This paper synthesises the evidence on the sexual and reproductive health situation of young people in India, and explores what we know about underlying factors that place them at risk of or protect them from unsafe and unwanted sexual and reproductive health experiences. The picture that emerges suggests that substantial proportions of young people experience risky or unwanted sexual activity, do not receive prompt or appropriate care, and experience adverse reproductive health outcomes. Contextual factors such as poverty, gender imbalances and lack of education or livelihood opportunities clearly increase the vulnerability of youth. Other factors at the family, community and facility level may also exacerbate risk. While young people's knowledge and awareness about sexual and reproductive health is increasing, much of this knowledge remains superficial and ridden with myths, misperceptions and a sense of invulnerability. Gender power imbalances make risky behaviours acceptable, encourage secrecy and fear of disclosure, and inhibit negotiation among partners. Lack of communication with parents and other trusted adults, similarly, keeps young people ill informed and unlikely to receive parental support or counsel in relation to sexual matters. Sexuality education remains inadequate and irrelevant to young people's needs, and services remain inaccessible, unacceptable, unaffordable and of indifferent quality. Several encouraging signs are, however, evident. The sexual and reproductive health needs of adolescents and young people are on the national agenda. There is growing recognition that young people themselves must be given a role in articulating, designing, implementing and evaluating such programmes. Finally, experiences of a few programmes already exist that appear to successfully respond to young people's sexual and reproductive health needs in innovative and acceptable ways. The paper concludes by recommending, on the basis of available evidence, a core set of promising actions that protect.
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