Abstract

As an interface between health and education, comprehensive sexuality education (CSE) offers a potent tool among other interventions to accelerate healthy transition of adolescents into adulthood. With increasing interest in in-school CSE provision/delivery, young people in out-of-school contexts may be left behind. This study forms part of implementation research to understand if the activities used to train and support the facilitators are feasible, appropriate, acceptable, and effective in enabling them to engage a defined group of young people, deliver CSE to them in the out-of-school context, and assist them in obtaining relevant services. This paper presents findings of mapping of out-of-school CSE interventions in Ghana, ongoing or completed between 2015 and 2020, and then discusses a needs assessment of two purposively selected groups of vulnerable out-of-school youth: young people living with HIV and AIDS (YPLHIV) and those living in detention (YPiD). We conducted 10 interviews with YPLHIV and three focus group discussions with YPiD in November 2020. Qualitative data were analysed thematically using both deductive and inductive approaches. The mapping yielded 29 interventions (18/62% were ongoing) focused extensively on the delivery of CSE-related knowledge and information; none were aimed at building facilitators’ capacity and most targeted the northern regions. Among YPLHIV, living positively after diagnosis, disclosure skills and use of HIV/AIDS health services were critical. YpID sought clarification on personal hygiene, consent in sexual relationships, medium/channel to deliver CSE, and issues around same-sex sexual intercourse. Both groups sought skills in dealing with stigmatisation and discrimination. Implications of the findings for our own and other interventions are highlighted.

摘要

作为健康与教育之间的接口，全面性教育（CSE）在其他干预措施中提供了一种有效的工具，可加速青少年向成年的健康过渡。随着对校内全面性教育提供/实施的兴趣日益浓厚，校外环境中的年轻人可能会被抛在后面。这项研究构成了实施研究的一部分，旨在了解用于培训和支持协调员的活动是否可行、适当、可接受且有效，使他们能够吸引特定的年轻人群体，并在外部环境中向他们提供全面性教育。学校背景，并协助他们获得相关服务。本文介绍了加纳 2015 年至 2020 年间正在进行或完成的校外全面性教育干预措施的调查结果，然后讨论了对两个特意选择的脆弱校外青少年群体的需求评估：艾滋病毒感染者的年轻人和艾滋病 (YPLHIV) 以及被拘留者 (YPiD)。2020 年 11 月，我们对 YPLHIV 进行了 10 次访谈，并与 YPiD 进行了 3 次焦点小组讨论。使用演绎和归纳方法对定性数据进行了主题分析。绘图产生了 29 项干预措施（18/62% 正在进行中），广泛关注 CSE 相关知识和信息的传播；没有一个旨在建设协调人的能力，而且大多数针对的是北部地区。对于艾滋病毒携带者来说，诊断后积极生活、披露技巧和使用艾滋病毒/艾滋病卫生服务至关重要。YpID 寻求澄清个人卫生、性关系同意、提供 CSE 的媒介/渠道以及同性性交问题。两个群体都寻求处理污名和歧视的技能。强调了研究结果对我们自己和其他干预措施的影响。