Adolescent Sexuality (page 3)

By — Pearson Allyn Bacon Prentice Hall
Updated on Jul 20, 2010

Sexually Transmitted Diseases (STDs) and HIV/AIDS

A possible consequence of not using effective contraception is contracting a sexually transmitted disease (STD). STDs are bacterial or viral infections that are passed from one person to another through sexual contact. Approximately 25%, or 3 out of 12 million, of sexually active youth (ages 15–19) contract an STD each year (CDC, 2003e). Sexually active adolescents are at high risk for STDs because they are more likely to have multiple sex partners in shorter-term relationships, engage in unprotected sex, and have partners who are also at higher risk for STDs.

Chlamydia and gonorrhea are the most common bacterial, and therefore curable, STDs among teens, and genital herpes is the most common viral STD contracted by adolescents.

Human immunodeficiency virus, or HIV, is the virus that causes AIDS. AIDS stands for Acquired Immunodeficiency Syndrome. Adolescents are disproportionately affected by the HIV/AIDS epidemic—they have higher infection rates than any other population group in the United States. The group with the highest infection rates is 20- to 24-year-olds. Given the 10-year incubation period for HIV, these young adults were most likely infected during adolescence. Reported rates for adolescents in other countries, particularly sub-Saharan Africa, are alarmingly high (UNAIDS/ WHO, 2002). Adolescent subgroups in the United States are not equally at risk for contracting HIV/AIDS. African American youth, other minorities, and females are particularly susceptible.  Homosexual male youth, urban youth, pregnant adolescents, and adolescent mothers are also at higher risk (Koniak-Griffin, Lesser, Uman, & Nyamathi, 2003). Although there is a decline in the national incidence of HIV/AIDS, it has not been accompanied by a decline in the number of new HIV cases among adolescents (CDC, 2003e).

Information about STDs is usually incorporated into sex education programs and, more recently, AIDS awareness programs. However, a recent study showed that being more knowledgeable about STDs or contracting an STD does not necessarily lead to an increase in condom use (AGI, 2003).

Adolescent Pregnancy

Another possible outcome from not using contraceptives is pregnancy. A total of 4.2% of adolescents reported being pregnant or had gotten someone pregnant one or more times (CDC, 2003d). This percent age marks a significant decline in pregnancy rates over the last decade,  but the United States still has the third-highest adolescent pregnancy rate in the world, behind only the Russian Federation and Bulgaria (Singh & Darroch, 2000). The pregnancy rate of African American teens in 2003 (9.1%) was almost four times higher than that of Caucasians who reported pregnancy during the same year (2.3%) (CDC, 2003d). The proportion of older adolescent females who become pregnant is twice as high (15.3% for ages 18–19) as the proportion of middle adolescents (6.2% for ages 15–17) (AGI, 1999).

An adolescent pregnancy may have several outcomes. The first is miscarriage, or a spontaneous abortion, in which the nonviable embryo or fetus is naturally expelled from the body. Approximately 14% of teen pregnancies end in miscarriage. A second outcome of pregnancy may be an induced abortion, in which the pregnancy is deliberately terminated. Abortion terminates approximately 30% of all adolescent pregnancies and involves a disproportionate number of Caucasian and higher-income teens (Donovan, 1995). Rates of adolescent abortion appear to be heavily underreported in national surveys, especially for non-White females (Jones & Forest, 1992). The number of reported adolescent abortions also has declined over the past decade.

A third pregnancy outcome is giving birth. The 2000 teen birthrate of 48.7 births per 1,000 15- to 19-year-old females is at a historic low for all racial/ethnic groups (Moore, Papillo, Williams, Jager, & Jones, 1999). Approximately one quarter of these births are to females under 15 years, and about three quarters are to 18- and 19-year-olds.

