HR 1319
112th CONGRESS
1st Session
H. R. 1319
To promote the sexual and reproductive health of individuals and
couples in developing countries, and for other purposes.
IN THE HOUSE OF REPRESENTATIVES
April 1, 2011
Ms. CLARKE of New York (for herself, Mr. GRIJALVA, Ms. CHU, Mr. PAYNE, Ms.
WILSON of Florida, Mrs. DAVIS of California, Mr. MORAN, Mr. MARKEY, Mr. RANGEL,
Mr. ENGEL, Mrs. MALONEY, Mr. COHEN, Ms. SPEIER, Ms. SCHAKOWSKY, Mr. GUTIERREZ,
Mr. HOLT, Ms. DEGETTE, Ms. HIRONO, Ms. BROWN of Florida, Mr. STARK, Mr. HONDA,
Mr. TOWNS, Ms. MOORE, Ms. BALDWIN, Mr. CONYERS, Ms. MATSUI, Ms. WOOLSEY, Mr.
RUSH, Ms. RICHARDSON, Mr. FILNER, Mr. CLAY, Mr. MCGOVERN, Mr. JOHNSON of Georgia,
Mrs. CAPPS, Mr. QUIGLEY, Mr. BLUMENAUER, Ms. WASSERMAN SCHULTZ, Mr. MCDERMOTT,
and Ms. LORETTA SANCHEZ of California) introduced the following bill; which
was referred to the Committee on Foreign Affairs
A BILL
To promote the sexual and reproductive health of individuals and
couples in developing countries, and for other purposes.
Be it enacted by the Senate and House of Representatives of the United
States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the `Global Sexual and Reproductive Health Act of
2011'.
SEC. 2. FINDINGS AND PURPOSES.
(a) Findings- Congress makes the following findings:
(1) The advancement of sexual and reproductive health is necessary to meeting
most of the eight United Nations Millennium Development Goals (MDGs), the
current international development framework developed by 189 countries in
2000, including the United States. Target 5B, which is found under MDG 5
on improving maternal health and which requires achieving universal access
to reproductive health by the year 2015, is an essential element in attaining
MDGs related to eradicating poverty (MDG 1), achieving universal education
(MDG 2), promoting gender equality (MDG 3), reducing child mortality (MDG
4), improving maternal health (MDG 5), combating HIV/AIDS (MDG 6), and ensuring
environmental sustainability (MDG 7).
(2) The report of the United Nations Secretary-General to the 2009 Commission
on Population and Development `. . . reaffirms that population, reproductive
health and gender issues are central to development and to the achievement
of the Millennium Development Goals.'.
(3) Throughout much of the world, the lack of access of women, particularly
poor women, to basic reproductive health services and information contributes
to death and suffering among women and their families, undermines women's
struggle for self-determination, and vitiates the efforts of families to
lift themselves out of the poverty in which over a billion of the world's
people live. By allowing individuals and couples to choose the number and
timing of their children, reproductive health care gives families and individuals
greater control over their economic resources.
(4) Aspects of sexual and reproductive health, including maternal mortality
and morbidity, reproductive cancers, and sexually transmitted infections
(STIs), including HIV, account for nearly 20 percent of the global burden
of ill-health for women and some 14 percent for men, according to the World
Health Organization (WHO).
(5) According to the Joint United Nations Programme on HIV/AIDS (UNAIDS),
HIV/AIDS is the leading cause of death among women of child-bearing age.
(6) School-based education and family planning play an interrelated role
in lifting the status of women. Delaying sexual debut, along with contraceptive
use among young women already sexually active, lowers the likelihood that
young women will leave their schooling due to pregnancy, and education increases
the chances that young women will delay the age at which they marry and
give birth.
(7) Sexual and reproductive health programs can empower women to make informed
decisions and better control their lives, and by engaging men and boys in
taking responsibility for the sexual and reproductive health of their partners,
can contribute to greater gender equality.
(8) Access to sexual and reproductive health services, including family
planning, has a direct and important impact on infant and child mortality.
By allowing women to choose the timing, number, and spacing of their pregnancies,
high-risk births are averted, and the children that are born have a greater
chance of surviving to adulthood. Three million newborns die in the first
4 weeks of life, which accounts for 38 percent of all deaths of children
under the age of 5. By providing women family planning services to space
their births 3 years apart, rates for infant and under-5 mortality would
drop by 24 percent and 35 percent, respectively.
