Sexual and Reproductive Health and Rights.

Abstract

Sexual and reproductive health is a fundamental human right for all people, including adolescents and young adults (AYAs). Sexual and reproductive health and rights (SRHR) encompasses the right to comprehensive, medically accurate, and evidence-based sexual health information and healthcare services, as well as the ability to understand and exercise these rights. SRHR are essential to AYA's emotional, cognitive, and psychosocial development, physical and mental health, gender equality, and wider economic and social development. Access to sexual and reproductive health information and healthcare, inclusive of sexual orientation, gender identity, sexual behavior, and reproduction, is critical to achieving healthy sexual development. A strong body of research demonstrates that access to comprehensive, confidential sexual and reproductive health education and healthcare services, as well as family and community supports, improves a range of outcomes for AYAs. These favorable outcomes include delays in the age of sexual debut, reductions in sexual activity rates and the number of sexual partners, and increases in contraception and condom use. While there have been significant advancements in SRHR across the globe, AYAs continue to experience disproportionately higher rates of sexually transmitted infections, human immunodeficiency virus, unintended pregnancy, reproductive coercion, and sexual exploitation, as well as violence based on sex assigned at birth, sexual orientation, and gender identity. These disparities contribute to morbidity, mortality, and health inequities. Accordingly, the Society for Adolescent Health and Medicine adopts the following positions: (1) comprehensive sexual and reproductive health information and healthcare are fundamental human rights for all AYAs; (2) all AYAs should have universal access to comprehensive sexual and reproductive health information and healthcare; (3) all AYA-serving clinicians should have requisite knowledge and skills to provide sexual and reproductive health information and healthcare, and nonclinical AYA professionals should be an SRHR resource and provide referrals; and (4) increased investments in AYA-related sexual and reproductive health education, services, research, and advocacy, with meaningful stakeholder engagement, are needed to actualize SRHR for AYAs. Further, AYAs should have a voice in SRHR interventions and policies that affect their lives to ensure these efforts are relevant and meet their needs. Opportunities to advance the SRHR of AYAs exist at each level of the socioecological system.