Saturday, September 3, 2016

Adolescent Reproductive Health; Sexual Risk Behaviors and Teen Pregnancy

About 16 million women 15–19 years old give birth each year, about 11% of all births worldwide.  

Ninety-five per cent of these births occur in low- and middle-income countries. The average adolescent birth rate in middle income countries is more than twice as high as that in high-income countries, with the rate in low-income countries being five times as high.

The proportion of births that take place during adolescence is about 2% in China, 18% in Latin America and the Caribbean and more than 50% in sub-Saharan Africa.

Half of all adolescent births occur in just seven countries: Bangladesh, Brazil, the Democratic Republic of the Congo, Ethiopia, India, Nigeria and the United States.

Teen Pregnancy in the United States

In 2014, a total of 249,078 babies were born to women aged 15–19 years, for a birth rate of 24.2 per 1,000 women in this age group.  This is another historic low for U.S. teens and a drop of 9% from 2013. Birth rates fell 11% for women aged 15–17 years and 7% for women aged 18–19 years. 
Although reasons for the declines are not clear, more teens may be delaying or reducing sexual activity, and more of the teens who are sexually active may be using birth control than in previous years.

Still, the U.S. teen pregnancy rate is substantially higher than in other western industrialized nations, and racial/ethnic and geographic disparities in teen birth rates persist.

Many young people engage in sexual risk behaviors that can result in unintended health outcomes. For example, among U.S. high school students surveyed in 2015
  • 41% had ever had sexual intercourse.
  • 30% had had sexual intercourse during the previous 3 months, and, of these 
    • 43% did not use a condom the last time they had sex.
    • 14% did not use any method to prevent pregnancy.
    • 21% had drunk alcohol or used drugs before last sexual intercourse.
  • Only 10% of sexually experienced students have ever been tested for human immunodeficiency virus (HIV).*
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*CDC recommends all adolescents and adults 13-64 get tested for HIV at least once as part of routine medical care.
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Sexual risk behaviors place adolescents at risk for HIV infection, other sexually transmitted diseases (STDs), and unintended pregnancy:
  • Young people (aged 13-24) accounted for an estimated 22% of all new HIV diagnoses in the United States in 2014.
  • Among young people (aged 13-24) diagnosed with HIV in 2014, 80% were gay and bisexual males.
  • Half of the nearly 20 million new STDs reported each year were among young people, between the ages of 15 to 24.
  • Nearly 250,000 babies were born to teen girls aged 15–19 years in 2014.


Preventing Pregnancies in Younger Teens, Infographic, CDC
Source: CDC


27% of women ages 15 to 17 report having ever had sex. This infographic shows 3 bar charts representing women ages 15 to 17 who report having ever had sex.
  • Age 15: Teens who have ever had sex, 15%. Teens who are currently sexually active, 8%.
  • Age 16: Teens who have ever had sex, 29%. Teens who are currently sexually active, 17%.
  • Age 17: Teens who have ever had sex, 39%. Teens who are currently sexually active, 30%.



The South Carolina Campaign to Prevent Teen Pregnancy, Poster, CDC
Source: CDC

 

Adolescent pregnancy is dangerous for the mother


Although adolescents aged 10-19 years account for 11% of all births worldwide, they account for 23% of the overall burden of disease (disability- adjusted life years) due to pregnancy and childbirth.

Fourteen percent of all unsafe abortions in low- and middle-income countries are among women aged 15–19 years. About 2.5 million adolescents have unsafe abortions every year, and adolescents are more seriously affected by complications than are older women.

In Latin America, the risk of maternal death is four times higher among adolescents younger than 16 years than among women in their twenties.

Many health problems are particularly associated with negative outcomes of pregnancy during adolescence. These include anaemia, malaria, HIV and other sexually transmitted infections, postpartum haemorrhage and mental disorders, such as depression.

Up to 65% of women with obstetric fistula develop this as adolescents, with dire consequences for their lives, physically and socially.


Adolescent pregnancy is dangerous for the child


Stillbirths and death in the first week of life are 50% higher among babies born to mothers younger than 20 years than among babies born to mothers 20–29 years old.

Deaths during the first month of life are 50–100% more frequent if the mother is an adolescent versus older, and the younger the mother, the higher the risk.

The rates of preterm birth, low birth weight and asphyxia are higher among the children of adolescents, all of which increase the chance of death and of future health problems for the baby.

Pregnant adolescents are more likely to smoke and use alcohol than are older women, which can cause many problems for the child and after birth.


Adolescent pregnancy adversely affects communities


Many girls who become pregnant have to leave school. This has long-term implications for them as individuals, their families and communities.