(9) Increasing access to sexual and reproductive health could significantly
decrease pregnancy-related mortality and morbidity by reducing the number
of pregnancies that place women at increased risk of experiencing such complications.
(10) An estimated 215,000,000 women in developing countries have an unmet
need for effective, modern contraceptives and would like to postpone childbearing,
space births, or want no more children but are not using a modern method
of contraception. Providing modern contraceptives to fill this unmet need
would avert an estimated 53,000,000 unintended pregnancies each year. Simultaneously
meeting the need for both family planning and maternal and newborn health
services would save the lives of 251,000 women and 1,700,000 newborns, and
prevent 14,500,000 unsafe abortions.
(11) Complications due to pregnancy and childbirth are the leading cause
of death among women ages 15 to 19. Each year, an estimated 356,000 women
worldwide die from complications related to pregnancy, childbirth, or unsafe
abortion.
(12) Unsafe abortion accounts for 13 percent of maternal deaths worldwide.
More than half of abortions (55 percent) in the developing world are unsafe.
Of the 20,000,000 unsafe abortions that take place each year, nearly all
occur in the developing world. Around 46,000 women die and millions more
suffer serious injuries from the complications of unsafely performed abortions.
Abortion rates are similar in countries whether abortion is illegal or legal.
However, death and injury from unsafe abortion is greatly reduced where
abortion is legal for a broad range of indications and where safe abortion
is accessible.
(13) Meeting the need for family planning services and pregnancy-related
care, by doubling the current global investment for both, would reduce maternal
mortality by more than two-thirds and deaths to newborns by more than half.
These goals can be achieved for $1,500,000,000 less than the cost of achieving
maternal and newborn health alone. Every dollar invested in family planning
saves $1.40 in maternal and newborn health care services.
(14) Worldwide, women of childbearing age account for more than half of
people living with HIV/AIDS. Integrating reproductive health services, including
family planning, with HIV prevention programs, such as those for voluntary
counseling and testing and prevention of mother-to-child transmission, is
essential to effectively combating HIV/AIDS and other STIs.
(15) The world is witnessing the largest generation of young people in history--almost
half of the world's population, approximately 3,000,000,000 people, are
under the age of 25. Unmet need for sexual and reproductive health services
is highest among this age cohort. Fewer than 5 percent of the poorest sexually
active youth use modern contraception.
(16) The WHO has identified unsafe sex as the second most important risk
factor for disability and death among young people in the world's poorest
communities. Forty-one percent of all new HIV infections occur among young
people.
(17) Sixty percent of unsafe abortions in Africa, 42 percent in Latin America
and the Caribbean, and 30 percent in Asia are performed on women under the
age of 25.
(18) The WHO has identified a 4-pronged approach to preventing HIV infection
in infants, which includes prevention of unintended pregnancy among HIV-infected
women as a key strategy to prevent mother-to-child transmission of HIV.
(19) According to the United States Agency for International Development,
enabling HIV-positive women who want to avoid a pregnancy with contraceptive
services can prevent an additional 55,000 child deaths and avert more than
150,000 unintended pregnancies in high HIV prevalence countries.
(20) Demographic factors exacerbate problems related to environmental sustainability.
The past century of population growth has put increasing pressure on natural
resources as the scale of human needs and activities expands. At the same
time, actual family size in most developing countries remains greater than
the desired family size. Access to family planning services helps couples
to determine their own family size, hence mitigating the depletion of natural
resources like clean water, air, and land.
(21) Practices like early marriage, female genital mutilation, and early
sexual debut adversely impact the sexual and reproductive health of young
people in many developing countries, and strong barriers exist to providing
the information, services, and other forms of support that young people
need to lead healthy sexual and reproductive lives.
(22) Comprehensive sexuality education seeks to help young people develop
the interpersonal skills necessary for the formation of caring, supportive,
and noncoercive relationships and the ability to exercise responsibility
regarding sexual relationships by addressing such issues as abstinence and
the use of condoms, contraceptives, and other protective sexual health measures.
(23) The United Nations has estimated that the minimum financial requirements
for sexual and reproductive health, including family planning and maternal
health, are roughly $23,500,000,000 in 2009 and increase to approximately
$33,000,000,000 in 2015. The minimum financial requirement for HIV/AIDS
is estimated at $24,000,000,000 in 2009, and increases to $36,200,000,000
in 2015. As agreed in the International Conference on Population and Development's
Programme of Action, which the United States committed to, developed-country
donors are responsible for one-third of the total cost needed per year.
