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Tell me more!: Children's rights and sexuality in the context of HIV/AIDS in Africa

Save the Children - Sweden


Posted with permission of the Pretoria office of Save the Children, Sweden.
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Executive summary

This report is an overview of the strategies children adopt for dealing with sexuality and relationships in the face of the HIV/AIDS scourge in sub-Saharan Africa. It is aimed at providing stakeholders with a coherent rights-orientated and child-oriented knowledge base to advocate for the development of a sexual and reproductive health agenda. The study is grounded in the principles laid out by the United Nations Convention on the Rights of the Child1 (UN-CRC).

The report summarises literature on children’s perspectives and opinions on the issue of sexuality and related concerns in their lives in sub-Saharan Africa. The report uses data and information from the work of Save the Children Sweden and the Swedish Association for Sexuality Education on sexuality and children with evidence from their programmes in Africa.

It addresses eight areas concerning children and HIV/AIDS:

  • Children’s preferred long-term strategies of protection against HIV/AIDS
  • Children’s perceptions of sexual and reproductive health services
  • Children’s perceptions of in-school HIV preventive education and counseling
  • Children’s perceptions of community-based HIV preventive education and counseling
  • Children’s perceptions of HIV preventive information in the media
  • Children’s awareness and views of transactional sex
  • The situation of children who express sexuality outside of the heterosexual norm
  • Children’s understandings of the “Abstinence, Be Faithful, Condoms” concept
Key findings

Children are well aware of the protective benefits of abstaining from sex, of having one sexual partner and using condoms. However, they do not always adopt these strategies to avoid sexually transmitted infections (STIs).

Children see the benefits of abstaining but they do not see it as being a realistic behaviour for themselves. Faithfulness was also seen as a good option for some children, although it is not clear if children understand the term the way it was originally conceptualised. Children are not fond of condoms for the many similar reasons that make them unpopular with adults (although some of these reasons are based on misinformation).

Children often develop their own strategies for avoiding sex, such as being involved in out-of-school activities like sports and clubs in order to keep one’s mind off sex, stringing men along for money but not giving sex, and having oral sex or practicing masturbation. Often they do not perceive themselves as being at risk.

Girls and boys usually perceive themselves as being governed by fairly strict gender roles, However the data regarding these perceptions is inconclusive. In some studies, girls feel they can decide over when and with whom they will have sex (but not condom use), but in others they do not feel they have any power and risk rape or other physical violence if they refuse a boy. Boys also felt restricted to gender norms about male sexual desire which they felt forced them to seek out sex with many girls.

Children do not value sexual education in schools as they perceive it as being moralistic and negative about sex. It was found that children would like to know HOW they could protect themselves as many of them are already sexually active., rather than just focusing on the biological side of sex. Children tend to receive the majority of their information about sexual and reproductive health from the media, although there is some debate as to the reliability of the information that is transmitted.

Effective Responses

Based on the findings in this report, we present a number of recommendations for policy makers and programme responses:

  1. Programmes should seek to understand and promote children and youth’s own strategies for avoiding HIV/AIDS, and help them develop their capacities for decision making and critical thinking.
  2. Traditional gender norms that may have harmful consequences, such as expectations for boys to have many sexual partners, need to be discussed and debated openly with children and adults.
  3. Children’s preoccupations with the confidentiality, privacy, and accessibility of services should be taken seriously and addressed. Where possible, sexual and reproductive health services for children should be free.
  4. Teachers should be trained to be able to provide appropriate and interesting sexual education to children, even those who are currently abstaining. This will probably require that teachers receive training regarding their own sexuality.
  5. Community-based education programs need to respect children’s desire for confidential discussions with peer educators and other community members, and to present sexuality and life skills in a way that is relevant for children.
  6. The media should be further engaged as a resource of reaching children with sexual and reproductive health messages.
  7. Girls should be provided with economic opportunities to avoid the necessity of transactional sex relationships. The ability to gain status through transactional sex needs to be critically reflected upon together with children.
  8. Given the fact that some children do not identify with the heterosexual norm, information on sexuality should be inclusive by not taking this norm for granted.
  9. Children’s concerns about their abilities to remain abstinent should be taken seriously.
This report provides an overview of sexual rights with a focus on children’s rights including their access to sexual and reproductive health information as endorsed by relevant international conventions and policies. It looks at the concept of sexuality and sexual development of children. It reinforces the importance of engaging with children on the issue of sexuality, especially in the context of HIV/AIDS. Children need to be specifically engaged in this discussion because children are vulnerable to HIV infection, they are often sexually active and they have been in general overlooked in this field because of restrictive moral standards that deem it inappropriate to discuss the issue of sexuality with children.


The report provides a clear general overview of sexuality, before focussing on children’s sexuality as a constant part of their lives and something that they need to be informed of. It further highlights the shortcomings often found in programmes and research that have been carried out on the sexual and reproductive health for children, particularly regarding relating this work to children’s rights. The report identifies further areas of research needed in this area including a greater focus on children’s opinions and views on issues of sexuality.

After looking at children’s responses to existing sexuality education and adult engagement, the report concludes that too little attention is often paid to children’s own capacities and desires.

There is also a dire need to link policies and programmes directly to respond to the sexual and reproductive health needs of children in a child-friendly and participatory manner.

  1. The Convention of the Rights of the Child defines a child as a person under the age of 18 years.

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