BlessWorld Foundation International

Affecting the World Through Health
A Global Health Initiative

Archive for February, 2018

These past weeks we’ve deliberated on the topic, Adolescent health- discussing various aspects of their health including physical and sexual health. In this write-up, we’ll focus specifically on the sexual health of this group- particularly in the areas of sexual behaviour. Some negative sexual behaviors among adolescents include unprotected sex, sex experimentation and having multiple sexual partners. These behaviors in turn result in unwanted pregnancies, sexually transmitted diseases (STDs) and sex addictions.

Sexual health problem in adolescents is indeed a global matter because it affects all countries and races alike. Additionally, adolescents behave in similar predictable patterns irrespective of their origin or location. Consequently, this group constitute significant sexual disease burden globally. Adolescents engage in negative sexual behaviors for several reasons. First, they’re young, naïve and unable to make good judgment and decisions due to lack of understanding or experience. Secondly, many adolescents are irresponsible and careless because they’re not accountable for their actions and behaviours as their parents are still responsible for them. Thirdly, peer influence is a common reason why adolescents engage in sexual behaviors members of their group consider trendy. Finally, a study on the influence of genetic composition on adolescent behaviors reveals there are unique individual differences due to genes, among adolescents in how and when they become sexually active adults as well as the behaviors they adopt.

Sexual risk behaviors such as unprotected sex place adolescents at risk for HIV infection, other STDs and unwanted pregnancies. According to CDC, approximately 230,000 babies were born to adolescents in 2015. More so, 20 million new STDs are reported annually among adolescents, who also account for about 22% of all new HIV diagnoses in the United States. Data from the Youth Risk Behavior Surveillance System (YRBS), which monitors health risk behaviors in adolescents showed low rates of testing for HIV, high rate of substance use preceding sexual intercourse, low rates of condom use during sex and multiple number of sexual partners.

To reduce sexual risk behaviours and associated problems among adolescents, there’s need for a global education about HIV and other STDs. This includes knowing and understanding their transmission and prevention, as well as which behaviors place individuals at greatest risk for infection. STDs awareness and education should be universally integrated into all forms of educational environments to reach this group.

Substance misuse or abuse is defined by World Health Organization as the harmful or dangerous use of psychoactive substances, including alcohol, illicit drugs and other substances. The use of these substances can lead to a medical condition known as dependence syndrome. Dependence syndrome refers to a cluster or variety of behavioural, cognitive, and physiological phenomena that develop following the repeated use of illicit substances and prescription drugs. Symptoms of this condition typically include: strong recurring desire to take psychoactive drugs, difficulty controlling use, persistent use irrespective of harmful consequences, prioritizing use at the detriment of other activities and obligations, increased tolerance, and occasionally, a physical withdrawal state.

Misuse of illicit drugs and other substances hinders the ability of adolescents to grow, develop and reach their full potential in life. In addition to being an exciting stage of life- filled with self-discoveries and youthful exuberance, many adolescents continue to mature and develop physically. They also become adventurous and experimental with drugs, trying out many new things which may compromise their health. This is why many unhealthy behaviors such as substance misuse are often started during adolescence and continue into adulthood, contributing to the global burden of addiction morbidity and mortality.

Drug or substance misuse in adolescents is on the rise and has become a global concern because it exposes them to dangers from the drug and associated risky or unhealthy behaviors. It is also likely to result in increased drug use in the future. Parents and guardians need to monitor this group and not overlook occasional instances of drug misuse and their significance. Substance misuse has long-term impacts on the developing brain of teenagers and may interfere with family, positive peer relationships, and school performance. The impairment of brain development and function due to drug use by adolescents may result in the present or subsequent development of substance use disorder in adulthood. It is therefore important to identify and intervene in drug use early.

National and global policies which favorably and positively influence the levels and patterns of substance use and consequent harm can significantly reduce the public health problems attributable to substance use. Additionally, interventions at the health care system level can support affected individuals towards health restoration, harm reduction and eventually, quitting substance use. There is need for a collaborative effort that engages multiple partners including government and non governmental agencies, community and international organizations to make recommendations on adolescent health, provide high quality age-appropriate health services and design adolescent focused substance misuse interventions. Given the age of adolescents, the school environment remains the best place to develop healthy behaviors since schools have direct contact with millions of them daily. Research also supports that school health programs reduce the prevalence of risky behaviors among young people as well as have a positive effect on academic performance.

Adolescent and School health: A Global Health MatterAccording to World Health Organization (WHO), adolescent health refers to the variety of strategies involved in preventing, identifying and treating teens and young people, as well as maintaining their health and well-being. Adolescent health and well-being encompasses the physical, emotional, social and metal health of adolescents that enable them participate fully in the family, school and community units. Adolescents consist of teenagers and young people, therefore, the term Adolescent Health is often used interchangeably with Youth Health.

WHO defines ‘Adolescents’ as individuals aged between 10-19 years, ‘Youth’ aged between 15-24 years and ‘Young People’ covers the age range of 10-24 years including all adolescents and youths. About 1.2 billion people, or 1 in 6 of the world’s population are adolescents, hence, it is important to understand that Adolescents are heterogeneous people who exist in various situations and possess different needs. The adolescent stage of human development is naturally accompanied with dramatic physical, sexual, psychological and social developmental changes, all occurring simultaneously. Consequently, this presents a critical period of information acquisition and decision making that ultimately increase risks to health and well-being. According to Centers for Disease Control and Prevention (CDC), it is easier and more effective to acquire healthy behaviors during adolescence than trying to change unhealthy behaviors in adulthood.

