1 Reproductive and Sexual Health

CONTENTS
1 Reproductive and sexual health ..... 2

Reproductive systems. . . . .. 4
Developing relationships . . 6
Sexual relationships . . 9
Family planning and contraception. . . . . . . . 14
Sexually transmitted infections. . . . . . . . . . . . . . . . 25
HIV/AIDS. . . . . . . . . . . . . . . . . .. . . . . . 30
Strategies for keeping myself safe . .42
Peer education . ...... 50
2 Family and relationships 58

Family . . ... 60
Peers. . . . . ................... 1m
Groups young people belong to .............. 103
3 Universal values 120

Developing your identity . . 122
Universal values.. . 138
Abortion. .............................. 143
Influences of universal values. . . 154
Role models. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .158
4 Sport and fitness 171

Glossary 208
Acknowledgments 209
For students For teachers
In this unit students will have an opportunity to:
Unit summary
• develop the capacity to understand all aspects
In this unit you will find out more about the of their sexuality including the biological,
reproductive system, what it means to be a boy or a psychological, socio-cultural and reproductive
girl and how to behave with other boys and girls. You
• challenge cultural barriers that relate to social
will find out more about how to make decisions about
issues such as HIV/AIDS
sexual matters and how to cope with problems when
you have a boyfriend or girlfriend and when you get • find out more about family planning and
married. You will also find out about the relationship counselling
between the size of a family and the well-being of the • develop skills to make responsible decisions
members of the family, which will help to prepare you and take actions with regard to sexual health
for the future when you are ready to start your own behaviour
family. For your assessment you will have to do a short • work individually and in small or large groups
answer test and also make a poster, wrtte a pamphlet
• complete a short answer test and make a written
or give a "radio" talk to a group of people on HIV/AIDS.
or oral presentation for assessment
Assessment for this unit is described at the end of the unit.

• Assessment task one_:_ashort answer test
• Assessment task two-students make a poster, write a pamphlet or give a "radio" talk to a group of people
on I::IIV/AIDS
Links with other units and strands

Who am 17
Health
Family and relationships
Relationships and character development strands
Healthy living and spirituality strand
Syllabus references
Students can:
10.1.1 explain the functions of male and female reproductive anatomy with respect to conception and pregnancy
10.1.2 explain the relationship between family size and family welfare
10.1.3 compare and contrast the effectiveness of a range of decision-making skills and conflict resolution skills in
regard to sexual issues
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Unit 1 Reproductive and sexual health will take 10 weeks to complete, including assessment.
A suggested timetable is shown below.
Week 1 Reproductive systems Week 6 HIV/AIDS

Lesson 1, 2 Introduction to Unit Lesson 1,2 Prejudice and discriminatio
The male reproductive system, The Why do we discriminate a~
female reproductive system other people?
Lesson 3 Developing relationships Lesson 3 The effect of HIV on the co
Week 2 Week 7
Lesson 1 Love in relationships Lesson 1,2 HIV and AIDS in PNG
Lesson 2 Sexual relationships Lesson 3 Reducing the spread of HI\,
Lesson 3 Rights and responsibilities
, WeekS
Week 3 Lesson 1 Strategies for keeping m.,
Lesson 1,2 Dealing with pressure to have sex Lesson 2, 3 Unwanted sexual activity, F
Lesson 3 Family planning and contraception yourself from unwanted se:
Week 4 Week 9 Peer education
Lesson 1 Ovulation method, condoms, the pill, Lesson 1, 2, 3 Formal and informal educat
injections, sterilisation Community advocacy
Lesson 2, 3 Pregnancy and early child

Week 10
development, Antenatal care
Lesson 1 Assessment task one
Week 5 Sexually transmitted infections Lesson 2, 3 Assessment task two
Lesson 1, 2, 3 Gonorrhoea, syphilis, Donovanosis,
HIVjAIDS
REPRODUCTIVE SYSTEMS
As you grow up, your body changes and you become sexually mature. This means that
your reproductive system develops so that you are able have children. The stage in life
when you begin to develop into an adult is called puberty. The time between puberty
and being a mature adult is known as adolescence. During adolescence you learn to
think and behave as an adult. It is important to be a mature adult before you think about
having children of your own.
The male reproductive system

• The main parts of the male reproductive system are the penis and testicles, which
are all outside the body.
• The job of the penis is to carry urine out of the body and also to carry sperm in the
semen so that it can fertilise an egg.
• The main job of the testicles is to produce sperm. A man will produce millions of
sperm throughout his life.
• The testicles hang outside the body in a bag of skin called the scrotum. This keeps
the testicles slightly cooler than the rest of the body, which helps to produce healthy
sperm.
• Two tubes called sperm ducts lead to the urethra.
• The urethra is the tube inside the penis that carries both sperm and urine outside the
body. The sperm are carried in a thick milky-white liquid called semen.
bladder
kidney
pelvic bone
ureter --1---+1'
prostate gland
sperm duct --+----+11'('11

urethra --t---+'dYl'll
penis
scrotum
penis
(a) Side view (b) Front view
The male reproductive system
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• During sexual intercourse, the erect penis is pushed inside the vagina. During ejaculation, semen passes
out through the urethra in the penis.
• The purpose of sperm is to fertilise the egg, which will then grow into a baby. When a boy starts to produce
sperm it means that it is possible for him to become a father.
• Sometimes when a boy is asleep, semen passes out of his penis. When this happens it is called a wet
dream. A wet dream is a normal thing to happen and boys should not feel ashamed about it.
The female reproductive system

• The main parts of the female reproductive system are the uterus, the ovaries, the oviducts and the vagina,
which are all inside the body.
• At puberty the ovaries begin to release eggs. Usually one egg is produced each month from one of the
ovaries.
• The egg travels down the oviduct or Fallopian tube towards the uterus.
• The uterus is the place where the baby develops. Before the egg is released the uterus grows a special
lining to receive it in case it is fertilised.
• If the egg is fertilised by a sperm in the oviduct, it moves down into the uterus and begins to grow into a
baby. Fertilisation is also called conception.
• If the egg is not fertilised it will die after one or two days and later pass out of the body. The lining of the
uterus continues to grow for several days. It then begins to break up and passes out of the body through
the vagina with some blood. This is called having a period or menstruation, and normally lasts for about
four or five days. Periods are a normal thing to happen and girls should not feel ashamed.
ureter
OVid9ct~
ovary -'-"+-----tItl
oviduct
uterus
cervix
/ cervix
vagina
bladder
urethra
vagina
anus
(a) Side view (b) Front view
The female reproductive system

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Did you know?
• Traditionally, women in Papua New Guinea use leaves or dry grass to absorb the
flow of blood. Modern feminine hygiene methods use cotton pads and tampons or
napkins made of material.
o.pens in the vulva
, just in front of the • Some girls have pains when they have their periods and may have different feelings
oRening of.the before or during a period. For example, a girl might feel worried, get cross or be
vagina. In boys, more easily upset at these times. These different moods can occur because of the
the urethra Carries
chemical changes taking place inside her body, and are a normal thing to happen.
beih semen and
I ..~rine at different
times.
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Do, think and decide
Draw a table to list the different parts of the male reproductive system and briefly
describe the function of each part.
2 Draw a table to.list the different parts of the female reproductive system and briefly
describe the function of each part.
3 Describe the similarities and differences between the male and female reproductive
systems.
Lesson DEVELOPING RELATIONSHIPS
3
As you grow up and change from an adolescent to an adult you will develop different
kinds of relationships. Of course, every person is different, but many young people
will begin to develop a particular attraction for another person, and this is a normal and
healthy thing to happen. During adolescence many young people develop a close or
intimate relationship with a girlfriend or boyfriend. This is often a very exciting time.
New word In order to make these relationships happy, satisfying and enjoyable, people must
il1timate know and understand their rights and responsibilities to each other. Most relationships
relationship=-a depend on qualities such as honesty, trust, understanding and patience, and these
very close qualities are also needed in our intimate relationships.
relationship
between two. However, intimate relationships are different from other relationships because you also
people that may have to learn how to deal with sexual feelings. You need to understand that there are
different kinds of love, and also understand the pressures that can come from an intimate
t~~~:ti~~;h~:xual
relationship.You must know what you want from a relationshipand how to get it by
using your rights and also meeting your responsibilities. When you are in an intimate
relationship you need to communicate your feelings to your partner, and your partner
also needs to communicate his or her feelings to you. In this way, a mutual respect will
develop that will help to build a positive relationship and help you to deal with problems.
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e Do, think and decide

