Knopf, A.S., McNealy, K.R., Al-Khattab, H., et al. PLOS ONE (March 2017), 12(3): e0173225, doi:10.1371/journal.pone.0173225, eCollection 2017.
The authors of this study described the process of sexual learning among East African adolescents living in the context of generalized HIV epidemics. Following a systematic search procedure, which identified 32 reports for inclusion, they constructed a framework depicting a lifelong process of sexual learning in this population. The framework includes three phases of sexual learning: (1) being primed for sex, (2) making sense of sex, and (3) having sexual experiences. Adolescents were primed for sex through messages on sexuality that they received through daily life and understanding gender norms, cultural practices, and economic structures, as well as through conversations and formal instruction. They made sense of sex by acquiring information about sexual intercourse (though levels of knowledge varied significantly), reproduction and pregnancy, sexually transmitted infections, and relationships; and by developing beliefs and attitudes about these topics. Some adolescents described having sexual experiences that met wants or needs, but many experienced sex that was coerced or violent; all adolescents worried about sexually transmitted infections after sexual experiences. The authors said that these three phases of sexual learning interact to shape adolescents' sexual lives and their risk for HIV infection. They expressed hopes that this framework would contribute to the development of sex education programs that address HIV risk within the broader context of sexual learning.