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    HCET Home > On-line Training > What Works in Adolescent Sexual Health Programs > 1. Adolescent Sexual Health Today (2006)

    1. Adolescent Sexual Health Today (2006)

    While fewer teens report being sexually active today than 15 years ago, the number of teens engaging in risky sexual behavior is high. Almost half of all teens will report having had sexual intercourse (46.8%) [1], and roughly two-thirds (63%) of all students will report having sex at least once before high school graduation (Figure 1) [2]. The average age for initiating sexual activity is 17.3 years for boys and 17.1 years for girls; however, studies show that adolescent sexual experience varies by age and population groups [3].

    Differences in age (Figure 1) [3]:

    • 1 out of 7 (14%) 15 year old females are sexually active.
    • One third (1/3) of 16 year old females are sexually active.
    • 50% of 17 year old females are sexually active.
    • Two thirds (2/3) of 18 year old females are sexually active.
    • 75% of all 19 year old females are sexually active.

    Disparities among population groups:

    • Non-Hispanic black teens are more likely than non-Hispanic white or Hispanic teens to engage in sexual activity [3] and HIV sexual risk-taking behavior [4].
    • Hispanic boys (55%) are significantly more likely than Hispanic girls (40%) to be sexually experienced [3].
    • Since 1991, sexual experience and the number of sexual partners in Hispanic youth has not declined significantly [4].

    Figure 1: National Campaign to Prevent Teen Pregnancy (2006) [3]

    Despite the decrease in sexual activity and an increase in condom use by sexually active students, still less than two-thirds of teens report using condoms during last intercourse [1; 5]. Consequently, these teens are putting themselves at risk for pregnancy and/or sexually transmitted diseases (STIs) including HIV. Approximately 50% of all new HIV infections occur among young people under the age of 25 [6]. It is estimated that 25% of all sexually active teens contract an STI each year, putting their health and their futures at risk [7].

    During the past decade, the rate of teen pregnancy in the United States has declined significantly to reach its lowest rate in 20 years [5]. Teen birth rates among females 15-19 years of age have declined by more than 33% since 1990 [8] (Figure 2). The National Campaign to Prevent Teen Pregnancy attributes these declines to both the decrease in the number of adolescents engaging in sexual activity and an increase in contraception use by teens who are already sexually active [3].

    Figure 2: From the National Center for Health Statistics (2005) [9].

    Hamilton BE, Ventura SJ, Martin JA, and Sutton PD. Preliminary births for 2004. Health E-stats. Hyattsville, MD: National Center for Health Statistics. Released October 28, 2005.

    Despite recent declines, the United States still has the highest rate of teen pregnancy of any industrialized nation (Figure 3) [10]. The US has twice the rate of teen pregnancy than Great Britain and 10 times the rate of the Netherlands [7]. More than one quarter (25%) of females under the age of 20 become pregnant each year – almost 900,000 pregnancies annually [7]. Fifty percent of all teen pregnancies occur within six months of a teen’s sexual debut [5], and over 90% of all teen pregnancies are unintended [6].

    Figure 3:

    Graph Retrieved from http://www.guttmacher.org/presentations/progress.ppt#9 : The Guttmacher Institute (AGI) *2001. Teenage Sexual and Reproductive Behavior in Developed Countries: Can More Progress be Made? Slides and Presentation, Slide 9. AGI, New York & Washington, December 2001.

    Teen parents and their children face many personal and financial challenges. A teen parent is more likely to be unemployed or earn low wages, as they are less likely to graduate from high school and receive a diploma or GED [10]. Children of teens generally experience poorer educational outcomes and poorer health outcomes [6] such as: low birth weight [5], problems with cognitive development and behavior [7;10]. Children of teen parents are also more likely to become teen parents themselves [7;10]. Since these children are more likely to be born into a single-parent household, money to provide for the child may become scarce. As a result, taxpayers pay roughly $7 billion per year in health services, childcare, and social services for children born to teen parents [10].

    While there has been progress in improving adolescent health outcomes, work remains to be done. We need to continue working with teens to delay the onset of sexual activity and promote the correct and consistent use of contraception among those teens already engaging in sexual activity to prevent the adverse consequences which may result. So the question then is what do we know? What has actually been proven effective in preventing pregnancy and STIs among teens in the United States? What can we do to improve the health outcomes for the youth in our programs?
     
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