1 Think about the rights that you believe are important to intimate relationships. Look at the
examples in the bottle below, then draw your own love magic bottle in your exercise book.
Choose what you would place in your bottle of love magic and add some more of your own
rights as well.
Rights of a relationship
The right to ...
express my feelings
be respected
feel loved
trust my partner
assert myself
discuss differences
and negotiate
enjoy physical contact
without pressure to have
sexual intercourse
change my mind
Love magic bottle
2 What personal rights do you think are the most important in a relationship? Choose the
three that are the most important and write a sentence about each one, explaining why
you think it is important in an intimate relationship.
3 How would you feel if you were in a relationship and your rights were not respected by
your boyfriend or girlfriend? What would you do?
4 If a person's rights were not respected by his or her partner for a long time, how would
this affect their relationship?
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Love in relationships
There are different kinds of love, and you can feel different kinds of love for different
people at the same time. The love that you feel for members of your family is different
from the love that you may feel for your boyfriend or girlfriend.
Adolescents sometimes feel that they are in love, and this feeling may last for a few
days, a few months or longer. People also talk about "falling in love" and this kind of
love is known as romantic love. Although it may be very exciting at first, many people
find that making a relationship work is not always easy, and so the relationship may
end. However, you can learn a lot about the way that relationships work by being in a
relationship, and so it may be easier the next time you have a relationship.
When love lasts for a long period of time, it is usually known as mature love and has
a number of special qualities, When people have mature love, their relationship has
many interesting parts (not just sex) and they are able to deal with the challenges and
problems that arise without giving up easily. Both partners understand the rights and
responsibilities that they share and are committed to make the relationship work in
good times and in bad times.
~ Do, think and decide

1 Interview the members of your class and ask them to name one of the qualities they
believe describes mature love and romantic love. Copy and complete the table below
including:·theideas of your classmates.
'.
Mature love Romantic love
Both partnersrespect eachother One personmay havemore power over
the other
The relationshiphasmany interestingparts One persontries to pleasethe other
Both partnersare ableto communicatewell Sexmay be the most important part of the
with eachother relationship
-
2 Write a short story about a relationship that shows two people who are in a romantic love
relationship.
3 What are three advantages and three disadvantages of being involved in a romantic
relationship?
Discuss and respond

People sometimes talk about "falling in love': In groups, discuss why you think we use
this expression. Share your ideas with other groups.
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SEXUAL RELATIONSHIPS Lesson

It is normal to have sexual feelings, and these can begin when we are still children,
When they grow up most people want to have a sexual relationship, and sooner or
later you will have to make sexual decisions, When you make decisions about sexual
behaviour, it is usually based on the values that you get from important people in your
2
life such as family, friends, teachers and members of your church or religion, These
decisions show the respect that you have for yourself as well as the respect that you
have for other people,
One of the most important things for you to decide is whether you are ready to have a
sexual relationship, Just because your body is physically mature does not always mean
that you are ready to cope with the responsibility of having a sexual relationship, For
example, when they are students, many young people decide that it is not the right
time to be so closely involved with another person, This can prevent a lot of problems
and difficult decisions in the future, When you make a decision to wait until you are
ready, it shows that you have thought about the possible result of your actions and care
about your future, When you follow your decision and put it into practice, it shows that
you are a strong person and know how to behave responsibly,
If you decide to have a girlfriend or boyfriend, then you should decide how far you will
go in your relationship before things start to happen, Sexual feelings are very strong
and you can easily do things that you will be sorry about later on, There are many things
you .can do to show your feelings for each other and that are enjoyable, such as holding
hands, kissing and touching, These are all ways that we can enjoy our sexual feelings,
You do not need to have sexual intercourse in order to enjoy being with somebody else,

1 Copy and complete the following quiz, saying whether each statement is true or false,
Compare your answers with a partner's and talk about them with the rest of your class,
(Youcan check your answers by looking at the end of the unit)
I.' How much do you know?

~ Answer t~!1eor false.
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1 A girl can become pregnant after she has begun to have her periods.
2 You must have sex several times before a girl can become pregnant.
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3 The only way to make sure that a girl does not become pregnant is not to have
sexual intercourse.
4 You only need to use contraception if you have sex with more than one person.
1 5 If a girl does not want to become pregnant then it is up to her to make sure she
usescontraception-it is not the boy's responsibility.
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6 Condoms do not reduce the risk of catching a sexually transmitted infection.
8 If young people know more about sex, it will encourage them to start having
sex at a younger age.
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l (~~swers on page 57)
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2 In many communities people do not talk about sexuality and issuesrelated to sexuality
when they have a relationship. Explainwhy this happens.
Rights and responsibilities

Lesson
When you have a relationship with somebody, it takes time to get to know each other
3 well and to find out if you are suitable for each other. It also takes time to find out how
you want your relationship to develop. Sometimes young people are in too much of a
hurry and do things that they feel sorry about later. We can all do things that we regret,
so it is best to think before you do anything. If you are not sure and cannot make up
your mind, then it is best to do nothing until you are ready to make a decision.
When you are in a relationship both people have rights and responsibilities. You should
talk to each other, listen to each other and respect each other. One person should not
force another person to do something that he or she does not want to do. You should
be assertive or stand up for yourself so that you don't do something that you don't
agree with. You need to be confident about your beliefs and values. You should be able
to decide what you will and will not do. You need to make this clear to your partner, and
then make sure that you do not change your mind.
~ Do, think and decide'

1 Make a list of your rights and responsibilities when yC?uhave a sexual relationship.
2 What things will you consider when you decide to have a sexual relationship with another
person?
3 What advice would you give to a friend who asks you whether he or she should have
sex in a relationship in which he or she is involved?What things should your friend think
about in this situation?
Dealing with pressure to have sex
Some young people try to force their girlfriends or boyfriends to have sexual intercourse
when they do not want to. It can be very difficult when the person that you want to
be with is trying to make you do something that you really don't want to do. For this
reason, it is important to think about these things beforehand, to assert yourself and not
to change your mind and give in to the pressure. For example, if someone encourages
you to drink alcohol and your self-control is reduced, then you might have sex more
easily. Some of the things that people might say to put pressure on you, or try to force
you, are shown below.
If you really loved me . If you don't have sex

you would show it by with me then I will Boys have a lot of sexual
letting me have sex leave you and find tension inside. If you don't let
with you. someone who will. . me show the way that I feel
for you then I will get sick.
Everybody else If you don't do it, I will

is doing it, so still tell everyone that
why can't we? you did, so they will all
. think we did it anyway.
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Some of the ways that can help you deal with the pressure to have sex are shown in the box below,
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Focus on the problem, not the other person.
Focuson the needs of you and your partner, not their position on the problem.
Emphasisecommon ground-what do you agree about?
~ •• Be creative about options-try to think of new ideas or solutions.
\ Make a clear agreement that you both understand.

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Elsie and Patrick

Elsie and Patrick have been friends since they
were in Grade 9 but have been trying to keep
it a secret, They spend time together when
they can and like to hold handsand sometimes
kiss and cuddle each other. They have both
agreed that they are not ready to have sex,
butjust recently after a school dance they met
alone and started to feel very excited. Now
Elsie is worried that in the future they might
lose control and have sex, even though they
have both said that they do not want to.
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Felicity and Joseph

Joseph is in Grade 10 and has told Felicity's friends
that he would like to make friends with Felicity,
Felicity is in Grade 9 and boys in Grade 10 don't
usually look at girls in her grade. Felicity doesn't think
that she is very pretty and so she is pleased that
an older boy is interested in her. She doesn't know
much about him although some girls have told her that
he already has a girlfriend and only wants her so that
he can have sex with her and then he will dump her,
She is not sure if this is true or if the other girls are
~jealous because he is interested in her and they think
he is good looking.
m Do, think and decide

Look at each of the examples on page 11 Copy each example in your book and explain
what should happen in each case. Describe how the other person should respond.
2 Readthe story of Elsie and Patrick.
a What do you think Elsie and Patrickshould do?
b Why do some people end up doing something that they do not want to do when they
are in a situation like this?
3 Readthe story of Felicity and Joseph,
a What do you think Felicity and Joseph should do?
b How can Felicity be assertive in this situation?
4 When young people have sex before they are ready,what are likely to be the results both
in the short-term and in the long-term?
Discuss and respond

Have a class discussion on the story of Elsie and Patrickand the story of Felicity and
Joseph.
a How can each of the individuals involved be assertive with the other person?
b Why do some people find it difficult to say" no" when they are in a situation like this?
c How can each couple sort out their situation?
d What suggestions would you make for each of the individuals involved?
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FAMILY PLANNING AND
CONTRACEPTION
You need to look after your own sexual health and well-being, and when you are in a
relationship you also need to look after the sexual health and well-being of your partner.
The two main risks to your health and well-being are unplanned pregnancy and catching a
sexually transmitted infection. You can prevent pregnancy by using one of the methods of
New word
family planning or contraception. Some methods of contraception are more effective than
contraceptives---
others, and some also help to prevent the spread of sexually transmitted infections.
drugs,equipment
or methodsthat are .#. .: •
f! .e
usedto preventa
womanbecoming Family planning and counselling
pregnant
Couples can get help, advice and supplies from Maternal and Child Health (MCH)
clinics run by the Department of Health in the provinces.
A couple can plan their family by choosing the number of children they want and
spacing the births of their children. For a long time, people in Papua New Guinea have
used traditional customs and their knowledge of plants that grow in the bush to plan
their families. There are also modern methods of family planning and some of these are
described on pages 16-19.