Studies have shown that delaying adolescent births could significantly lower population growth rates, potentially generating broad economic and social benefits, in addition to improving the health of adolescents.


The Importance of Prevention


Teen pregnancy and childbearing bring substantial social and economic costs through immediate and long-term impacts on teen parents and their children.

  • In 2010, teen pregnancy and childbirth accounted for at least $9.4 billion in costs to U.S. taxpayers for increased health care and foster care, increased incarceration rates among children of teen parents, and lost tax revenue because of lower educational attainment and income among teen mothers.
  • Pregnancy and birth are significant contributors to high school dropout rates among girls. Only about 50% of teen mothers receive a high school diploma by 22 years of age, whereas approximately 90% of women who do not give birth during adolescence graduate from high school.
  • The children of teenage mothers are more likely to have lower school achievement and to drop out of high school, have more health problems, be incarcerated at some time during adolescence, give birth as a teenager, and face unemployment as a young adult.

These effects continue for the teen mother and her child even after adjusting for those factors that increased the teenager’s risk for pregnancy, such as growing up in poverty, having parents with low levels of education, growing up in a single-parent family, and having poor performance in school.


Having youth-friendly reproductive health visits for teens


Teens Visiting a Health Clinic, Infographic, CDC
Source: CDC


Preventing Pregnancies in Younger Teens, Infographic, CDC
Source: CDC


To reduce sexual risk behaviors and related health problems among youth, schools and other youth-serving organizations can help young people adopt lifelong attitudes and behaviors that support their health and well-being—including behaviors that reduce their risk for HIV, other STDs, and unintended pregnancy. The National HIV/AIDS Strategy calls for all Americans to be educated about HIV. This includes knowing how HIV is transmitted and prevented, and knowing which behaviors place individuals at greatest risk for infection. HIV awareness and education should be universally integrated into all educational environments.

Abstinence is the only 100 percent effective method for avoiding unintended pregnancy and sexually transmitted infections, including HIV. Teens—especially young teens—should be encouraged to delay sexual initiation. Educators should acknowledge the importance of abstinence and provide youth with the knowledge, attitudes, and skills necessary to make abstinence work. However, even youth who pledge to remain abstinent need information about contraception and condoms to help them prevent unintended pregnancy, HIV and other STIs when they do become sexually active.

The correct and consistent use of male latex condoms can reduce the risk of STD transmission, including HIV infection. However, no protective method is 100% effective, and condom use cannot guarantee absolute protection against any STD or pregnancy.


What Could We Do


Federal government is

  • Developing and evaluating programs in communities where teen births are highest.
  • Supporting states in efforts to reduce pregnancies, births, and abortions among teens.
  • Working to improve the health and social well-being of teens to reach the Healthy People 2020 national objective to reduce pregnancy in teens ages 15-17.


Doctors, nurses, and other health care providers can

  • Encourage teens to delay sexual activity.
  • Encourage sexually active teens to consider the most effective reversible methods of birth control. Refer to CDC guidelines.
  • Make clinic visits suitable for teens by offering convenient office hours and confidential, respectful, and culturally appropriate services[PDF - 3.20MB].
  • Talk about using condoms correctly every time during sex to prevent sexually transmitted diseases, including HIV/AIDS, even if another birth control method is used.
  • Discuss normal physical, emotional, and sexual development with teens and parents.


Parents, guardians, and caregivers can

  • Talk with teens about sex, including:
  • Normal sexual development, and how and when to say "no" to sex.
  • Having a mutually respectful and honest relationship.
  • Using birth control if they have sex and a condom every time.
  • Know where their teens are and what they are doing, particularly after school.
  • Be aware of their teen's use of social media and digital technology (e.g., cell phones, computers, tablets).


Younger teens can

  • Know both they and their partner share responsibility for preventing pregnancy and resisting peer pressure to start having sex until they are older.
  • Talk openly about sexual health issues with parents, other adults they trust, and their friends.
  • See a health care provider to learn about the most effective types of birth control and use it and condoms correctly every time.

School can
School health programs can help youth adopt lifelong attitudes and behaviors that support overall health and well-being—including behaviors that can reduce their risk for HIV and other sexually transmitted diseases (STDs).


HIV, STD, and teen pregnancy prevention programs in schools should

  • Address the needs of youth who are not having sex as well as youth who are currently sexually active.
  • Ensure that all youth are provided with effective education to protect themselves and others from HIV infection, other STDs, and unintended pregnancy.
  • Be developed with the active involvement of students and parents.
  • Be locally determined and consistent with community values and relevant policies.


  
For More....




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