On kidsdata.org, indicators of teen sexual health include rates of sexually transmitted infections (i.e., chlamydia and gonorrhea), by age group and by gender among young people ages 10-19; and the percentage of teens ages 14-17 who report that they have not had sex.
There is much pressure, biological and social, for young people to be sexually active, yet sexual activity can have serious negative consequences, including sexually transmitted infections (STIs). Even though youth ages 15-24 represent only 25% of the sexually active population in the U.S., they account for almost half of the 19 million new STI cases each year and are at increased risk for HIV infections (1). Chlamydia and gonorrhea are the most frequently reported bacterial STIs in the U.S., with the highest rates among girls ages 15-19 (2). If untreated, chlamydia and gonorrhea can lead to pelvic inflammatory disease and, in the long term, to infertility and adverse pregnancy outcomes (1, 2).
Many teens lack the information and cognitive skills needed to make informed decisions about sexual activity and how to prevent STIs (1). Once an STI is contracted, detection and treatment can be difficult because the majority of chlamydia and gonorrhea cases in women are asymptomatic (2). For this reason, education and routine screening are crucial. However, the Centers for Disease Control and Prevention (CDC) reports that STI screening occurs for less than half of those who should be screened (3).
STIs also have serious economic consequences. A 2004 study estimated the lifetime medical costs of STIs among American youth ages 15-24 to be $6.5 billion (4). In 2010, the CDC estimated that, overall, STIs cost the U.S. health care system about $17 billion annually (3).
For more information on teen sexual health, see kidsdata.org’s Research & Links section.
Sources for this narrative:
- Guttmacher Institute. (2011). Facts on American teens’ sexual and reproductive health. Retrieved from: http://www.guttmacher.org/pubs/FB-ATSRH.html
- Centers for Disease Control and Prevention. (2011). Sexually transmitted disease surveillance 2010. Atlanta, GA: Department of Health and Human Services. Retrieved from: http://www.cdc.gov/std/stats10/default.htm
- Centers for Disease Control and Prevention. (2011). STD trends in the United States: 2010 national data for gonorrhea, chlamydia, and syphilis. Atlanta, GA: Department of Health and Human Services. Retrieved from: http://www.cdc.gov/std/stats10/trends.htm
- Chesson, et al. (2004). The estimated direct medical cost of sexually transmitted diseases among American youth, 2000. Perspectives on Sexual and Reproductive Health, 36(1), 11-19.
Teens need accurate information and access to health care to make safe
choices about sexual activity and to receive appropriate care.
California law prevents withholding information about contraception if
sex education is offered in schools, and requires that factual
information provided be medically accurate and free of gender, racial,
and ethnic bias (1). But sex education itself is not required. Of
course, families also play an important role in teen
sexual health; teens who grow up in stable families with good
parent-child
relationships (including communication about sex) are more likely to
delay
sexual intercourse and use contraception (2).
California youth have the right to talk to their doctor confidentially
about sexual health (with limitations regarding sexual assault and
statutory rape), but some teens, their doctors, and parents may not
fully understand those rights (3). Insurance coding and reimbursement
can reveal the nature of the doctor visit, and thus challenge
confidentiality, or create disincentives for medical providers to
conduct assessments related to teen sexual health or safety.
According to research and subject experts, policy options to influence teen sexual health include:
- Requiring comprehensive health education in schools, including
specific skills-based information about reproductive health and
contraception (4, 5)
- Informing health care providers and youth about state confidentiality laws concerning sexual health and contraception (3)
- Expanding insurance reimbursement to cover comprehensive
psychosocial assessments (often known as a HEEADSSS exam) as a separate
service (6)
- Adapting public health and reimbursement policies to encourage
broader screening of youth for chlamydia and other sexually transmitted
diseases (7)
For more policy ideas and research on this topic, see kidsdata.org’s Research & Links section, or visit The National Campaign to Prevent Teen and Unplanned Pregnancy, or The Guttmacher Institute. Also see Policy Implications on kidsdata.org under Teen Births, Dating and Domestic Violence, and Health Care.
Sources for this narrative:
- California Adolescent Health Collaborative. (n.d.). Reproductive and sexual health. Retrieved from: http://www.californiateenhealth.org/pregnancy_sti_overview.asp
- Child Trends. (2010). Sexually experienced teens. Retrieved from: http://www.childtrendsdatabank.org/?q=node/316
- Duplessis, V., et al. (2010). Understanding confidentiality and minor consent in California: A module of the adolescent provider toolkit. Adolescent Health Working Group, California Adolescent Health Collaborative. Retrieved from: http://www.californiateenhealth.org/download/toolkit-rri-Web.pdf
- Mueller, T. E., et al. (2008). The
association between sex education and youth’s engagement in sexual
intercourse, age at first intercourse, and birth control use at first
sex. Journal of Adolescent Medicine, 42(1), 89-96. Retrieved from: http://www.jahonline.org/article/PIIS1054139X07003254/fulltext
- Ball, V., & Moore K. A. (2008). What works for adolescent
reproductive health: Lessons from experimental evaluations of programs
and interventions. Child Trends Fact Sheet, 2008-20. Retrieved from: http://www.childtrends.org/Files/Child_Trends-2008_05_20_FS_WhatWorksRepro.pdf
- Goldenring, J. M., & Rosen, D. S. (2004). Getting into adolescent heads: An essential update. Contemporary Pediatrics, 21(1), 64-90. Retrieved from: http://www.aap.org/pubserv/PSVpreview/pages/Files/HEADSS.pdf
- Fiscus, L. C., et al. (2004). Infrequency of sexually
transmitted disease screening among sexually experienced U.S. female
adolescents. Perspectives on Sexual and Reproductive Health, 36(6), 233-238. Retrieved from: http://www.guttmacher.org/pubs/journals/3623304.html
About 81% of California teens ages 14-17 reported in 2009 that they had
not had sex, similar to previous years. These data come from the
California Health Interview Survey, and should be considered estimates.
Some teens who engage in sexual activity contract infections, such as
chlamydia and gonorrhea. While those infections sometimes go unreported,
many of them are documented. In California, chlamydia rates increased almost 30% over a 10-year period, from 634.7 per 100,000 youth ages
10-19 in 2001 to 810.2 in 2011. The state’s rate of gonorrhea infection
among teens, which is lower than the chlamydia rate, fluctuated over the
last decade; it was 92.5 per 100,000 in 2011. Statewide and in most
counties, data from 2011 and previous years show that more females are diagnosed with gonorrhea and chlamydia than males. Similarly, teens ages 15-19 have higher rates of sexually transmitted infections than youth ages 10-14.