Developing countries are responsible for the remaining two-thirds, on average,
with low income countries requiring a larger share of external funding.
(24) The United States has had a history of supporting and recognizing the
fundamental health and human rights of all people through the signing or
ratifying of various international agreements. Those agreements include
the Universal Declaration of Human Rights (1948), the International Covenant
on Civil and Political Rights (1966), the International Covenant on Economic,
Social, and Cultural Rights (1966), the Convention on the Elimination of
All Forms of Discrimination Against Women (1979), the Convention on the
Rights of the Child (1989), the International Conference on Population and
Development Programme of Action (1994), and the United Nations Millennium
Development Goals (2000).
(25) The United States has been the largest donor to international family
planning and reproductive health efforts over the last 40 years and has
been an unparalleled source of leadership and innovation in the field. Nonetheless,
it has not met its fair share of financial assistance to global sexual and
reproductive health programs. Now is the time to shore up the United States
political and financial commitment in order to satisfy the large unmet need
for these services, thereby helping to improve women's sexual and reproductive
health worldwide.
(b) Purposes- The purposes of this Act are to--
(1) authorize assistance to improve the sexual and reproductive health of
individuals and couples in developing countries; and
(2) implement comprehensive sexual and reproductive health programs offering
a continuum of care that are responsive to the sexual and reproductive health
needs of young people and adults.
SEC. 3. STATEMENT OF POLICY.
The following shall be the policy of the United States Government:
(1) All individuals and couples shall have the basic reproductive right
to decide freely and responsibly the number, spacing, and timing of their
children and shall have the information and means to do so, and the right
to attain the highest standard of sexual and reproductive health.
(2) All individuals and couples also shall have the right to make decisions
concerning reproduction free of discrimination, coercion, and violence,
as expressed in human rights documents.
(3) The promotion of the responsible exercise of these reproductive rights
for all people shall be the fundamental basis for sexual and reproductive
health programs supported by United States Government assistance.
(4) The principle of free and informed consent must underlie all sexual
and reproductive health programs and services. This principle applies to
individuals whether they choose to continue or terminate their pregnancies--thus,
forced pregnancies as well as forced abortions or sterilizations are prohibited.
Decisions relating to contraceptive use should be made on an informed and
voluntary basis after adequate information, counseling, and services are
provided on a range of methods.
(5) Incentives and disincentives should not be used in family planning programs
in order to meet numerical population targets or quotas for fertility goals.
Instead, governments should use other indicators, such as unmet needs, to
define family planning goals.
(6) In sexual and reproductive health programs funded by the United States
Government, special attention should be paid to serving the needs of young
people.
SEC. 4. ASSISTANCE TO SUPPORT THE ACHIEVEMENT OF UNIVERSAL ACCESS TO SEXUAL
AND REPRODUCTIVE HEALTH.
(a) Assistance Authorized- The President is authorized to provide assistance
in order to support the achievement of universal access to sexual and reproductive
health in developing countries and to ensure individuals and couples in developing
countries can freely and responsibly determine the number, timing, and spacing
of their children and have the means to do so.