1 List some of the reasons why people use family planning.
2 Why do people who live in traditional village societies often choose to have large
families?
Discuss and respond
In groups discuss the following:
1 What are the advantages for children to be part of a small, well-spaced family?
2 What are the advantages for women to have small, well-spaced families?
3 What are the disadvantages of small, well-spaced families from the point of view of both parents and children?
4 Look at the box "What size family do you want?" Think about your future and discuss your responses to each of
the questions.
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Methods of family planning

Ovulation method
A woman can only become pregnant for a few days each month close to the time of
ovulation, which is when she produces an egg. Ovulation usually occurs about fourteen
days before the start of her period. When she is fertile a woman can also feel clear,
slippery mucus in her vagina which will stretch between two fingers. When a woman
keeps a record of her periods and mucus days on an ovulation chart each month, it will
help her to know when she is fertile. If a couple want to have a baby then they must
have sexual intercourse close to the time of ovulation. If a couple do not want to have a
baby then sexual intercourse must be avoided at this time.
The ovulation method is a natural method of family planning but it is not always
reliable because some women find it hard to know when they are ovulating. Another
disadvantage is that the couple can only have sexual intercourse for about three or
four days after the end of the woman's period and for about ten days before her next
period. Both the man and woman must communicate and cooperate to make this
method work well.
Mucus days
Menstruation
14
Late safe days
A chart used for the ovuiation method of family planning

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fertile mucus infertile mucus
When a woman is fertile the mucus from her vagina will stretch between two fingers
Sperm can live in the

vagina for two or three
Yes, I have a 26-day cycle so ovulation
In different women the length days, so you can become
will be between day 9 and 12. My sister
of the menstrual cycle can be pregnant when you have
has a 31-day cycle so her ovulation will
longer or shorter, so the time sexual intercourse either
be between day 14 and 17.
of ovulation will be different. before or after ovulation.
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Condoms
A condom is a thin rubber skin that a man unrolls onto his
erect penis before sexual intercourse, The semen is caught
inside the condom so that the sperm cannot fertilise the egg,
After sexual intercourse the man must hold on to the condom
when he removes his penis from the vagina so that the
semen does not spill inside the vagina.
Condoms are an effective method of family planning when
they are used properly and also help to provide protection
against sexually transmitted infections. The condom is a contraceptive and also prevents
the spread of sexually transmitted infections
Condoms are available from family planning clinics and can
also be bought in trade stores, supermarkets and chemists.
The pill
The pill is a tablet that contains special chemicals that prevent a woman ovulating. The
tablets usually come in special packets of twenty-eight pills, one for each day of the
month. The woman takes one pill at the same time each day until the packet is finished.
The woman will have her "period" during the last week and when the packet is finished
she must begin a new packet. When a woman wants to have a baby then she can stop
taking the pill and she can become pregnant.
The pill is a very effective and reliable method of family planning and can make a
woman's moods more stable. However, there can also be some disadvantages. For
example, some women gain weight, have painful breasts and may feel sick. Blood clots
can also occur in the veins and arteries.
The pill
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Injections - Depo-Provera
Depo-Provera is a contraceptive that is given to a woman every
three months as an injection by a doctor or nurse. Depo-Provera
works in the same way as the pill by stopping ovulation so the
woman will not produce any eggs.
Depo-Provera is an effective and reliable method of contraception,
but in Papua New Guinea it is given only to women who have
already had children because it sometimes stops the release of
eggs permanently.
Intra-uterine device (IUD)

The intra-uterine device or IUD is a small piece of plastic that is
placed inside the woman's uterus by a doctor or nurse. The best
time for a woman to be given the IUD is after the birth of a child
and so it is usually given only to women who have already had
children. The IUD can remain inside the uterus for several years
and can be removed when the woman wants to have another
baby. A small string hangs down into the cervix so the woman can
An intra-uterine device inside the uterus
check that the IUD is still in the uterus. It is an effective method
of contraception but it can cause heavy periods and period pain.
Sterilisation
Both men and women can have an operation that prevents them from having children.
In men, the sperm tubes are cut or tied. This is called vasectomy. In women, the egg
tubes are cut or tied. This is called tubal ligation. These operations cannot usually
be reversed and so they are given to either the man or the woman when they have
decided that they do not want to have any more children.

1 a What is family planning?
b What are contraceptives?
2 What are the traditional methods of family planning that are used in your area?
3 Draw a table to compare the different methods of family planning. Choose suitable
headings for your columns. Show your table to a partner and discuss any similarities
and differences.
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Lessons
Pregnancy and early child development
The main steps in the early development of a baby from the time of the fertilisation of
2 the egg until it is born are as follows.

• During sexual intercourse the penis moves backwards and forwards in the vagina
and eventually semen is ejaculated that contains millions of sperm.
3 • Some sperm pass through the cervix into the uterus and begin to swim up the
oviducts or fallopian tubes.
• When an egg is moving down the oviduct one of these sperm may combine with it
to form a fertilised egg. When this happens it is called conception or fertilisation
and as a result the woman will be pregnant. The rest of the sperm all die within a
few days.
• When no egg is present in the oviduct, all the sperm die.
• The fertilised egg takes about a week to pass down the oviduct to the uterus. The
egg divides many times to make a ball of cells called the embryo.
• The embryo then sinks into the soft lining of the uterus which has grown to receive
it. This is called implantation.
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4 cells carryon dividing 3 fertilised egg divides into

to make a ball of cells two cells
5 when the hollow ball of

cells arrives in the uterus
it is about four days old
placenta forming
6 the embryo sinks

into the soft lining
of the uterus
What happensfrom ovulationto implantation

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The first sign that a woman is

Some women do not
pregnant is when her periods
have their periods when
stop, although periods can
they are breast feeding,
stop for other reasons too.
which helps to prevent
them becoming pregnant
again too quickly.
• A special organ starts growing from the embryo and

the mother. This is called the placenta. The placenta
is attached to the embryo by the umbilical cord.
• The umbilical cord contains three blood vessels. One
carries dissolved food and oxygen and food to the
embryo and the other two carry waste products away.
• About three months after fertilisation bones begi.n to
umbilical cord
form, the embryo looks more like a baby and is called
a foetus.
• The foetus continues to grow and develop inside the
baby
uterus until it is thirty-eight weeks old.
• When the baby is ready to be born, the muscles of the amniotic sac
uterus contract and gradually open the cervix so that
the baby can be pushed out. This process is called
A fully developed baby in the uterus
labour and is also known as delivery of the baby.
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Antenatal care
Pregnancy can be a dangerous time for women and their babies, and in Papua New
New word
Guinea many women die when they are giving birth. When we understand the
antenatalcare-
risks, there are many things that we can do to look after the mother and her baby
the way we look
after mothers when so that they both stay healthy. The management of pregnancy is called antenatal
they are pregnant care and prepares the mother for a normal delivery and for looking after the baby.
so that they stay
healthy and have Some women have a greater chance of having problems and are known as high
healthy babies risk mothers. Women who have a high risk are those who are having their first
baby, women who have had four or more children already, and women who are
having problems with their pregnancy or who have had problems in the past when
giving birth.
Women having their first baby Women having their fifth and later babies
High risk mothers should go to the health centre for delivery

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Did you know?

