or intimate partners

  COMPREHENSIVE SEXUALITY EDUCATION