Generally, adolescents are considered a healthy group as a result of high immunity of young people and absence of chronic diseases due to old age. However, many adolescents have died prematurely from accidents, substance abuse, drunkenness, suicide, violence, pregnancy related complications and other illnesses that are either preventable or treatable. Others are victims of hereditary diseases, long-term debilitating ill-health and disability. In addition, many serious diseases, illness or premature death later in adulthood have their origin in adolescence; for example, tobacco use in adolescence may lead to lung cancer in adult life; risky sexual behaviors may result in incurable, immune-compromising sexually transmitted infections including HIV/AIDS; poor eating and exercise habits lead to obesity and other weight related illnesses; some mental health disorders (such as depression) in adulthood start by age 14, but most cases are undetected and untreated.

Adolescent health is important because illnesses can hinder their ability to grow, develop and reach their full potential in life. Adolescence is an exciting stage of life full of self-discoveries and youthful exuberance. Adolescent behaviors may be influenced at the individual, peer, family, school, community, and societal levels. At the start of this period, many adolescents begin to mature and develop physically. They also become adventurous, trying out many new things which may compromise their health. This is why most preventable health risk behaviors are often started during adolescence and continue into adulthood, contributing to the leading causes of death. Some of these risky behaviors include substance abuse, drunk driving, violence, unprotected sexual intercourse and other poor behaviors which are began within the adolescent age range. In 2015, an estimated 1.2 million adolescents died- over 3000 daily, mostly due to preventable or treatable causes. For this group, road traffic injuries, respiratory infections, suicide, complications from pregnancy and childbirth, diarrheal diseases, and drowning are the major causes of death. Among girls aged 15 to 19 years, there are 44 births per 1000 annually.

To improve the health of young people, many sectors of the society should contribute to adolescent health, safety, and well-being- a collaborative effort that engages multiple partners. Government agencies and International organizations such as WHO, CDC and United Nations initiate or participate in producing evidence-based guidelines to support health services and other sectors, making recommendations to governments on adolescent health, providing high quality, age-appropriate health services, documenting progress in adolescent health and development, designing adolescent focused interventions and raising awareness of health issues for young people among the general public and other interested stakeholders.

The school environment is considered the best place, to develop healthy behaviors since schools have direct contact with millions of students daily during the most critical years of their social, physical, and intellectual development- adolescence. Research has shown that school health programs reduce the prevalence of risky behaviors among young people as well as have a positive effect on academic performance. Consequently, schools play a major role in promoting the health and safety of young people as well as helping them establish lifelong healthy behaviors.

Adolescents are pre adults or teenagers who may no longer be considered to be children. This group consists of young people between the ages of 10 and 19 years, and are often thought of as a healthy group. Nevertheless, many adolescent deaths result from accidents, suicide, violence, pregnancy related complications and other illnesses that are either preventable or treatable.

Adolescenceis one of the most rapid phases of human development characterized by increased engagement of many young people in sexual risk behaviors that can result in unintended health outcomes. This increase in sexual risk behaviors is demonstrated by the following statistics from the United States Centre for Disease Control and prevention (CDC).
• 41% of adolescents have had sexual intercourse
• 30% had sexual intercourse during the previous 3 months, and, of these, 43% did not use a condom the last time they had sex and 14% did not use any method to prevent pregnancy
• 21% had drunk alcohol or used drugs before last sexual intercourse
• Only 10% of students surveyed in the US have been tested for human immunodeficiency virus (HIV)
• Mostly adolescents accounted for an estimated 22% of all new HIV diagnoses in the United States in 2015
• Half of the nearly 20 million new STDs reported each year were among adolescents and young people, between the ages of 15 to 24
• Nearly 230,000 babies were born to adolescent girls aged 15–19 years in 2015

Adolescent health is an important topic because sexual risk behaviors are major public health concerns. These behaviors are the most common public health problem associated with this group, placing these teenagers at a high risk for HIV infection and other sexually transmitted diseases (STDs) as well as unintended pregnancies.
To prevent or decrease sexual risk behaviors and related health problems among adolescents, schools and affiliated organizations should promote the adoption of lifelong attitudes and behaviors that support their health and safety. This includes health education, health promotion and appropriate reinforcement to adopt and sustain healthy choices and behaviour. CDC’srecommendation for routine medical care includes a HIV test, especially for sexually active adolescents and adults.

Abstinence from vaginal, anal, and oral intercourse remains the only 100% effective way to prevent HIV, other STDs, and pregnancy. Additionally, the accurate and consistent use of condoms can reduce the risk of STD transmission while birth control pills reduce the risk of unwanted pregnancies only. However, no protective or control method besides abstinence is 100% effective, and condom use cannot guarantee absolute protection against any STD or pregnancy.

Programs and initiatives targeted towards adolescent sexual awareness include data collection and analysis, science-based guidance, funding to state and local departments of education and national nongovernmental organizations, research, evaluation and partnerships.