~ Ten things pregnant mothers should do
Accordingto the
law in PapuaNew Do normal work but get plenty of rest. Do not carry or lift heavy things because
Guinea,mothers this can harm the baby.
cannotbuy bottles
for feedingbabies 2 Eatplenty of different kinds of food to help the baby grow and develop properly.
unlessthey havea 3 Do not smoke or drink alcohol, both of which harm the baby.
prescriptionfrom a
doctor.Themain 4 Do not take medicines unless they are given by a health worker because these
reasonsfor this can harm the baby.
law are:
5 Attend the antenatal clinic regularly to be checked by health workers.
• Many mothers
are not ableto 6 Be able to recognise the signs that labour is starting-such as regular
steriIisebottles contractions, slight bleeding or liquid coming from the vagina.
properlyto kill
germs. 7 Make plans about where the baby will be born.
• Bacteriacan B Wash every day and wear clean, loose clothes to prevent infection.
grow in warm
milk in the bottle 9 Go to the hospital, health centre or aid post if the mother has any problems
and can make such as bleeding, fever, cough, pain when passing urine or vaginal discharge.
the babysick.
• Many mothers ~ 10 Make plans about what family planning method she will use after the baby
are not able & is born.
to storethe ),
preparedmilk in
a refrigeratorto
keepit safe.
• Motherswho
cannotread
Englishmay not
be ableto follow
the instructions
on the sideof
the can of milk
powder.
Breastmilk does
not haveany of
theseproblems
and so is bestfor
babies.
Wash newborn babies every day
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1 Describe some of the things that women should do and
should not do to stay healthy when they are pregnant.
Remember to give reasons why they should or should
not do these things.
2 Explainwhy breast feeding is best for babies.
3 Make a list of some of the ways that parents take care of

small children. Why is parental care important in humans?
4 Make a poster to encourage pregnant women to

do something that will help them or their babies to
be healthy.
Discuss and respond

Make groups of five or six students and discuss the law
in PapuaNew Guineathat controls the availability of
bottles for bottle feeding of babies. Do you think this is a
good law? Give reasons for your opinions and be ready to
share your ideas with other groups.
Breast feeding is the best food for babies. It also contains

antibodies that help protect the baby from disease
People can get family

planning supplies and
advice from clinics that are
run by the Department of
Health at health centres
and hospitals.
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SEXUALLY TRANSMITTED INFECTIONS Lessons

Sexually transmitted infections or STls are usually spread by having sexual intercourse
with another person who has the infection. Sexually transmitted infections are
sometimes called sexually transmitted diseases (STDs) or venereal diseases. There are
many different sexually transmitted infections, but the four most important in Papua
1
New Guinea are gonorrhoea, syphilis, Donovanosis and HIV/AIDS.
gJ
, .SexuallY transmitted infections
2
~ gonorrhoea
• syphilis
• genital warts
• genital herpes
3
• Donovanosis • thrush
• trichomoniasis Did you know?

• HIV/AIDS
hepatitis B • bacterial vaginosis Some people can
catch a sexually
non-specific urethritis • pubic lice transmitted
infection but do
chlamydia • scabies not have any
pelvic inflammatory disease (PID) symptoms so they
might not know
that they have
got the disease.
Gonorrhoea . However, they are
• Gonorrhoea is the most common sexually transmitted infection in Papua New sti II carriers of the
Guinea. disease and can
pass it on to other
• It is caused by bacteria that live in warm, moist places such as the urethra and people who will
the vagina. usually get sick
later. Syphilis and
• The symptoms usually appear from three to seven days after sexual contact with HIV are examples
an infected partner. of this sort of
disease.
• In males the symptoms are feeling the need to pass urine many-times, a burning
pain when passing urine and a discharge of pus from the end of the penis.
• Females usually have the same symptoms but they are much more difficult to
notice, and females often do not know that they have the disease. It is normal
for healthy females to have some discharge from the vagina, but when there is
infection, there will usually be more discharge than normal.
• Any person who gets any of these symptoms should go to the clinic or hospital to
get medical help. Gonorrhoea can be treated with penicillin or other antibiotics.
• When the disease is not treated the symptoms will slowly disappear, but this does
not mean that the person is cured. The bacteria are still inside the body and may
cause sterility if they spread to the oviducts or sperm tubes. This means the person
will not be able to become a father or a mother.
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Syphilis
• Syphilis is less common than gonorrhoea but much more serious.
• It is caused by bacteria that live around the sex organs, in the mouth and in the blood.
• The symptoms can appear from one week to three months after sexual contact with an infected
partner.
• At first there is a small, painless sore on the penis or outside the vagina. This sore has a regular
shape and hard edge but goes away in about six weeks, even if no treatment is given.
• Weeks or months later some or all of the following symptoms may appear:
a rash of small red marks on all parts of the body
enlarged lymph glands
fever
sores on moist areas of the body, such as mouth, sex organs and armpits.
• The person is very infectious at this stage.
• Without treatment the symptoms go away, but the person is not cured and the syphilis continues
to destroy the body.
• Between five and twenty years later there may be symptoms in different parts of the body such
as the heart, brain and bones.
• Syphilis can be treated with injections of penicillin, but when it is not treated it can eventually result
in death.
syphilis ulcer on male penis syphilis ulcer on female genitals
Syphilis produces painless sores on the sex organs

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GONORRHOEA In men In women
It hurts to pass urine

Yellow discharge
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Over half have no symptoms
Hurts to pass urine
Yellow discharge
Sterile because
sperm duct blocked
Bladder problems
)1 Sterile because egg tube blocked
If an infected woman has a baby,

it may become blind if untreated
~
SYPHILIS In women
III
E
Sore sex organs
!E Weeks and Sore on sex organs and
months later- rash as in men
~ copper-coloured
rash on body
... Years later- Babies may be badly damaged

$
blindness, heart
...
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trouble, madness and
in the uterus
Years later-as for men
a:I then death
A comparison of gonorrhoea and syphilis in men and women

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Donovanosis
• Donovanosis is less common than gonorrhoea and less serious than syphilis but causes permanent
damage if not treated early.
• It is caused by bacteria that live in warm, moist places.
• Symptoms develop between one and six weeks after sexual contact with an infected partner.
• First, small sores or ulcers appear in or around the sex organs. The edges are raised and hard and
there is a watery discharge with a bad smell.
• The ulcers are often painful and look like a piece of raw meat. If they are not treated, the ulcers
gradually get bigger and parts of the genitals are eaten away.
• Donovanosis can be treated by using an antibiotic called chloramphenicol over a period of three
weeks or until the ulcers_have disappeared.
When people have a

sexually transmitted infection,
their partners need to come
and get treated too. This is
called contact tracing.
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Don't die of embarrassment
If you think that you might have caught a sexually transmitted infection, it is important to go and get tested.
Gonorrhoea, syphilis and Donovanosis can all be cured if treated early enough. Your sexual partner or
partners should also be tested because they may also be infected.
Lucy's story
Some defence force soldiers came to the
town to do some trainingand there was a
dance at the school. One of the soldiers
was very interested in me and bought me a
soft drink from the canteen. I was pleased
because I wasjust a schoolgirl and he was in
the defence force-and he was good looking
too. His name was Diro.
~ Anyway, instead of going back to the dance
Diro took me to the long grass behind the
hall and we had sex. It was my first time and
I didn't know what to do. It all happened so
qutcklq, I was stupid because I already had
a boyfriend called Jerome at school, but he
had gone home to his village because his
father had died.
Jerome came back a couple of weeks later and he was still upset because of his father.
When I was trying to comfort him we got carried away and ended up having sex. A few
days later I started getting this burning pain when I passed urine and I also got a thick
discharge that stained my panties. I knew something was wrong, but I felt shame about
going to the clinic.
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Did !:J ou know? HIV/AIDS An opportunistic infection is an

infection that you get when your
Acquired means In the 1980s a new disease began to
immune system is low and allows
obtained appear in some parts of the world. disease-causing organisms to
Immune meansthe In Africa it was called "slim disease" infect your body.
systemof the body because many of the people who got
that protectsus it lost a lot of weight and eventually
againstdisease
died. At first doctors did not understand
Deficiency is a how the disease was spread but after a
lack of something
few years they found out that it was a
Syndrome is a
sexually transmitted disease that affects
groupor setof
conditionsthat the immune system of the body. The
showsyou havea disease was called Acquired Immune
particulardisease Deficiency Syndrome or AIDS, and it
is caused by a virus called the Human
Immunodeficiency Virus or HIV.
The immune system of the body
protects us against disease and helps
us to fight infection caused by bacteria
and viruses. However, the HIV virus
causes the immune system of the
body to lose its ability to fight infection.
Diseases such as pneumonia and cancer
can then use the chance to attack the
body because it is weak, and so they
are known as opportunistic infections.
These diseases continue to develop until
the patient dies.
How is HIV transmitted?
In order to be transmitted the virus must leave the body of an infected person and enter
the bloodstream of an uninfected person. This can happen when people exchange body
fluids such as blood, semen or vaginal fluid, and also from mother to child. There must
be enough of the virus present in order for it to be infective. '-{
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Ways HIV can be transmitted
• during sexual intercourse with an infected person
• when giving an injection if needles and syringes are being reused
• when giving tattoos and during traditional ceremonies that cut the skin
~ • from an infected mother to her baby before birth, during birth or when
~ breastfeeding.
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m Ways HIV cannot be transmitted

