Salud reproductiva

A total of 30 studies assessed ASRH. At the individual level, gender, psychosocial well-being, and mental health were key factors associated with ASRH. Within the microsystem, the quality of the parent–adolescent relationship, the presence of violence, substance abuse or mental health problems in the family, and peer relationships were important determinants of ASRH. Within the macrosystem, cultural attitudes had an effect on youth's sexual behavior and generally, safer sex practices appear to be increasing. Within the chronosystem, a history of physical and sexual abuse was associated with several ASRH outcomes.

The Programme of Action of the International Conference on Population and Development (ICPD) in 1994 defined strategies and goals for advancing reproductivehealth and rights that are still far from being reached in Latin America. This paper will use elements of a framework developed by Gruskin et al1 that analyses the interconnected factors affecting the sexual and reproductivehealth of people living with HIV. We use and adapt some of these elements to examine the extent to which sexual and reproductive rights have been realized in Latin America since 1994. Specifically, we consider the rights, needs and aspirations of people; the socioeconomic context; national and international law and policy; health systems, services and programmes; the opposition; the perceived high costs of political support; the role of civil society, NGO networks and coalitions; and development aid, donor policy and government funding. There are a growing number of progressive regional and national bodies, organizations, groups and individuals with a commitment to sexual and reproductivehealth and rights in the region, and many gains have been made in the realization of these rights. However, these gains are only partial, given the acute inequality across ethnic, socioeconomic and geographic lines, and there is evidence of widening gaps. Given the breadth of the subject and the number of countries involved, this paper can cite only a few of the enormous number of examples from the literature. We hope the paper will stimulate further in-depth, critical reviews of these issues at the country and regional level.