Syndemic sex education

ABSTRACT

In this article, we consider what would happen if the resources and energy devoted to formal, school-based sex education were redirected into a syndemic sex education approach that centres the individual, social, and structural conditions that shape adolescents’ sexual and reproductive health (SRH). Drawing on a case study of youth in Malawi, we argue that sex education in its current form fails to broadly prevent negative SRH outcomes and meaningfully improve wellbeing. Yet it, and the (female) sexuality it seeks to prevent, remain the subjects of considerable attention and moral anxiety. We call to move beyond sex as a focus for institutionalised teaching and learning, replacing it with holistic efforts to support the wellbeing of young people living in syndemic conditions.

KEYWORDS:

• Malawi
• HIV/AIDS
• pregnancy
• syndemic
• youth wellbeing

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1. The first author (RS) met Mphatso as part of a 9-month, multi-sited ethnographic study of student pregnancy in Southern Malawi in 2016. Kendall has been actively engaged in research and partnership in Malawi since 1997.

2. In Malawi, 28% of young women aged 14–18 report having experienced intimate partner violence (UNAIDS 2021).

3. Malawi’s abstinence-plus curriculum supplements abstinence-focused messaging with limited information about contraception. Malawian teachers, however, often omit or amend this information in practice (Mwale 2019).

4. Ngabaza and Shefer (2019) analyse the limitations of South Africa’s Life Orientation curriculum in promoting gender justice. Life Orientation shares much in common with Life Skills in Malawi.

5. Abortion is illegal in Malawi except to save a mother’s life. Even then, access to health facilities is highly uneven.

6. Yet transactional sex is neither straightforwardly disempowering nor driven solely by poverty (Gichane et al. 2022).