mosquitoes or other insects
• coughing and sneezing
hugging and kissing
sharing cups, plates and spoons
sharing towels and bed sheets
sharing the same toilet.
People who are infected with the virus are described as HIV-positive, and when they have sex they continue
to spread the virus without knowing.
There are no symptoms that are special to this disease. However, people with AIDS often have diarrhoea
that lasts for a long time, so the person usually loses a lot of weight, feels very tired and also has fever. Other
symptoms are night sweats, pneumonia and tuberculosis. However, because the virus affects the immune
system of the body, a person with the virus can be affected by any infection.
There is no vaccine to prevent AIDS and there is no medicine to cure a person who has caught the virus. In
some parts of the world, medicine is available to treat people with AIDS, but this treatment is expensive and
not always available. People can live for many years after they have got the virus, but in Papua New Guinea it
is usually a fatal disease and it seems that people who get the virus get sick and eventually die.

1 Explainwhat is meant by a sexually transmitted infection.
2 Explainwhy contact tracing is important. What will happen if a partner of a person with a sexually transmitted
infection is nottreated?
3 What are the similarities and differences between sexually transmitted infections and other diseases?
4 Copy and complete the following table in your exercise book.
Sexually transmitted How it spreads Symptoms How it is treated

infection i ,
gonorrhoea
syphilis ,
. .. .
- . I'
, .'
Donovanosis
HIV/AIDS
5 Use a library to find out information about some of the other sexually transmitted infections such as hepatitis and
pelvic inflammatory disease.
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Discuss and respond

1 With a partner, read Lucy's story on page 29. Discuss the following questions and write down your answers.
a Why did Lucy have sex with Diro? Do you think her reasons were good ones?
b Why did Lucy have sex with Jerome? Do you think her reasons were good ones?
c Do you think Diro and Jerome used a condom when they had sex with Lucy? Explain why or why not.
d For each of the three people in the story, explain how their own behaviour affects them and how it affects each
of the others.
2 With a partner, read the following case studies and decide whether there is no risk, low risk or high risk of
catching or passing on a sexually transmitted infection. Explainyour reasons for each situation and write down
your answers.
'121
~ No risk, low risk or high risk?
Ife has started making friends with Gaima. When they go out they have been kissing and cuddling very
closely with each other. .
Kopia has recently found out he has a sexually transmitted infection called herpes. He is afraid that if
he tells his partner, she will be very cross and will stop having sex with him, so he has decided not to
I
tell her.
3 Korninika is sexually active but always uses a condom when he has sex. He carries a condom in his
pocket when he goes out in case he gets lucky.
'4 lara has had many boyfriends. She wants to follow the teaching of her church and parents and she has
decided that she will not have sexual intercourse until she is married. However, she sometimes gets
very excited when she is with her boyfriend and has almost had sex on several occasions.
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Prejudice and discrimination

One of the things that can happen to a person with a sexually transmitted infection
such as HIV or who gets sick with AIDS is that people will discriminate against them.
When we discriminate against a person we do not treat them well or fairly.
It is easy to make judgments or decisions about other people and the way they behave.
We usually see other people from our own point of view and what we think is normal.
When people are different from us, we often think that their ideas or ways are not
as good as ours. It is easier to think that they are strange than to try to change the way
that we think. Very often we make up our mind about something before we
have enough information. When we make decisions like this that are unfair it is Discrimination
known as prejudice. means that we treat
people unfairly or in
When we think other people are different, or we do not understand them a different way from
or do not respect them, then prejudice can develop. We may other people
judge other people because we are afraid or do not understand. or groups.
However, if we are humble, show respect and are ready to

accept different ideas and different ways of doing things, then
we will not need to judge other people or criticise them. Before
we can respect other people we must have self-respect
Why do we discriminate against

other people?
Most people do not like to feel discrimination and so we
should not discriminate against other people. Discrimination
may happen because:
• we do not like or do not trust people just because they are
different in some way from us
• we judge a group of people or make up our mind by looking
at the actions and attitudes of only a few and think that the
whole group is all the same
• we think that what we believe and how we live and behave
is the only way or the right way to believe, live and behave.
New word
Discrimination may be something that we learn when we are
prejudice-to
children. We see the way that our parents and other adults in strongly like or
the community behave and respond to people from another dislike something
place, or who belong to another religion or who are different in some way. We may or somebody
learn to respond in the same way and never stop to think if this is fair. Even if you do
without good
reasons
think for yourself and decide to act in a differ.ent way, it can be hard to go against the
view of most people in the community.
Sometimes discrimination against a group can begin or get worse after a few members
of the group do something that is bad. For example, on 11 September 2001, terrorists
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hijacked four commercial jet aeroplanes and flew two of them into the Twin Towers of the World Trade Centre
in New York City. These were the two tallest buildings in New York City and both caught fire and fell down.
A third aeroplane crashed into the Pentagon near Washington and the fourth crashed into a field. There were
no survivors from the aeroplanes and nearly 3000 people died altogether, which was a big shock to people
everywhere. A Muslim group was blamed and discrimination against Muslims increased both in the United
States and in other parts of the world. However, most Muslims are peaceful people who do not kill others, and
they were as shocked as many non-Muslim people when terrorists attacked the Twin Towers.

1 People can show prejudice and discrimination in different ways. Give an example based on each of the following:
a the province or country a person comes from
b religion
cage
d disability
e gender
f sexual orientation (for example, being homosexual)
2 Look at the questionnaire "What should you do?" on page 35. For each question there are three choices, Each
of them is an easy way to respond to the situation. With a partner, think of a better way to respond and write it
down in your notebook as the fourth choice (d).
Discuss and respond

1 Make groups of four or five students and discuss the following:
I
~
The world would be a better place if we did not discriminate against a particular group because of the
behaviour of a few members of that group but learned to look at people as individuals.
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2 How would people in your community respond if a person with HIV came to live in the community? Would they
suffer from discrimination? Explainthe reasons,
!,! W1hat should. ypu do?

When someone tells bad stories about somebody from a different province, what do you do?
a feel happy because the story was not about you

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b laugh because everybody else.is laughing

c join in by telling your own story about people from other provinces
d
2 When your friends try to force you to do something that is wrong, what do you do?
a join in because you want to be part of the group

b blame someone else because you got involved
c feel bad because they make fun ofyou if you don't join in
d
3 C When someone saysthat girls and women are not as strong as boys and men, what do you do?
a agree becauseyou ate a boy

".- -"""
b disagree because you are a girl
c 'give your own examples to.show that females are weak
ta
d
.a keep quietand hope the teacher doesn't look at you

b complain about ~heteacher to your friends later
~
e c think that you are lucl<y'becausethe teacher didn't blame you
~ 5 dwhen ",moone says that if a pe""n gets HIV it is always the;, own fault, what do you do?
,t . a "agree with them even though this is not true

~ b keep quiet even though youknow this is not true
~ c hope that nobody will ask yo~ what you think
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The effect of HIV on the community

We can look at countries in Africa to understand what happens to people when there is
an epidemic of HIV and AIDS. The virus occurred there before it arrived in Papua New
Guinea and other parts of the world. There are many similarities between countries in
Africa and countries in the Pacific and we can learn by looking at what has happened
in other countries. Some of the effects of HIV and AIDS that have happened in
communities in Africa are shown in the box below.
~
The effects of HIV and AIDS on the
I community
II able to treat all the sick people.

2 The number of people dying increases-especially the adults who make
1f gardens and take care of children and old people. "-
3 There is a shortage of people to do the work that is needed such as working

on plantations, working for the government and in businesses.This affects the
~ 4 ~:""OU:b::::c~;:,:::~:d a::eo::~:::;ncreases Orphans ace

chi ldren
whose parents have died.
5 When men die, mothers or grandmothers must take care of children on

their own.
6 When both parents die, sometimes children take care of themselves and older !.
children become the "mother" and "father" to the younger ones.
I
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7
9
Children and adults do not get enough food to eat.
There is no longer about the same number of males and females in an

age group.
More young adults may leave the village and move to town.
t 10 The number of children going to school gets smaller.
, 11 The number of children dropping out of school increases.

