Godwin John, Szabo Gabrielle, Sass Justine, Sauvarin Josephine
Consultant, John Godwin Consulting, Elizabeth Bay, NSW, Australia.
Consultant, United Nations Population Fund (UNFPA) Asia Pacific Regional Office, Bangkok, Thailand.
Reprod Health Matters. 2014 Nov;22(44):137-47. doi: 10.1016/S0968-8080(14)44808-0.
The context of sexual relations is changing in the Asia-Pacific. While the age of sexual debut remains the same, young people are generally marrying later and sex outside of marriage is increasing. The first systematic review of how laws and policies govern young people's access to sexual and reproductive health services was conducted in 2013. The study considered >400 national documents and held focus group discussions with >60 young people across three countries in the region. This paper examines the study findings in light of epidemiological data on young people's sexual behaviour and health, exposing a critical mismatch between the onset of sexual activity and laws and policies governing consent (to sex and medical treatment), and the restriction and orientation of services to married persons. An enabling legal and policy environment is an essential foundation for efforts to improve young people's sexual and reproductive health. This paper argues that international guidance and commitments (including the widely ratified Convention on the Rights of the Child) provide a framework for recognising young people's evolving capacity for independent decision-making, including in the realm of sexual and reproductive health. A number of countries in the region are using these frameworks to expand access to services, providing valuable examples for others to build on.
亚太地区的性关系背景正在发生变化。虽然首次性行为的年龄保持不变，但年轻人普遍结婚更晚，非婚性行为也在增加。2013年对法律和政策如何规范年轻人获得性与生殖健康服务的情况进行了首次系统审查。该研究审议了400多份国家文件，并在该地区三个国家与60多名年轻人进行了焦点小组讨论。本文根据关于年轻人性行为和健康的流行病学数据审视了研究结果，揭示了性活动开始与关于同意（性行为和医疗治疗）的法律和政策之间，以及服务对已婚者的限制和定位之间存在严重不匹配。有利的法律和政策环境是改善年轻人性与生殖健康努力的重要基础。本文认为，国际指导和承诺（包括广泛批准的《儿童权利公约》）为承认年轻人不断发展的独立决策能力提供了一个框架，包括在性与生殖健康领域。该地区一些国家正在利用这些框架扩大服务获取途径，为其他国家提供了宝贵的借鉴范例。