(b) Activities Supported- Assistance provided under subsection (a) may be
used to--
(1) expand access to and use of voluntary family planning information and
services, to enable individuals and couples to avoid unintended pregnancies
and other risks to sexual and reproductive health, including those associated
with pregnancy, reproductive tract infections, and sexually transmitted
infections (STIs), including HIV;
(2) improve public knowledge of contraceptives, including where methods
may be obtained, and risk-reduction strategies, and to promote the benefits
of family planning and other sexual and reproductive health care to individuals,
families, and communities, including through the use of education and awareness
programs, mass media, and community mobilization and outreach;
(3) increase the responsiveness of sexual and reproductive health programs
to the needs of the intended beneficiaries during the entirety of their
sexual and reproductive lives, including young people and older adults;
(4) reduce the incidence of unsafe abortion, including research on the health
consequences of unsafe abortion, and provide for the equipment and training
necessary for medical treatment of the consequences of unsafe abortions;
(5) notwithstanding any other provision of law, provide safe abortion, to
the extent permitted by the laws of the recipient country;
(6) promote the integration of family planning services in HIV and other
STI prevention, treatment, care, and support;
(7) integrate family planning services with maternal and newborn health
care, especially in antenatal, post-partum, and post-abortion care settings;
(8) ensure the consistent availability and affordability of high-quality
sexual and reproductive health supplies and services, including male and
female condoms, for the prevention of HIV and other STIs;
(9) encourage the abandonment of female genital mutilation, early marriage,
early childbearing, and other harmful traditional practices that have negative
reproductive health consequences;
(10) prevent and repair obstetric fistula;
(11) promote the constructive engagement of men and boys, the empowerment
of women and girls, and more equitable gender norms in order to improve
health outcomes and support the adoption of healthy reproductive behaviors;
(12) prevent and mitigate gender-based violence;
(13) provide comprehensive sexuality education for young people;
(14) prevent, diagnose, and treat, where appropriate, infertility and cancers
of the reproductive system and refer as appropriate;
(15) develop improved methods of safe and effective contraception and related
disease control through investments in biomedical research, with particular
emphasis on methods which--
(A) are likely to be safer, easier to use, more efficient to make available
in developing country settings, and less expensive than current methods;
(B) are controlled by women, including barrier methods and microbicides;
(C) are likely to prevent the spread of STIs; and
(D) encourage and enable men to take greater responsibility for their
own fertility and the protection of their partner;
(16) support an enabling environment for women to access sexual and reproductive
health care services by working with communities to identify and lower or
remove barriers to access, including financial, gender, socio-cultural,
and transportation barriers;
(17) train health care professionals on educating individuals, including
young people, about their sexual and reproductive health care options, including
family planning options; and
(18) foster conditions to create favorable policy environments, improve
quality, strengthen systems, and contribute to the sustainability of family
planning and other reproductive health programs.
SEC. 5. ASSISTANCE TO REDUCE THE INCIDENCE OF UNSAFE ABORTION AND ITS CONSEQUENCES.
(a) Assistance Authorized- The President is authorized to provide assistance
to reduce the incidence of unsafe abortion in developing countries and provide
care for women experiencing injury or illness from complications of unsafe
abortion in developing countries.
(b) Activities Supported- Assistance provided under subsection (a) shall be
used to--
(1) ensure access to family planning services to prevent unintended pregnancies;
(2) ensure that women who experience an unintended pregnancy have access
to reliable information and compassionate counseling on all of their options,
including access to antenatal care and safe abortion when permitted by the
laws of the recipient country;
(3) where local laws permit abortion, support safe abortion services, including
referrals, and support the training of abortion providers and the necessary
equipment and commodities for surgical and medical abortion; and
(4) support emergency treatment for complications of induced or spontaneous
abortion, including provision of services and training and equipping of
providers.
(c) Eligibility for Assistance- Notwithstanding any other provision of law,
regulation, or policy, in determining eligibility for assistance authorized
under this section, sections 104, 104A, 104B, and 104C of the Foreign Assistance
Act of 1961 (22 U.S.C. 2151b, 2151b-2, 2151b-3, and 2151b-4), foreign nongovernmental
organizations--
(1) shall not be ineligible for such assistance solely on the basis of health
or medical services, including counseling and referral services, provided
by such organizations with non-United States Government funds if such services
are permitted in the country in which they are being provided and would
not violate United States Federal law if provided in the United States;
and
(2) shall not be subject to requirements relating to the use of non-United
States Government funds for advocacy and lobbying activities other than
those that apply to United States nongovernmental organizations receiving
assistance under part I of the Foreign Assistance Act of 1961.
SEC. 6. ASSISTANCE TO PROVIDE SEXUAL AND REPRODUCTIVE HEALTH SERVICES DURING
EMERGENCY SITUATIONS.
(a) Assistance Authorized- The President is authorized to provide assistance,
including through international organizations, national governments, and international
and local nongovernmental organizations, to ensure that sexual and reproductive
health services are provided in developing countries at every phase of a humanitarian
emergency, including early recovery.
(b) Priority- In providing assistance authorized under subsection (a), the
President shall give priority to--
(1) those reproductive health services that are essential in emergencies,
whether they are conflict or natural disaster settings, to save lives and
help survivors fulfill their potential even under the most difficult circumstances;
and
(2) building local capacity and improving national systems whenever possible
during displacement and early recovery.