~
~ 12 The community loses people with a lot of knowledge and experience.
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Hospitals will not be able You might have to go to

to cope with the number two funerals every week
of people who are sick because someone you
and dying from AIDS. know has died.

1 Look at the box that shows "The effects of HIV and AIDS on the community':
a Choose three effects and explain in more detail what you think will happen to the community because of
each effect.
b Choose three effects and say what you think will happen in PapuaNew Guinea if the epidemic of HIV and
AIDS develops in the way that it has in Africa,
c Write down any other effects you can think of and explain why you think they are important.
2 In PapuaNew Guinea what will be the effect of the epidemic of HIV and AIDS on each of the following:
a the children
b the loss and grief that people feel
c the workforce
d the economy of the country,
Discuss and respond

Make groups of four or five students and do the following:
a Discuss what you think will be the effect of HIV and AIDS on communities in PapuaNew Guinea.
b Make a list of things that people in the community can do to help prevent the spread of HIV.
c Make a list of things that the community can do to help people who get sick with AIDS.
d Share your ideas with other groups.
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HIV and AIDS in PNG

It is difficult to know the exact numbers of people with HIV and AIDS because some
people can be infected without having any symptoms, and not everybody who is sick
goes to a health centre or hospital. Also, people with AIDS suffer from a number of
different sicknesses which may be written down on their record instead of AIDS.
However, the information available up to 2006 is shown in the graphs and table below.
The spread of HIVIAIDS in PNG
ReportedHIV/AIDSinfections in PNG
16,000 (1987-2006)
14.467
14,000 • New cases
o Cumulative cases
12,000
'"Cll
en
co 10,000
-
o
0
Qi
.0
8,000
6.469
8,785
•
E 6,000
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Z 4,755
4,000 3,442
2,000
6 19
6 13
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Key to graphs
~ ~ ~ ~ ~ ~ ~ ~ ~ * ~ * ~ ~~~~
~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~~~~~~ .~
Yearof detection
cumulative-
adding the number
HIV/AIDSinfections reported in PNG,
of cases together by province of detection (1987- 2006)
perinatal-
Eastern Highlands Province, _
around the time of Enga & other provinces
the birth of the baby 3,744 20% National
Capital District
mode of Morobe
9,312 52%
1,673 9%
transmission-
method or way the
Western Highlands Province ---~
virus is spread 3,554 19%
orphan-
a child wliose HIV infections reported in PNG,
parents have died by mode oftransmission (1987-2006)
6,000
ART-
5,000
anti-retroviral .Male
therapy, or medicine 4,000 o Female
used to treat people 3,000 o Unknown
with HIV 2,000 ,I
indicators-
signs or information
that tells us about
1,000
o t::::l
Heterosexual Homosexual Pennatal Blood Contaminated
n
Mode
transfusion needle not recorded
something Mode of transmission
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Mode of transmission
Key indicators on the HIV epidemic
.2003
D2005
D2007
1,098
300
People living with AIDS deaths Orphans due to ART treatment

HIV/AIDS AIDS
Indicator
PNGYearbook 2008
How the epidemic of HIV and AIDS affects the community
How are people affected? 2003 2005 2007 Future?

Adults and children living with HIV/AIDS 19738 32904 56175 1000000
Deaths in adults and children due to AIDS deaths 2185 3871 5995 ~qCf vn'l
Orphans (0-17) living with HIV or AI DS 1 549 2704 3730 666
Adapted from the PNGYearbook 2008

Look at the graphs that show the spread of HIV/AIDS in PNG and the key that explains new words (page 38),
In your notebook write about each graph as follows:
a Describe the pattern of HIV/AIDS infections from 1987 to 2006 for both new cases and cumulative cases.
b Describe the pattern of HIV/AIDS infections according to the province in which they were found.
c Describe the pattern of HIV infections according to the way the virus was spread.
d What are the key indicators of the HIV epidemic? How did they change from 2003 to 20077
2 Look at the table above that shows how the epidemic of HIV is affecting the community.
a Write down any other ways that you think people will be affected.
b For each of the ways that people are affected, describe what you think is going to happen in the future.
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Reducing the spread of HIV

Lesson
We understand how the virus is spread from person to person, so we can reduce the risk
3 of catching HIV by behaving in ways that are safe and avoiding ways that are unsafe.
When a person has HIV then the virus will be found in their body fluids, especially a
man's semen, a woman's vaginal fluid and their blood. This means that you can protect
yourself by making sure that you do not get the semen, vaginal fluid or blood of another
Did you know? person into your body.
Duringvaginal
intercourseit is
easierfor a female Ways to prevent the spread of HIV
to catch HIV from during sex
herpartnerthan
it is for a maleto A = Abstinence-do not have sex.
catch it from a B = Be faithful to one uninfected partner. Do not have sex before you get married
,
femalepartner. and when you get married have sex only with your wife or husband.
C = Use condoms.
D = Delay or postpone sexual intercourse. Do not start having sex until you are
Did you know? ready for the responsibility of what may happen.
Anal intercourse ~
increasesthe risk
of spreadingHIV
becausethe semen i.HOW to avoid the spread of HIV in blood
may mix with
smallamountsof
blood. I.
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Do not touch the blood of another person, especially if you have any small cuts
on your hands.
If you have to help someone who is bleeding, try to wear special rubber gloves. If
@ you do not have special gloves then make sure you wash the blood off your body
I
with plenty of water as soon as possible.
When blood spills onto any surface, wash the surface with soap and water as
I
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soon as possible.
~. If you are injured when you are playing sport and you start bleeding, you should
@ stop playing and go off the sports field straight away.
, • Cover any wound that is bleeding with a dressing.
~ • Make sure that you do not get an injection with a needle that hasbeen used on
, somebody else and may contain a small amount of their blood.
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Another student has cut himself and you are the only person who can help. You have a small cut on your hand but
it is covered with a clean Band-Aid.What should you do? Explainwhy.
2 You are playing rugby and one of the players hurts himself and starts to bleed. The blood gets on your legs and
onto other players too. What should you do? Explainwhy.
3 You go to the health centre and you notice that the health worker is going to give you an injection with a needle
that you have just seen him use on another patient. What should you do? Explainwhy.
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STRATEGIES FOR KEEPING MYSELF

SAFE
When you have a relationship there are a number of things that you can do in order to
keep yourself safe. Each person needs to allow the other person to make choices about
whether to become sexually involved and at what level. Having a sexual relationship
is a shared experience which should be discussed or negotiated before you make
a decision about what to do. In this way each person can protect herself or himself
from the responsibility of becoming a mother or father before they are ready and from
sexually transmitted infections, including HIV.
When you can't or don't want to do something then it is all right to refuse. You have to
be assertive to let the other person know what you want.
g)
II· Remember, when you are ...

• assertive-you show respect for yourself and others
aggressive-you try to force somebody to do something, which means you are

selfish and do not show respect for others
passive-you hide your true feelings and do not resist the things you do not like,
~~ . which shows that you do not respect yourself
~ We can also show these different kinds of behaviour on a range or scale:

~------------------------------------------------------~
~ Passive Assertive Aggressive
~
1 Be assertive
When you are dealing with problems in relationships and being assertive, it is important
to try and remain calm and not get angry. At the same time you should not let the other
person try to change the decision that you have made.
The words that you use to give your point of view, and the way that you use them, are
very important. For example, when you have made up your mind about something, you
should let the other person know in a clear, positive voice that will discourage them
from trying to change your mind. If they do try to make you change, you should tell
the other person that you have made up your mind and will not change. If the other
person continues then you can say that you have something else to do and that you
have to leave.
When someone that you know tries to force you to do something that you do not want
to do, there are a number of things that you can do in order to say no.
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How to say "no"

1 Listen to the other person with respect and do not interrupt. Be polite.
2 Say "no" as simply as possible in a confident way without changing your normal voice.
3 You don't have to give reasons.You have your reasons but you may not want to talk about them.
4 If you do feel like explaining, then keep it simple.
S Stand firm. If the other person does not want to accept your answer, then tell him or her that your mind
is made up and you will not change it. If the person continues, you can try to change the subject or say,
"I'm sorry but I need to go" and then leave.
6 It may help to suggestan alternative if you can.
2 Learn to negotiate
It usually helps if you can think about what you will say before you begin to negotiate so that you can be
prepared. Think about your own needs as well as the needs of the other person. If possible, try to think
of something that you can do that will give you both what you want. Be positive and confident that you
can find a way that will be good for both of you.
Try to respond to the situation rather than reacting to it by doing the following:
• Learn to manage your feelings-negotiation can be an emotional time.
• If the other person accuses you of doing something you did not do or makes a threat, it may be better
to ignore this.
• Try to allow the other person to change their position without feeling shame-for example, by saying
how the situation has changed.
Some of the ways that can help you to negotiate and deal with the pressure to have sex are shown in
the box "Negotiation and sexual activity" (next page).
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Assertiveness is the way that If you are sexually

you behave that shows your active, be assertive,
self-respect and the respect negotiate and make
that you have for others. good decisions.
m
j Negotiation and sexual activity
~ • Talk about the problem, not the other person.
I'· Talk about your Reedsand your partner's needs, not your partner's position on the problem.
~. Emphasisecommon ground-what do you agree about?
~ •• Be creative about options-try to think of new ideas or solutions.
\ Make a clear agreement that you both understand.

