A Few Teaching AIDS

Long rebuffed, adolescent sexuality has of late found a curious awakening in India's development agenda. A slew of policies and programmes are suddenly toppling over each other to cater to the unmet and, probably, still little understood, physical and emotional needs of India's young adults. There are over 190 million of them—between 10 and 19—who need help in the reproductive and sexual health area.

Union health minister C.P. Thakur recently announced plans for setting up specially designed clinical services for adolescents in hospitals and also promised adolescent health camps in remote areas. The government, along with the WHO, has set up an adolescent health centre at Delhi's Safdarjung Hospital. All this, even as the NCERT continues with its project on adolescence (read sex) education in about 20,000 schools across the country and currently engages itself in running a pilot project in "Skill Building in Adolescence Education" in six states. And yet some more assistance comes from the CBSE's plans to launch a helpline for sexually harassed school students.

Then there are the many macro-health directives that reflect concern for the well-being of our young. The latest Population Policy stresses on addressing the "needs of under/unserved population groups like adolescents", while the National Health Policy emphasises the requirement for establishing new health infrastructure for "deficient(ly)" catered areas. The Draft National Youth Policy, Reproductive and Child Health Programme, Integrated Child Development Services also focus on adolescents.

Increasing incidence of teenage pregnancies, abortions, STD and AIDS, and adolescent depression have been crying for attention for some time now. Studies indicate that sexual activity among adolescents is beginning earlier than ever before. A National Institute of Health and Family Welfare study revealed that around 15 per cent Indian adolescents indulge in pre-marital sex, and about 30 per cent feel it's nothing unusual. Other studies show the average age for the first sexual intercourse is 17.6 years for boys and 18.4 years for girls. Among street kids, this age could be as low as 10 years, for the rural male the average age is 17 years, with the age of the female partner (usually unmarried) between 15 and 19.

Also, many of our adolescents have to cope with marriage and parenthood before they are out of their teens—30 per cent of women aged 15 to 19 are married and the median age at first birth is 19.6.

"There's still no comprehensive database on adolescents' special needs," observes J.L. Pandey, NCERT's national coordinator for the National Population Education Programme. A fact Rajesh Mehta, in-charge of the adolescent centre at Safdarjung Hospital, stumbled upon only after he saw the results of a survey conducted among young people before the centre was set up. Around 30 per cent of the 2,000 young people interviewed said they were most concerned with height-weight issues: "It was a revelation, considering even career came second!"

The centre has had about 40 clinic days till now, only 70-odd young people have registered. "But I am not disheartened," says Mehta, "It's a sensitive area, full of prejudices, secrets. A 17-year-old girl came in recently with hair loss complaints and ended with breast size issues—#it's going to take time, but a beginning had to be made."

Significantly, the Indian Medical Association has developed a long-distance post-graduation course to familiarise interested physicians with adolescent health care and 522 doctors have already enrolled.

But a profusion of such programmes could end up harming the adolescents. Cautions Chennai-based sexologist Narayana Reddy: "Too many agencies with no coordination or clear-cut goals will result in our adolescents being pulled in different directions." Radhika Chandiramani of TARSHI, a Delhi-based sexual health helpline, shares an important lesson that she has learnt: "Most sexuality education messages focus on safety and restraint alone. Sexuality is as much about desire and pleasure...." Have fun, but play safe.