(c) Activities Supported- Assistance provided under subsection (a) shall be
used to--
(1) direct the Secretary of State and the Administrator of the United States
Agency for International Development to implement the Minimum Initial Services
Package (MISP), a set of life-saving priority activities that must be put
in place in the earliest days of an emergency and that is set out in the
Sphere Project's Humanitarian Charter and Minimum Standards in Disaster
Response;
(2) among other activities, establish critical reproductive health coordination
mechanisms, prevent sexual violence and assist survivors by providing essential
medical care including psychosocial services, prevent transmission of HIV
and other sexually transmitted infections (STIs), ensure access to emergency
obstetric and newborn care, to contraceptive methods, and to treatment of
STIs, continue antiretroviral treatment, and lay the groundwork for comprehensive
reproductive health care; and
(3) as soon as conditions permit, ensure that comprehensive reproductive
health care programs, including comprehensive family planning, are put in
place for the duration of displacement and are maintained as the relief
phase ends and communities transition to early recovery.
(d) Coordination- Assistance authorized under subsection (a) shall be coordinated
in terms of policy, practice, and funding across and within relevant United
States Government departments and agencies involved in emergency situations.
SEC. 7. ASSISTANCE TO PROMOTE SEXUAL AND REPRODUCTIVE HEALTH CARE FOR YOUNG
PEOPLE.
(a) Assistance Authorized- The President is authorized to provide assistance
to ensure access to sexual and reproductive health care for young people in
developing countries.
(b) Priority- In providing assistance authorized under subsection (a), the
President shall prioritize a plan to increase comprehensive knowledge about
sexuality among young people and improve sexual and reproductive health outcomes
among young people, while improving coordination and implementation of host
country and United States Government activities focused on adolescent and
youth sexual and reproductive health.
(c) Activities Supported- Assistance provided under subsection (a) shall be
used, among other things, to--
(1) provide universal and affordable access to--
(A) evidence-based comprehensive sexuality education and reproductive
health education, in consultation with local communities, in and outside
schools to ensure young people can delay sexual debut and make informed
decisions about their sexual and reproductive health; and
(B) youth-friendly comprehensive sexual and reproductive health care,
including activities described in section 4(b), as appropriate;
(2) coordinate the achievement of the goals of sexual and reproductive health
programming for young people in United States Government-funded programs;
(3) educate implementers on best practices in adolescent and youth programming
and delivery and for effective dissemination of policy guidelines regarding
adolescent and youth programming; and
(4) incorporate the recommendations of young people in program design and
service delivery oriented for young people.
SEC. 8. STRATEGY TO INTEGRATE AND LINK SEXUAL AND REPRODUCTIVE HEALTH SERVICES.
(1) IN GENERAL- The President shall develop and implement a strategy to
improve and create linkages among the various components of sexual and reproductive
health with each other and with other global health care services, delivery,
and policies in order to meet the goal described in paragraph (2).
(2) GOAL DESCRIBED- The goal of better linkages and integration referred
to in paragraph (1) is to ensure that individual men and women are provided
with a continuum of sexual and reproductive health services that meet their
needs. Integration does not require that all of these services should be
provided by the same clinician or even in the same setting; rather, there
should be a mechanism in place, so that every person has access to the sexual
and reproductive health services he or she needs, either directly or by
referral.
(b) Elements- The strategy required by subsection (a) shall include the following:
(1) In general, at the program level, supporting health systems to link
the various components of sexual and reproductive health services both in
terms of health system management, such as integrating commodity and supply
systems, training, supervision, data collection and analysis, and service
provision, to ensure that people have access to a full range of services
in their community.
(2) In general, such services should include prevention of ill-health, provision
of information and counseling, screening, diagnosis and curative care and
referral for a full range of sexual and reproductive health and other health
and social services.
(3) With respect to linkages and program integration of sexual and reproductive
health services, such services shall include activities described in section
4(b).
(4) With respect to linkages of sexual and reproductive health services
with other global health services, such services shall include--
(A) counseling about and referrals to other related health services such
as addressing newborn, infant, and child health (including educating families
about proper antenatal and delivery care, breastfeeding, hygiene, and
interventions for neonatal infections and life-threatening childhood illnesses),
malaria, tuberculosis, neglected tropical diseases, and proper nutrition
for all ages; and
(B) referrals to nearby, quality services that cannot be provided by the
primary provider and other social services.
SEC. 9. COORDINATION; RESEARCH, MONITORING, AND EVALUATION.
(a) Coordination- Assistance authorized under this Act shall promote coordination
between and among donors, the private sector, nongovernmental and civil society
organizations, and governments in order to support comprehensive and responsive
sexual and reproductive health programs in developing countries.