\
3 Make decisions
When you make any important decision in your life you should think about it carefully. Decisions about sexual
behaviour are also important and can have an effect on the rest of your life. The young people on the next
page have been thinking about some of the decisions that they need to make when they have a relationship.
One of the first things for you to decide is whether you are ready to have a sexual relationship. Everybody is
different, and if you feel that you are not ready then you have the right to say so. You should not do something
because you think that other people are doing it or because you are forced to do it. Some of the things that
are likely to affect your decision are your age, the length of time that your relationship has been going on, the
strength of your feelings for each other and your plans for the future.
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How willi protect

How much physical myself against
contact will you have How will I
sexually transmitted protect myself
with your girlfriend Willi have sexual
infections? against
or boyfriend? intercourse or not?
unplanned
pregnancy?
When you feel ready to be sexually active, you should decide how far you want to go before you become
involved. Then make sure that you do not change your mind. When we are sexually excited our feelings are
very strong and you can easily do things that you will be sorry about later on.
Girls saying "no" more often

Teenagegirls are less likely to have sex with their boyfriends, are more demanding in what they want in a
boy and are finding it easier to say no, according to a survey.They're more likely to take a stand with boys
and make their own decision about what they want to do. A university study comparing the attitudes of
teenage girls from ten years ago to today found that boys posed nowhere near as many problems for girls
as they did in the past. Yet when it came to what they did want in a boy, both looks and personality had to
pass the test instead of a single feature.
~1
} Fromthe Daily Telegraph
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1 When you decide to have sex, what factors will you think about to help you make your
decision? Give some examples of the sorts of situations when you would decide not to
have sex.
2 Readthe story "Girls saying 'no' more often': which is taken from an Australian
newspaper.
a According to the study, how have the attitudes of teenage girls changed?
b Explainwhat it means to be "more demanding':
c In the past. what kinds of problems do you think the girls had to face?
d What are the similarities and differences for teenage boys and girls in PapuaNew
Guinea compared with those mentioned in the study?
e In PapuaNew Guinea, what qualities do girls look for in a boy?What qualities do boys
look for in a girl?
Unwanted sexual activity

Lessons
Sexual feelings are very strong, and some people have not learned to control
2 themselves and to behave with respect towards other people. As a result there are
different kinds of unwanted sexual activity, such as sexual assault, rape and incest.
Sexual assault, rape and incest are against the law and are not the fault of the victim.
3 Sexual assault
If someone touches you i~ a sexual way or does something sexual that you do not
Did !:IOU know? want them todo, this is called sexual assault. For example:
• unwanted touching-for example, touching the breast of a woman
Incest is sexual
behaviour between • exposure-for example, showing the genitals in public
members of the
same family such tI Rape
as between father
and daughter,
: auntie and • incest-sexual behaviour between close relatives
nephew, or brother ~
) • rape by a stranger ..
and sister. Incest is
against the law. ~ ~ rape by someone the victim knows (sometimes called "date rape")
~
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Protecting yourself from unwanted sex

You are not responsible for the things that other people do and it is not your fault if another person forces
you to have sex, if they trick you or are violent to you. If someone tries to force you to have sex that you do
not want, then you should not give in. You have the right to decide what you will do and what will happen to
your body. When you say "no" it means "no", and if the person does not respect you then this may not be
the person that you want to have sex with. When you have good self-esteem and feel good about yourself,
it will help you to make good decisions about what is best for you. Do not worry about what the other
person thinks or what other people will think.
If you are attacked and someone is holding your arms, you can lift your leg quickly so that your knee hits
him in the groin. This will hurt the attacker and may make him stop for long enough so that you can run
away or call for help.
Just do what
I tell you and
don't scream.
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What can you do if you are being abused by someone

you know?
• Try to avoid being alone with the person.
• Tell them that you do not want what they are doing.
• Ask them to stop.

• Try to talk to someone that you trust about the problem such as a family member, health worker, teacher
or church member.
Bosaribu's story
Bosaribu attended Hohola Youth Development Centre
and had a boufriend who lived in Gerehu, but her famil!:J
did not know about this. One weekend she tricked her
famil!:Jand told them that she was going to sta!:Jwith a
girlfriend. However, she went to visit her boufrtend in
Gerehu instead. After visiting him she was waiting for a
PMV to come home. It was earl!:Jin the morning when a
~:~ car stopped and three men forced her to get into the
car. The!:Jtook the back road and stopped b!:JBaruni dump
where the!:Jtook her into the long grass and raped her.
She tried to resist and asked them to stop, but there was
really nothing she could do. Later, the!:Jdropped her off
near Konedobu and she found her own way home from
there. She was too ashamed to tell her famil!:Jbecause
of what happened and because she had not been honest
about her reasons for being awa!:Jfrom home.
1 Read Bosaribu's story and answer the following questions:
a What are the reasons that Bosaribu ended up being raped?
b What could Bosaribu have done in order to keep herself safe?
c What advice would you give to Bosaribu or someone who was in a similar position?
2 Imagine that you havejust started to make friends with someone that you really like.This person is alreadytrying to
force you to have sex with him or her, but you do not feel good about this. Write a short story or role play showing
a an aggressive response
b an assertive response
c a passive response
Discuss and respond

Work with a partner and look at the examples below. One student tries to persuade the second student to do
something they do not want to do. The second student must try to say "no" using the ideas in the box "How to
say' no" (page 43). Swap over so that you both get a turn at saying" no'.'
a Student A tries to persuade student B to leave the dormitory at night. which is against school rules.
b Student B tries to persuade student A to drink alcohol.
c Student A tries to persuade student B to steal from the Chinese trade store in town.
d Student B tries to persuade student A to visit him or her after lights out.
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PEER EDUCATION
Your peers are the people who are about the same age as you and have a similar
background. Peers are important throughout your life, but during adolescence your
peers have a particularly important effect on the way you think and behave. Young
people like to feel that they belong to a group and so they often have similar interests,
may listen to the same sort of music and talk in a particular way. People with different
interests or who do not talk in the same way will not feel part of the group and may
feel unhappy about this.
Formal and informal education

Most of the education that takes place in schools is known as formal education. This
means that the teacher is in charge and has a lot more knowledge than the students.
The teacher is recognised as an authority and organises learning activities that usually
take place inside the classroom with students sitting at desks. However, this is not the
only way that we learn. We also learn a lot of knowledge and skills from our parents,
the community and our peers. We learn many things by watching what other people do
in the community and we can learn a lot by talking to our friends. When we learn in this
. way it is known as informal education.
.:»: In many parts of the world peer education is one of the ways that is being used to
teach adolescents about reproductive and sexual health. This means that young people
are being given the chance to teach and learn from each other. Peer education is
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normally informal. There is no need to use notebooks and there is no assessment test
at the end. Peer education is very useful where formal education is not available, but
peer education can also be used to help support the formal education system.
We know that peer education is important and works because many people will
make changes to their behaviour based not only on what they know, but also on the
opinions and actions of their peers. Because they are members of the peer group, peer
educators understand the group well and can communicate in ways that people who
are outside the peer group cannot.
Peer educators are usually about the same age or slightly older than the group they are
working with. They usually work with a teacher, adult coordinator or community leader
and can run their own educational activities or organise and implement activities in
the school or community. Peer educators can help raise awareness, provide acc~rate
information and help their classmates develop skills to change behaviour. Some. of the
ways that peer educators work include:
• leading informal discussions
• making drama presentations
• talking with individual students
• handing out leaflets and brochures
• providing counselling, support and information about health services.
Community advocacy New word

