SEX EDUCATION AND MEDICINE

“In my four years into medical college, I have witnessed many people being reluctant towards sharing their history on STDs even to the treating physician. Even when prompted many times they deny it as they fear the sociocultural impose. It saddens me to have witnessed a 24 year old pregnant mother living with HIV/AIDS and the healthcare workers being biased and judgemental to her. It all needs to change. Awareness on sex education is a must to obliviate the social stigmata surrounding the topic.”

– Karthikeyan G, Final year MBBS, Madras Medical College, Chennai

“I recently started working at the hospital during my internship and was alarmed by the prevalence of HIV positive cases. It emphasized the failure of safe sexual practises directly impacted by the lack of proper sex education. On one of my night shifts, a nurse had asked me if it was even worth treating such patients who have clearly sinned. I was stunned and had no valid response to that. Over time I observed that while some are subtle by wearing double gloves, some are directly mean to these patients. It made me realize how dire the need for sex education is, not just among public, but more so among health care workers and medical professionals.”

– Dr Sai Lavanya Patnala, Intern, Apollo Medical College, Hyderabad

Introduction

Across the world, studies have demonstrated the need for sex education for adolescents (between 10 and 19 years). In India, the population aged between 10–24 years accounts for 373 million (30.9%) of 1210 million of nations’ population with every third person in our country belonging to this age group. This makes sex education crucial to mitigate issues like sexual and gender-based violence, substance abuse, and STDs.

Sexual health and education in India

Sexual health is the most neglected part of an individual’s health. The proportion of youth involved in sexual activity is rising and most of them are known to practise risky sex behaviour. The incidence of STDs among adolescents has been on the rise as well, about 6 percent of the adult population in India are infected with sexually transmitted infections and reproductive tract infections (STIs/RTIs) every year.

The GoI had initiated (Adolescent Reproductive and Sexual Health) clinics in 2006 to address sexual and reproductive issues. Currently these clinics are non-functional in many PHCs and CHCs.

The idea of labelling sex outside the so-called “social norms” is the reason why many are reluctant to come forward and address these concerns.

After years of sex education being banned, PM Narendra Modi rolled out a sex education program in 2018. In this training, students learn about sexual violence and sexual health among other topics.

The Family Planning Association of India conducted a workshop on “Sexual and Reproductive Health and Rights for All” in July of 2019. It hopes to break down taboos around sex, reproduction and homosexuality.

Even with the modernisation and availability of various resources easily accessible online, most schools in our country do not prioritise sex education. They also hesitate to include it in their curricula owing to the sociocultural norms revolving around this topic.

Sex education and medicine

Proper health education will help decrease the prevalence of STDs and unwanted pregnancies. Hence it can be expected of a doctor to be trained in sexual health to address these concerns of at-risk individuals and patients. The current medical curriculum neither offers medical graduates any separate course on sexual health nor offers a postgraduate degree in this field. By including sexual health in the medical curriculum, competent doctors can be trained to reduce the burden of sexual disorders

What can be improved?

• A mandatory sexual health module for Undergraduates should be implemented to better train future professionals
• A new post-graduation course in Sexual Health to provide experts in the field
• Annual training sessions for all hospital staff involved in care of vulnerable population to instil sensitivity and give latest updates regarding infection protocols
• A comprehensive website or online portal which provides accurate information under one domain for anyone seeking answers.
• To produce more trained professionals, a sexual health module for undergraduate medical education should be implemented.

Conclusion

In the wake of the new era, safe sex has become the need of the hour. It is of much concern to a developing country like India to establish a stable and comprehensive sex education embedded in the school and college curriculums to reach a young population.

Although we fail to provide young adults with adequate and accurate information and services, we are quick to judge the new generation for their actions in the name of culture and beliefs. Educational reform along with community level awareness can be brought about by medical students via conducting awareness drives and camps targeting the adolescent population in schools, colleges and community health centres.

References:

1.         Riya Thakur, Poonam Muttreja. Why India needs to change its approach towards sexuality education. The Hindu, June 11 2022.

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3.         Sarah Beebe MD, Nicolette Payne BA, Tasha Posid MA PhD, Dinah Diab BA, Paul Horning BS, Alicia Scimeca BS, et al. The Lack of Sexual Health Education in Medical Training Leaves Students and Residents Feeling Unprepared. Vol 18, Issue 12; The Journal of Sexual Medicine: Elsevier;2021.

4.         Eli Coleman PhD. Sexual Health Education in Medical School: A Comprehensive Curriculum. AMA Journal of Ethics; 2014.

5.         Madeline Kind PharmD BCIDP, Myriam Shaw Ojeda PharmD. Sexual Education: Counseling Patients from Various Cultural Backgrounds. 2nd ed. Public Health in Pharmacy Practice: A Casebook.

6.         Comprehensive sexuality education. Committee Opinion No. 678. American College of Obstetricians and Gynecologists. Obstet Gynecol 2016;128:e227–30.

7.         Surendran Uma Maheswari, S. Kalaivani. Pattern of sexual behavior in adolescents and young adults attending STD clinic in a tertiary care center in South India. Indian J Sex Transm Dis AIDS. 2017 Jul-Dec; 38(2): 171–175.

8.         Sexually Transmitted Diseases – Statistics and Epidemiological Profile of India. Medindia: Health Statistics

9.         Emily Joy Oomen. 5 Facts about Sex Education in India. The Borgen Project. February 17 2020.

10.       Strengthening adolescent-responsive health systems. Article: WHO.