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- Definition: Number of chlamydia and gonorrhea infections among youth ages 10-19, by age group.Rate of chlamydia and gonorrhea infections per 100,000 youth ages 10-19, by age group.
- Data Source: California Dept. of Public Health, Sexually Transmitted Diseases Data; California Dept. of Finance, Race/Ethnic Population with Age and Sex Detail, 2000-2010, 2010-2060; Centers for Disease Control and Prevention, Sexually Transmitted Diseases; U.S. Census Bureau, Population Division, Estimates of the Resident Population by Sex & Age for the United States, 2000-2010, 2010-2014 (Sept. 2015).
- Footnote: LNE (Low Number Event) refers to data that have been suppressed because the population at risk minus the number of (non-zero) cases of sexually transmitted infections was less than 100. N/A means that data are not available.
- Measures of Teen Sexual Health on Kidsdata.org
On kidsdata.org, indicators of teen sexual health include rates and counts of sexually transmitted infections (i.e., chlamydia and gonorrhea), by age group, gender, and race/ethnicity, 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
- Intimate Partner Violence
- Health Care
- Delayed or No Medical Care
- Length of Time Since Last Routine Health Check-Up
- Visited the Emergency Room in Last Year, by Type of Insurance
- Uninsured at Any Point in Last Year
- Health Insurance Coverage (Regions of 65,000 Residents or More), by Type of Insurance and Age
- Health Insurance Coverage (Regions of 10,000 Residents or More), by Type of Insurance and Age
- Medi-Cal Enrollment
- Receipt of Care Within a Medical Home (Regions of 70,000 Residents or More)
- Adequate Health Services Provided at School (Staff Reported)
- School Health Centers
- Youth Alcohol, Tobacco, and Other Drug Use
- Alcohol/Drug Use in Past Month (Student Reported), by Grade Level
- Alcohol/Drug Use on School Property in Past Month (Student Reported), by Grade Level
- Alcohol Use in Past Month (Student Reported), by Grade Level
- Alcohol Use in Lifetime (Student Reported), by Grade Level
- Alcohol Use on School Property in Past Month (Student Reported), by Grade Level
- Usual Level of Alcohol Intoxication (Student Reported), by Grade Level
- Binge Drinking in Past Month (Student Reported), by Grade Level
- Drinking and Driving or Riding with a Driver Who Had Been Drinking (Student Reported), by Grade Level
- Cigarette Use in Past Month (Student Reported), by Grade Level
- Cigarette Use in Lifetime (Student Reported), by Grade Level
- Cigarette Use on School Property in Past Month (Student Reported), by Grade Level
- Inhalant Use in Lifetime (Student Reported), by Grade Level
- Marijuana Use in Past Month (Student Reported), by Grade Level
- Marijuana Use in Lifetime (Student Reported), by Grade Level
- Marijuana Use on School Property in Past Month (Student Reported), by Grade Level
- Recreational Use of Prescription Drugs in Lifetime (Student Reported), by Grade Level
- Usual Level of Marijuana or Other Drug Intoxication (Student Reported), by Grade Level
- Student Alcohol and Drug Use Is a Problem at School (Staff Reported)
- Substance Abuse Prevention Is an Important Goal at School (Staff Reported)
- Substance Use Prevention Education Is Provided at School (Staff Reported)
- School Provides Effective Support and Referral Services for Substance Abuse, Violence, or Other Problems (Staff Reported)
- 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.; rates are highest among young people (ages 15-24) and some racial/ethnic minority populations (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 (2, 3).
STIs also have serious economic consequences. In 2013, the CDC estimated that, overall, STIs cost the U.S. health care system about $16 billion annually (3).For more information on teen sexual health, see kidsdata.org’s Research & Links section.
Sources for this narrative:
1. Guttmacher Institute. (2014). American teens’ sexual and reproductive health (Fact Sheet). Retrieved from: http://www.guttmacher.org/pubs/FB-ATSRH.html
2. Centers for Disease Control and Prevention. (2014). Sexually transmitted disease surveillance 2013. U.S. Department of Health and Human Services. Retrieved from: http://www.cdc.gov/std/stats13/default.htm
3. Centers for Disease Control and Prevention. (2013). Incidence, prevalence, and cost of sexually transmitted infections in the United States (CDC Fact Sheet). U.S. Department of Health and Human Services. Retrieved from: https://npin.cdc.gov/publication/incidence-prevalence-and-cost-sexually-transmitted-infections-united-states
- 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 increased steadily between 2000 and 2008, but have begun to decline in recent years. Rates per 100,000 youth ages 10-19 have decreased from 815.0 in 2008 to 684.4 in 2014. The state’s rate of gonorrhea infection among teens, which is lower than the chlamydia rate, fluctuated over the last decade; it was 112.1 per 100,000 in 2014. Statewide and in most counties, data from 2014 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, and African American/Black and Hispanic/Latino youth have higher rates of infection than White and Asian/Pacific Islander youth.
- 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:
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.
