Sexuality and sexual health: constructs and expressions in the extended Middle East and North Africa.

The extended Middle East and North Africa (EMENA) region is the world region with the second youngest population, where globalization, migration, information technology, and political changes are contributing to the shaping of sexuality and sexual behaviors. Understanding the various sociocultural, demographic and public health dimensions of sexual and reproductive health of young people is fundamental to understanding the pattern of sexual behavior and the burden of sexually transmitted infections (STIs), including human papillomavirus-related diseases. New norms and forms of marriage have emerged to accommodate the changing trends in sexual behavior of premarital and extra-marital sex, as well as reports of increased prevalence of premarital penetrative and non-penetrative sexual behavior. Despite these trends, the burden of sexual illnesses remains low and is estimated at 7% of the general population being infected with curable STIs. Other STIs, such as herpes simplex virus 2, are also prevalent. The existing policies and health systems remain short of promoting youth reproductive and sexual health. Efforts should address establishing national preventive programmes, such as screening for STIs, primary prevention, comprehensive sexuality education, as well as youth-friendly services. This article forms part of a regional report entitled "Comprehensive Control of HPV Infections and Related Diseases in the Extended Middle East and North Africa Region" Vaccine Volume 31, Supplement 6, 2013. Updates of the progress in the field are presented in a separate monograph entitled "Comprehensive Control of HPV Infections and Related Diseases" Vaccine Volume 30, Supplement 5, 2012.