The stigma around sex, sexual reproductive health, and family planning services is largely tied to religion. Samoa is a predominantly Christian nation, with the majority of denominations advocating for youth to not engage in sex until marriage” Ministry of Health report
Whilst in the college curriculum, Sex Education is supposedly mandatory, monitored and enforced Samoa, in practice, it is actually not taking place.
The teaching of Sexual Reproductive Health is further beset by other difficulties.
They include a lack of confidentiality in a small island nation; few opportunities for open discussion and family the unwritten rule that youth should not engage in sex until marriage.
“Sex education is a mandatory part of public college level curriculum enforced and monitored by the Ministry of Education, Sports and Culture (M.E.S.C) the Ministry of Health report says.
However, due to cultural and religious stigma towards sex and sexuality, in addition to poor curriculum enforcement and development by M.E.S.C. sex and Sexual Reproductive Health (S.R.H.) education is poorly implemented nation-wide,” according to the Ministry of Health’s sixth annual report to U.N.AIDS.
Obtained by the Samoa Observer, this report is evidence of Samoa’s commitment to the global response to HIV, AIDS, and Sexual Transmitted Infections S.T.I.’s.
However, the Health report indicates that chlamydia rates in Samoan youth are particularly high.
“In 2015, 36.7% of all S.T.I. testing was done with youth ages 10-24 and approximately 22% of all positive cases of chlamydia were youth aged 10-24.
“In particular the age group 20-24 had the highest number of positives cases (21.5%).
“Youth ages 10-24 made up 26.5% of all positive chlamydia tests.
“The actual chlamydia rates in youth for 2016 are likely similar as chlamydia prevalence has only increased in the past few years (2013- 24%, 2015- 26%).”
The Demographic Health Survey 2014 surveyed 1,891 youth on their knowledge of HIV/AIDS and for male youth only, their knowledge of the source of condoms.
“Knowledge was defined by the survey as; 1) knowing that using condoms and limiting sexual intercourse to 1 uninfected person are prevention methods, 2) being aware that a healthy looking person can have the virus, 3) and rejecting 2 most common local misconceptions about the virus.
“HIV knowledge was relatively the same between male and female youth and very low. “Male youth age 20-24 were more likely to know where to access condoms than those ages 15-19.
“Youth also have high rates of awareness of contraceptive methods. Particularly youth ages 20- 24 have heard of modern methods of contraception.
“This knowledge has increased over the years across all age groups, especially regarding male condoms (37-51%).”
According to the Health report, in recent years, the health sector and its partners have been advocating for a comprehensive sexual reproductive health education in public schools to address HIV, STI’s and sexual reproductive health awareness.
“The stigma around sex, sexual reproductive health, and family planning services is largely tied to religion.
“Samoa is a predominantly Christian nation, with the majority of denominations advocating for youth to not engage in sex until marriage.
“Family planning services are also to a large extent discouraged due to conflict with religious values.
“This stigma prevents all age groups from accessing services, discussing S.R.H., discussing S.T.I.’s, and hinders S.T.I. prevention.”
According to the report the youth is a particular barrier, as it is not socially permissible to be sexually active at younger age and therefore concerned about accessing S.R.H. services, worried that it will affect how they are perceived by their communities or conflict with their families’ values.
“Confidentiality is therefore also a major concern in Samoa, as with most small island nations.
“Youth accessing condoms at a Health Centre could easily be seen by a relative or village member, who may also work at the district health centre.
“So while youth awareness of contraception (including condoms) is high, youth utilization is low.”
The Health’s report indicates the youth are also at risk with only 5% of women and 6% of men having comprehensive knowledge of HIV.
“Urban youth are also more likely to have sex before the age of 15 than rural youth (DHS 2014).
“Youth ages 15-19 are less likely to know where to access condoms (25.1 compared to 34.7 for all age groups).
“Youth ages 15-24 account for 26.3% of all chlamydia infections in 2015, which has a relationship with HIV (Global Fund Progress report 2015).”