(b) Research, Monitoring, and Evaluation-
(1) IN GENERAL- Assistance authorized under this Act shall be used for the
conduct of formative research and to monitor and evaluate the effectiveness
and efficiency of programs.
(2) REQUIREMENTS- In carrying out paragraph (1), the President shall ensure
that there is--
(A) support for formative research on the determinants of accessing sexual
and reproductive health products and services, and adopting healthy behaviors
related to sexuality and reproduction, to inform program design;
(B) support for the ongoing, regular, and systematic collection of information
to serve as the basis for monitoring change in population-based outcomes;
(C) support for evaluations of programmatic effectiveness by measuring
the extent to which change in population-based outcomes can be attributed
to program interventions or environmental factors;
(D) support for operations research that uses appropriate scientific methods
to compare different interventions with the objective of increasing the
efficiency, effectiveness, and quality of programs;
(E) support for field research on the characteristics of programs most
likely to result in sustained use of effective family planning in meeting
each individual's lifetime reproductive goals, with particular emphasis
on the perspectives of family planning users, including support for relevant
social and behavioral research focusing on such factors as the use, nonuse,
and unsafe or ineffective use of various contraceptive and related-disease
control methods; and
(F) support for the development of new evaluation techniques and performance
criteria for sexual and reproductive health programs, emphasizing the
user's perspective and reproductive goals.
SEC. 10. DEFINITIONS.
(1) ADOLESCENT- The term `adolescent' means an individual who has attained
the age of 10 years but not 20 years.
(2) COMPREHENSIVE SEXUALITY EDUCATION- The term `comprehensive sexuality
education' means helping young people develop the interpersonal skills necessary
for the formation of caring, supportive, and non-coercive relationships
and the ability to exercise responsibility regarding sexual relationships
by addressing such issues as sexual diversity, abstinence, and the use of
condoms, contraceptives, and other protective sexual health measures.
(3) INTEGRATION- The term `integration' means joining together different
kinds of services or operational programs, either directly or by referral,
to ensure more comprehensive services, promote a continuum of care, and
to maximize health outcomes.
(4) LINKAGES- The term `linkages' means--
(A) the bi-directional synergies in policy, programs, services, and advocacy
related to sexual and reproductive health, including HIV/AIDS; and
(B) refers to a broader human rights based approach, of which service
integration is a subset.
(5) REPRODUCTIVE HEALTH- The term `reproductive health'--
(A) means a state of complete physical, mental, and social well-being
and not merely the absence of disease or infirmity, in all matters relating
to the reproductive system and to its functions and processes; and
(B) implies that an individual is able to have a satisfying and safe sex
life and that such individual has the capability to reproduce and the
freedom to decide if, when, and how often to do so, including the right
of men and women to be informed and to have access to safe, effective,
affordable, and acceptable methods of family planning of their choice,
as well as other methods of their choice for regulation of fertility which
are not against the law, and the right of access to appropriate health-care
services that will enable women to go safely through pregnancy and childbirth
and provide couples with the best chance of having a healthy infant.
(6) REPRODUCTIVE RIGHTS- The term `reproductive rights'--
(A) means those rights that embrace certain human rights that are already
recognized in national laws, international human rights documents, and
other consensus documents;
(B) includes the recognition of the basic right of all couples and individuals
to decide freely and responsibly the number, spacing, and timing of their
children and to have the information and means to do so, and the right
to attain the highest standard of sexual and reproductive health; and
(C) further includes the right of all couples and individuals to make
decisions concerning reproduction free of discrimination, coercion, and
violence, as expressed in human rights documents.
(7) SEXUAL HEALTH- The term `sexual health'--
(A) means a state of physical, emotional, mental, and social well-being
in relation to sexuality and not merely the absence of disease, dysfunction,
or infirmity;
(B) includes a positive and respectful approach to sexuality and sexual
relationships, as well as the possibility of having pleasurable and safe
sexual experiences, free of coercion, discrimination, and violence; and
(C) further includes the sexual rights of all persons to be respected,
protected, and fulfilled.
(8) UNMET NEED- The term `unmet need' refers to nonuse of a modern contraceptive
method by an individual who is married or unmarried and sexually active,
is able to become pregnant, and wants to stop childbearing or to wait at
least 2 years before having a child.
(9) YOUNG PEOPLE- The term `young people' means those individuals who have
attained the age of 10 years but not 25 years.
(10) YOUTH- The term `youth' means an individual who has attained the age
of 15 years but not 25 years.
END
