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1 in 5 teens has sex before 15th birthday
New report underscores teen sexual activity
A 13-year-old female sits in your exam room. On her initial gynecologic exam at age 12, she did not indicate that she was sexually active. On this return visit, which was prompted by complaints of vaginal itchiness and discharge, tests indicate Trichomonas vaginalis infection. What is your next step?
Know that this young teen is not the only adolescent who has initiated early sexual activity. According to a new report issued by the Washington, DC-based National Campaign to Prevent Teen Pregnancy, approximately one in five adolescents has had sexual intercourse before his or her 15th birthday.1 The report also notes that one in seven sexually experienced 14-year-old girls reports having been pregnant.1
Despite recent declines, the United States has one of the highest teen pregnancy rates in the developed world. The U.S. teen-age birthrate of 45 per 1,000 women aged 15-19 in 2001, down 27% from its peak in 1991, remains about twice as high as rates in Great Britain and Canada, and five times as high as in Sweden and France, according to the Alan Guttmacher Institute (AGI), the New York City-based research organization. AGI has just issued newly updated data on numbers and rates of teen-age births from 1972-2001 and on teen-age pregnancies, abortions, and miscarriages from 1972-1999.2
There is very good reason to be concerned about sexual activity among very young adolescents, says Sarah Brown, director of the National Campaign to Prevent Teen Pregnancy.
"We know that as compared to those who delay sexual activity, those who have sex at a young age are more likely to have a greater number of sexual partners over time, thereby increasing their risk of both too-early pregnancy and sexually transmitted diseases [STDs]," Brown observes. "Second, we know that the younger a girl is the first time she has sex, the more likely she is to say that the sex was unwanted."
Eight out of 10 sexually experienced youth ages 12-14 say they wish they had waited longer to have sex,3 notes Brown. Children who are born to girls age 14 and younger are more likely than children born to older girls and women to have numerous problems as they age, ranging from health problems to father absence to school failure,1 she points out.
What can you do?
How can clinicians approach the subject of sexuality, particularly when it comes to young teens? Melanie Gold, DO, associate professor in pediatrics at the University of Pittsburgh School of Medicine and director of family planning services at the Children’s Hospital of Pittsburgh, offers the following suggestions:
• Encourage parents to respectfully ask younger teens about their ideas about love, sex, and future plans and share with them their own values and beliefs. Acknowledge where they see eye to eye and where they do not.
• Advise parents to encourage their younger teens to spend time with same-age peers (same and opposite-gender) in supervised settings and discourage single-couple dating, especially with partners who are three or more years older, until teens are 15 or older.
• Advocate for and demand that schools teach middle school students about sexuality, contraception, and STD prevention in a nonjudgmental, factual way.
• Always provide adolescents, especially those who are 9 to 14 years old, the opportunity to discuss and ask questions about reproductive health issues without a parent or caretaker present.
• Discuss with parents and younger teens the potential risk of forced or unwanted sex when a boyfriend or girlfriend is three or more years older than the teen. Health care providers, parents, and teens should know what constitutes statutory rape in the state in which they live and be aware of the health care provider’s legal obligations to report such behaviors.
What is the next step when it comes to preventing teen pregnancy, particularly among young teens?
"At the most fundamental level, these young people need what all adolescents need — close, caring, involved relationships with parents and other adults in their lives; options for the future that are more attractive than early sex, pregnancy, and parenthood; and the opportunity to participate in engaging, useful activities and programs suited for their age group," states Brown.
They also need strong encouragement to delay sexual activity, along with close supervision and connections to positive peer groups and friends, she says.
"They [also] need good information about sex, love, and relationships, including information about the benefits and limitations of contraception," Brown says.
1. National Campaign to Prevent Teen Pregnancy. 14 and Younger: The Sexual Behavior of Young Adolescents. Washington DC; May 2003. Available at www.teenpregnancy.org.
2. Henshaw SK. U.S. Teenage Pregnancy Statistics with Comparative Statistics For Women Aged 20-24. New York City: Alan Guttmacher Institute; May 2003.
3. National Campaign to Prevent Teen Pregnancy. With One Voice: America’s Adults and Teens Sound Off About Teen Pregnancy. Washington DC; December 2002. Available at www.teenpregnancy.org.