Opportunities and challenges of sexual health services among young people: a study in Nepal.

摘要

INTRODUCTION: It has been well documented that young people are more likely to engage in high-risk sexual activity. Appropriate understanding of safe sex, sexual practices, and related behaviors must recognize the importance of socioeconomic and cultural factors in prevention efforts related to HIV and other sexual transmitted infections (STIs). AIM: To examine and summarize the opportunities and challenges of sexual health services among young people in Nepal. MAIN OUTCOME MEASURES: Review of literature--assessing knowledge, attitudes, and understanding of sex, sexual health, and related sexual risk behaviors, among young people (15-24), in line with the current sociocultural and health service practices. METHODS: Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Science, Cochrane database, and Google were searched. Similarly, documents published at the WHO, United Nations Population Fund, United Nations Development Program, and at national/local level--Ministry of Health, National Center for AIDS, and STD Control were also assessed to access the relevant reports and articles. Published and gray articles were also reviewed. RESULTS: This study contends growing expansion of communication and transportation networks, urbanization, and urban in-migration is creating a different sociocultural environment, which is conducive to more social interactions between young girls and boys in Nepal. Rising age at marriage opens a window of opportunity for premarital and unsafe sexual activity among young people and this creates risks of unwanted pregnancy, STIs/HIV and AIDS. Socioeconomic, demographic, and cultural factors have been identified as encouraging factors for risk-taking behaviors among young people. CONCLUSIONS: Understanding safer sex and responsible sexual/reproductive behavior is important. Effective and appropriate interventions on sexual and reproductive health education directed at young people and the whole family, including fathers, could have significant effect on reducing risk and related risk practices in the context of Nepal.