- 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 in order to ensure that sexuality and other important components of adolescents' histories are discussed (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)
Sources for this narrative:
1. California Department of Education. (2014). Comprehensive sexual health & HIV/AIDS instruction: Frequently asked questions. Retrieved from: http://www.cde.ca.gov/ls/he/se/faq.asp
2. Markham, C. M., et al. (2010). Connectedness as a predictor of sexual and reproductive health outcomes for youth. Journal of Adolescent Health, 46(Suppl. 3), S23-S41. Retrieved from: http://www.researchgate.net/publication/51442181
3. Duplessis, V., et al. (2010). Understanding confidentiality and minor consent in California (2nd ed.). Adolescent Health Working Group and California Adolescent Health Collaborative. Retrieved from: http://www.californiateenhealth.org/what-we-do/publications/understanding-confidentiality-and-minor-consent-in-california
4. Kirby, D. (2011). Sex education: Access and impact on sexual behavior of young people. Paper presented at the United Nations Expert Group Meeting on Adolescents, Youth and Development. Retrieved from: http://www.un.org/esa/population/meetings/egm-adolescents/p07_kirby.pdf
5. Marcell, A. V., et al. (2011). Male adolescent sexual and reproductive health care. Pediatrics, 128(6), e1658-e1676. Retrieved from: http://pediatrics.aappublications.org/content/128/6/e1658
6. Adams, S. H., 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.jahonline.org/article/S1054-139X(08)00406-0/fulltext
7. Levine, D. (2011). Using technology, new media, and mobile for sexual and reproductive health. Sexuality Research and Social Policy, 8(1), 18-26. Retrieved from: http://link.springer.com/article/10.1007/s13178-011-0040-7
8. Ethier, K. A., 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.researchgate.net/publication/51130158
- Websites with Related Information
- Center for Research on Adolescent Health and Development, Public Health Institute
- Centers for Disease Control and Prevention: Sexual Risk Behaviors
- Child Trends: Teen Pregnancy/Reproductive Health
- Guttmacher Institute: Adolescents
- Journal of Adolescent Health
- Physicians for Reproductive Health
- The National Campaign to Prevent Teen and Unplanned Pregnancy
- Key Reports
- 2013 Sexually Transmitted Diseases Surveillance: Special Focus Profiles, 2014, Centers for Disease Control and Prevention
- Adolescents’ Views Regarding Uses of Social Networking Websites and Text Messaging for Adolescent Sexual Health Education, 2011, American Journal of Health Education, Selkie, E. M., et al.
- American Teens' Sexual and Reproductive Health, 2014, Guttmacher Institute
- Finding Teens in TheirSpace: Using Social Networking Sites to Connect Youth to Sexual Health Services, 2011, Sexuality Research and Social Policy, Ralph, L. J., et al.
- Improvement in Adolescent Screening and Counseling Rates for Risk Behaviors and Developmental Tasks, 2012, Pediatrics, Duncan, P., et al.
- Programs to Reduce Teen Pregnancy, Sexually Transmitted Infections, and Associated Sexual Risk Behaviors: A Systematic Review, 2013, U.S. Department of Health and Human Services, Goesling, B., et al.
- School-Based Health Center Access, Reproductive Health Care, and Contraceptive Use Among Sexually Experienced High School Students, 2011, Journal of Adolescent Health, Ethier, K. A., et al.
- Sexual Health Disparities Among African American Youth and the Need for Early Prevention Approaches: Parenting and Youth Development Programs as Strategies for Pre-Risk Prevention, 2009, Journal of Equity in Health, Miller, K. S., et al.
- Sexual Initiation, Contraceptive Use, and Pregnancy Among Young Adolescents, 2013, Pediatrics, Finer, L. B., & Philbin, J. M.
- Sociocultural Determinants of Teenage Childbearing Among Latinas in California, 2010, Maternal and Child Health Journal, Dehlendorf, C., et al.
- Trends and Recent Estimates: Contraceptive Use Among U.S. Teens and Young Adults, 2011, Child Trends, Welti, K., et al.
- What Works for Adolescent Sexual and Reproductive Health: Lessons from Experimental Evaluations of Programs and Interventions, 2014, Child Trends, Fish, H., et al.
- County/Regional Reports
- 2012 California Adolescent Sexual Health Needs Index (CASHNI), California Dept. of Public Health
- 2016 Kern County Report Card, Kern County Network for Children
- Children's Report Card, Sacramento County Children's Coalition
- Community Health Assessment 2015, Los Angeles County Dept. of Public Health
- County of San Mateo Adolescent Report 2014-15, San Mateo County Health System
- Fresno Community Scorecard
- San Diego County Report Card on Children and Families, 2015, The Children's Initiative & Live Well San Diego
- San Diego: Increasing Condom Use Among Sexually Active Teens, 2011, Centers for Disease Control and Prevention
- Santa Clara County Children's Agenda: 2016 Data Book, Planned Parenthood & Kids in Common
- More Data Sources For Teen Sexual Health
- California Health Interview Survey, UCLA Center for Health Policy Research
- CDC WONDER: Sexually Transmitted Diseases - Interactive Data, Centers for Disease Control and Prevention
- Childstats.gov, Federal Interagency Forum on Child and Family Statistics
- National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP) Atlas, Centers for Disease Control and Prevention
- Youth Risk Behavior Surveillance System (YRBSS), Centers for Disease Control and Prevention