U.N. Delegates Tackle Tough Issue of Youth, Sex : Population: Confidential access to contraception is key to opposition from Vatican and Islamic countries.

Delegates at a U.N. conference here are plunging into one of the most contentious topics they face in setting a new agenda for global population: sex and adolescents.

In a world that prefers not to talk about children and sex in the same breath, the International Conference on Population and Development is tackling teen-age pregnancy, AIDS in young people and, most controversial of all, sex education and confidential reproductive health services for adolescents.

“These are sensitive issues that have to be addressed, and they are out in a U.N. conference discussion perhaps for the first time,” said Nafis Sadik, secretary general of the conference, which is expected to adopt a wide-ranging plan for slowing population growth before it closes Tuesday.

“We’ll have, I’m sure, a heated discussion on the how, and the how may be different for different regions,” she said. “Perhaps not all countries are going to accept these practices because it does not fit in with their cultures and goals.”

The Vatican and several Islamic countries have expressed fears that offering teen-agers confidential access to contraception and possibly abortion could undermine the important role that parents should play in educating their children about sex.

On the other side is a large group of nations that believe that only better education can protect adolescents from the potential dangers of sex.

The debate is critical for many reasons, the greatest of which is that the world is growing younger.

* One-third of the world’s population is between the ages of 10 and 24, about 500 million of them teen-agers.

* Young women between 15 and 19 account for at least 5 million abortions every year--1 million of them in the United States. Indeed, one of every five pregnancies happens to a teen-age girl, and the increased risk to young mothers has led to the disturbing fact that pregnancy is now the leading cause of death for women under the age of 18.

* An estimated two-thirds of all people who acquire AIDS are infected by the age of 25, and one in 20 adolescents is infected with some kind of sexually transmitted disease (STD).

“More people than ever in history will be reaching reproductive age over the next few years. This signifies that much of the work of the (conference) is ultimately directed at influencing the behavior, improving the lives and widening the choices of that critical segment of the population,” said James Grant, executive director of the United Nations Children’s Fund.

“We must remember that youth is no longer the ‘good health’ age group,” he said. “The increasing prevalence of STDs, the hurricane-like emergence of HIV/AIDS over the last decade, the rapid rise of violence and the rapid rise in teen-age pregnancies make health care a central issue for young people.”

In a statement preceding the conference’s debate on adolescent sexuality, the Holy See did leave open the door for some sex education programs.

“Good information services and programs encourage sexual self-control among adolescents and prepare them to become adults with a mature and healthy vision of sexuality,” the Vatican said.

But it objected to any attempts to provide youngsters with confidential access to reproductive health services without parental knowledge.

Islamic countries have also emphasized that the family is the best forum for teaching children about sex.

“One should not overlook the dangerous implications . . . of expanding (sex education) to children and teen-agers,” Iran’s chief delegate, Mohammed Ali Taskhiri, told the conference. “We reject this very strongly.”

In Cairo’s Islamic community, the reaction has been intense. Popular Muslim television cleric Sheik Metwalli Shaarawi rejected all forms of sex education for youth.

“Sex is an instinct and cannot be taught,” he said. “. . . Let’s steer away from arousing such instincts.”

Norway’s prime minister, Gro Harlem Brundtland, expounded another view.

“We know that lack of education and services does not deter adolescents and unmarried persons from sexual activity,” she said at the conference’s opening session. “On the contrary, there is increasing evidence from many countries, including my own, that sex education promotes responsible sexual behavior and even abstinence.”

The proposed U.N. plan calls for a wide variety of programs and actions aimed at discouraging teen-age pregnancy and marriage, protecting children from sexual and economic exploitation and providing them with access to education about sex and reproductive health.

In its most controversial section, the plan urges countries to remove barriers--legal, regulatory and social--to information about sex. “Services for adolescents must safeguard their rights to privacy, confidentiality, informed consent and respect,” the section reads.

Even before the debate opened, conferees were fashioning a compromise that would emphasize the traditional right and responsibility of parents to provide guidance to adolescents on sexual matters but would not specifically require parental consent or notification. U.S. officials said they believed the Vatican would accept such language.

Hundreds of young people have gathered on the sidelines of the Cairo conference to debate these issues. Surveys from their home nations have been presented, workshops and seminars organized, sentiments exchanged.

The overwhelming feeling among these youths is that they would prefer to discuss sex with their parents or at school but usually learn what little they know from books, movies, magazines and friends.

“When we asked people questions on issues related to sex, they replied that their peers were sexually active, and girls started having sex at the age of 12, boys started having sex at the age of 13. Yet all of them interviewed said the ideal age to start having sex is 20,” said Joseph Karueru, a young man from Kenya who helped direct a youth sex survey there.

After several days of debate, official youth delegates adopted a “Cairo Youth Declaration” that, among other things, called on governments to provide sex education, to prohibit female genital mutilation and any form of sexual exploitation, to provide care for young women who experience rape, abortion or sexual abuse, and to ensure that pregnant teen-agers are not expelled from school.

“Every youth is at risk: either to AIDS, STDs or pregnancy or drugs. There must be access to some treatment, that’s all we’re saying,” said Clement Wiredu, a youth worker in Ghana, where 8,000 of the 11,000 reported AIDS cases involve victims between the ages of 10 and 24.

“We can’t hide it. We can’t say it’s not going on. And the youth must be protected,” he said.