The recent trends in reduced adolescent pregnancies and births have been attributed to a decline in sexual activity and an increase in contraceptive use. The decline in sexual activity has been linked to greater HIV/AIDS awareness, more cautious attitudes towards casual sex, the heightened impact of abstinence education programs, and increased communication between parents and youth about sex. The increase in contraceptive use has also been attributed to HIV/AIDS awareness and to increased parent-teen communication. In addition, the higher availability of effective contraceptives and their correct use may have contributed to the reduction in pregnancies. From an analysis of available data the Alan Guttmacher Institute (2001) estimated that one quarter of the decline in teen pregnancies was due to delayed onset of sexual activity (abstinence) and three quarters to improved contraceptive use. A more recent study estimated that among single 15- to 19-year-old females, the delay of sexual activity (abstinence) accounts for 67% of the decline in pregnancy rates and 100% of the decline in birthrates (Mohn, Tingle, & Finger, 2003).

Consequences of adolescent pregnancy.
Despite these recent declines in adolescent pregnancies and birthrates, approximately 900,000 adolescent females give birth each year in the United States. Our society believes that teenage mothers put themselves and their offspring “at risk.” Past research has shown that mothers under 19 exhibit poorer educational achievement and are more likely to drop out of school (Hotz, McElroy, & Sanders, 1997; Woodward & Fergusson, 2002). They are also more likely to experience high stress and to suffer from depression (O’Callaghan, 2001), are less involved with peers and families, less effective in problem solving, and less cognitively prepared to assume parenting roles (Sommer, Whitman, Borkowski, Schellenbach, Maxwell, & Keogh, 1993). Adolescent mothers followed 3 to 5 years after the birth of their first child by the Notre Dame Parenting Project still tended to be undereducated, underemployed, and give birth to additional children (Whitman, Borkowski, Keogh, & Weed, 2001). Adolescent fathers typically complete less schooling, earn less income, and appear to engage in more delinquent behaviors and drug use than older fathers (Brien & Willis, 1997; Thornberry, Smith, & Howard, 1997; Thornberry et al., 2000).

Children of adolescent mothers weigh less at birth, have more health problems, suffer more physical abuse and neglect, and perform at a lower level in school (Wolfe & Perozek, 1997; Maynard, 1997; Moore, Morrison, & Greene, 1997). Children of adolescent mothers are also more likely to drop out of high school, run away from home, spend time in prison, and have their own children before the age of 19 (Haveman, Wolfe, & Peterson, 1997; Grogger, 1997).

In addition to the less-than-desirable individual outcomes associated with teenage parenting, Maynard (1997) estimated the financial cost to society of adolescent childbearing to be approximately $21 billion per year. As a result of a range of negative and costly consequences, countless pregnancy prevention programs have been designed and implemented, as illustrated in (Kirby, 2001). The following recommendations for middle and high school pregnancy prevention programs are based on existing programs that have had proven success:

  • Use instructional techniques that encourage youth engagement in and attachment to school
  • Address both pregnancy and STDs/HIV in sex education programs
  • Develop service-learning programs that incorporate community service and ongoing small group discussions
  • Have school-based or school-linked clinics that focus upon reproductive health and give clear messages about abstinence and use of contraception
  • Make condoms available through school programs

Although teenage pregnancy is viewed in the United States largely as a “problem” with negative short- and long-term outcomes for mothers, fathers, and children, recent research based on comprehensive and longitudinal data suggests that this profile does not apply to all adolescent families (Whitman, Borkowski, Keogh, & Weed, 2001). For some adolescent girls, becoming mothers makes them vulnerable to the stress associated with single parenting, including higher rates of depression, child abuse, unemployment, and poverty. However, there are teen mothers who, with sufficient cognitive skills and educational and economic support, show a resiliency that encourages competent parenting and more favorable developmental outcomes for themselves and their children. By examining individual trajectories, we get a better and more accurate sense of the complexity of the factors that determine the outcomes of teenage pregnancy. In addition, we see more clearly how the “interwoven lives” of mothers and children influence the direction of these trajectories.

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