Sexually Transmitted Infections, by Age Group
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Learn More About Teen Sexual Health

Measures of Teen Sexual Health on Kidsdata.org
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.
Teen Sexual Health
Alcohol, Tobacco, and Other Drugs
Dating and Domestic Violence
Health Care
Teen Births
Why This Topic Is Important
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:

  1. Guttmacher Institute. (2011). Facts on American teens’ sexual and reproductive health. Retrieved from: http://www.guttmacher.org/pubs/FB-ATSRH.html
  2. 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
  3. 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
  4. 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. Retrieved from: http://www.guttmacher.org/pubs/journals/3601104.html

How Children Are Faring
About 82% of California teens ages 14-17 reported in 2011-12 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 have increased more than 20% over the past decade, from 635.4 per 100,000 youth ages 10-19 in 2000 to 772.6 in 2012. The state’s rate of gonorrhea infection among teens, which is lower than the chlamydia rate, fluctuated over the last decade; it was 95.8 per 100,000 in 2012. Statewide and in most counties, data from 2012 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.
Policy Implications
Teens need accurate information and access to health care to make safe, informed choices about sexual activity, and to receive appropriate care. While sex education is not required (beyond HIV/AIDS prevention, which has been required since 1992), California law prevents withholding information about contraception if sex education is offered in schools, and mandates that the facts are medically accurate and free of gender, racial, and ethnic bias (1). 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 to 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, doctors, and parents/guardians may not fully understand those rights (3). In addition, insurance coding and reimbursement is a challenge to confidentiality as it can reveal the nature of the doctor visit to parents or guardians.

According to research and subject experts, policy options to improve teen sexual health include:
  • Informing health care providers and youth about state confidentiality laws concerning sexual health and contraception (3)
  • Requiring comprehensive health education in schools, including specific skills-based information about reproductive health, including STD-prevention, and contraception (4)
  • Expanding insurance reimbursement to cover comprehensive psychosocial assessments (often known as the HEEADSSS exam) as a separate service (5)
  • Adapting public health and reimbursement policies to encourage broader screening of youth for chlamydia and other sexually transmitted diseases (6)
  • Exploring technologically innovative methods (such as text messages and online interactives) of communicating sexual health education as they offer confidentiality and are consistent with adolescents’ new-media communications style (7)
  • Supporting school-based health centers to ensure accessible preventive and ongoing services for teens (8)
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: 

1.  California Department of Education. (2013). Frequently asked questions. Retrieved from: http://www.cde.ca.gov/ls/he/se/faq.asp

2.  Markham, C., et al. (2010). Connectedness as a predictor of sexual and reproductive health outcomes for youth. Journal of Adolescent Health 46(3), S23-S41. Retrieved from: http://www.researchgate.net/publication/51442181_Connectedness_as_a_predictor_of_sexual_and_reproductive_health_outcomes_for_youth/file/32bfe5118294039b06.pdf

3.  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

4.  United Nations Expert Group Meeting on Adolescents. (2011). Sex education: Access and impact on sexual behavior of young people. (2011). Retrieved from: http://www.un.org/esa/population/meetings/egm-adolescents/p07_kirby.pdf 

5.  Marcell, A., et al. (2011). Male adolescent and sexual reproductive health care. Pediatrics, (128)6, e1658-e1676. Retrieved from: http://pediatrics.aappublications.org/content/128/6/e1658.full

6.  Adams, S. et al. (2009). Adolescent preventive services: Rates and disparities in preventive health topics covered during routine medical care in a California sample. Journal of Adolescent Health, 44(6), 536-545. Retrieved from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2730825/

7.  Levine, D. (2011). Using technology, new media, and mobile for sexual and reproductive health.  Sexuality Research and Public Policy, 8(1), 18-26. Retrieved from: http://link.springer.com/article/10.1007/s13178-011-0040-7

8.  Ethier, K., et al. (2011). School-based health center access, reproductive health care, and contraceptive use among sexually experienced high school students. Journal of Adolescent Health 48(6), 562-565. Retrieved from: http://www.region8ipp.com/Docs/Ethier.pdf

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