Peer educators need to be trained so that they have the skills and knowledge to do a
advocacy-
good job. The local community needs to be involved in the training in order to get their support,
support and to reduce any fears that they may have about peer education. People wb_o encouragement or
can give good support are parents, uncles and aunties, and community and religious sponsorship
leaders.
It is also possible that some members of the community will not support the ideas of
peer education, so peer educators also need to be prepared to deal with any criticism or
resistance that may come from the community.
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I Advantages of peer education

• Peereducators can work with groups that are normally hard to reach, such as people living in squatter
settlements or remote villages.
• Young people are more likely to accept information from their peers than from adults.
• People in peer groups usually find it easier to talk and ask questions.
• Peereducators themselves also benefit from the experience by improving their own knowledge and
leadership skills, which helps them to develop.
• Peereducation programs are community-based activities that can link young people to other community
services.
()
l • Peereducators can act as role models for change in the community .
... and getting

Community support from
advocacy means the community
learning from in decision
trainers in the making.
community ...
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1 Explainwhat we mean by community education. Why is it important?
2 Explainwhat we mean by community advocacy and give an example from your community or a community
that you know.
3 Describe the advantages of peer education.
4 If you tried to use peer education in your community, what kind of support would you expect and what
challenges would you have to face?
Find out about the health services in your area that help people in any matters related to sexual health,
sucha~,famil~planning',maternal and child,healtlir.andse~uallytransmitted infections. Put the information
together in theforr'n ola bookie, with a suitatlle GoverandJlie title "Guide to Local Health Services': Use
suitable headings inside the booklet and include the following information:
c address and telephone nUrlib~r
types of services that are available

~
e times when these ~~rvices
I
are available
a map to s~pw where each service can be foynd

"' .......
,., I '.'."
Work with your teachers.and other leaders in the.cornrnunitv to develop some peer education activities on
reproductive and sexual health for a group of young people in your community. Some resources that could
be use(l for peer education are shown in the boxes on pages 54..,c56.
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~:;l,}.· Peer education resources 1

:: Common but ineffective messages and methods used to
i.
reduce sexual risk and prevent HIV/STls
1 Fearsand threats
For example: "You will get a disease or die if you have sex
without using condoms."
Guilt and humiliation
For example: "You should be ashamed if you have sex outside
of marriage or if you have homosexual sex."
Misinformation and lies
For example: "Condoms don't work." "Sex education causes
young people to try sex earlier."
4 Incentives and bribes
For example: "If you stay out of trouble I'll give you more
t
pocket money."
5 Force and manipulation
~ For example: "You cannot stay in this house if you have
) a baby."
'.
j Pee, education resources 2
Effective messages and methods used to reduce sexual
risk and prevent HIV/STls
What behaviours do we want to encourage?
What behaviours do we want young people to give up or change? I am going to get
them to discuss
The four Ps How are you "the four PS':
• Postpone or delay sexual getting on with
intercourse, planning your peer
education activity?
• Prepare for sexual
intercourse (talk to parents/
peers/partners, obtain
condoms).
Protect yourself (each and

every time you have sexual
intercourse).
Plan for your future (family,

schooling, career).
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j{; Peer education resources 3
I Factors that contribute to and support behaviour
i
"
lChange
Information regarding the need to
change
I 2 Motivation to change
3 Skills to start and continue the new

behaviour
I
~
4
(ability to take action, physical/
emotional factors)
The belief that change is possible and
positive
(emotional or spiritual factors,
I 5
empowerment)
Supportive changes in community
norms
~
(society, media, peer and family factors)
~
~ 6 Policies that support behaviour change
1 (institutional-political, legal and economic factors)
)
?).
~ Peer education resources 4
~
Factors that contribute to and support behaviour
change
1 Information and services
• sexuality information that is suitable for people from different cultures and is honest, accurate and
balanced
I· • information about the possible results of unprotected sexual intercourse and how to protect yourself
information about the advantagesof delaying sex
t?)", •. community resources to supply condoms

• community resources for survivors of sexual abuse
, • anonymous HIV testing, support groups and peer education groups.
l
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~ (continued next page)
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2 Motivation
• seeking a positive outcome
• talking with partners, respected adults and peers
• testing and/or treatment for HIV
• using two methods of protection
I • making future plans.
3 Skills
I
• to resist peer pressure
• to negotiate safer sex
• to communicate with your partner, peers and parents
• to be able to use health services, including testing and treatment.
4 Belief that change is possible

• that it is all right if you do not have sex
• that it is all right for young people to enjoy sexual relationships
• that sexual intercourse should be safe and both people should agree
• that early treatment of STlswill make a difference
• that health workers will be helpful and not criticise patients because of their behaviour.
5 Community customs
• regarding the use of alcohol, drugs and condom availability
• regarding the value and abilities of youth
• regarding different cultural, religious and health beliefs.
6 Policies related to
• advertising for condoms or other contraceptives
• anonymous HIV testing for young people
~ • sex education in schools

~ • research on HIV infection
~ • sufficient funding for health education and health services that are suitable for each community
~
• the availability of health services to people in different communities.
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Week 10
ASSESSMENT
Assessment task one
For assessment task one you must complete a short answer test covering the
following topics:
1 the impact of family size on your future
2 how family size can be managed
3 forms of contraception available
4 male and female reproductive systems
5 sexual intercourse
6 conception.
When you do this assessment you must be able to:

a explain how the human reproductive system works
b explain the process of conception
c describe the reasons for managing family size
d describe how we manage family size.
(30 marks)
Assessment task two

Lessons
For assessment task two you need to do either 1 or 2.
1
2
Make a poster or write a pamphlet or leaflet.
Give a talk to a group of people or imagine that you are talking on a radio
program.
2
Your poster, pamphlet or talk must describe the common ways that HIV/AIDS is
transmitted and how young people can avoid getting the disease. 3
When you do this assessment you must:
a show that you understand the risk of HIV/AIDS to young people like yourself
b show that you know how to reduce the risk to yourself in different situations.
(30 marks)
Answers to quiz on page 9: 1 True. 2 False. 3 True. 4 False. 5 False. 6 False. 7 True. 8
False. 9 False. 10 False.

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CONTENTS

1 Reproductive and sexual health ..... 2

2 Family and relationships 58

3 Universal values 120

4 Sport and fitness 171

Assessment for this unit is described at the end of the unit.

Links with other units and strands

Week 1 Reproductive systems Week 6 HIV/AIDS

Lesson 3 Developing relationships Lesson 3 The effect of HIV on the co

Week 4 Week 9 Peer education

Lesson 2, 3 Pregnancy and early child

The male reproductive system

sperm duct --+----+11'('11

(a) Side view (b) Front view

The male reproductive system

The female reproductive system

(a) Side view (b) Front view

The female reproductive system

Did you know?

Lesson DEVELOPING RELATIONSHIPS

e Do, think and decide

Love magic bottle

~ Do, think and decide

Discuss and respond

SEXUAL RELATIONSHIPS Lesson

~ Do, think and decide

I.' How much do you know?

Rights and responsibilities

~ Do, think and decide'

If you really loved me . If you don't have sex

Everybody else If you don't do it, I will

Focus on the problem, not the other person.

Emphasisecommon ground-what do you agree about?

~ •• Be creative about options-try to think of new ideas or solutions.

\ Make a clear agreement that you both understand.

Elsie and Patrick

Felicity and Joseph

m Do, think and decide

2 Readthe story of Elsie and Patrick.

a What do you think Elsie and Patrickshould do?

3 Readthe story of Felicity and Joseph,

a What do you think Felicity and Joseph should do?

b How can Felicity be assertive in this situation?

Discuss and respond

c How can each couple sort out their situation?

~ Do, think and decide

Methods of family planning

Late safe days

A chart used for the ovuiation method of family planning

fertile mucus infertile mucus

Sperm can live in the

Intra-uterine device (IUD)

~ Do, think and decide

b What are contraceptives?

2 the egg until it is born are as follows.

4 cells carryon dividing 3 fertilised egg divides into

5 when the hollow ball of

6 the embryo sinks

What happensfrom ovulationto implantation

The first sign that a woman is

• A special organ starts growing from the embryo and

High risk mothers should go to the health centre for delivery

Did you know?

Wash newborn babies every day