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Focus on Sexual and Reproductive Health

Across the United States, young people are at risk for unintended pregnancy and sexually transmitted Infections (STIs) including HIV. Florida’s youth are likelier to experience negative sexual health outcomes than most U.S. youth – with young people of color and LGBT (lesbian, gay, bisexual, and transgender) the most at risk. Because the risk for negative sexual health outcomes is a reality, comprehensive sexuality education, health equity, and access to contraception are more important than ever to the health of Florida’s youth.

Florida’s Youth Population is Diverse and Growing

• Youth age 15-24 make up almost 13 percent of the total population of Florida.
• According to the 2010 Census, 58 percent of Floridians are white, 16 percent are African American/Black, 22.5 percent are of Hispanic descent and 2 percent are Asian.
• In 1995, Florida had the third largest youth population out of any state, is anticipated to have the second largest youth population by 2025.

Sexual Health Outcomes in Florida: Many Youth Experience Pregnancy, HIV, and STIs

• The teen pregnancy rate in Florida in 2005 for girls age 15-19 was 77 pregnancies per 1,000, which is higher than the national average of 70 pregnancies per 1,000. Almost 30,000 youth experienced pregnancy in Florida in 2005. Florida is ranked number 12 among the states for teen pregnancy rate (meaning only 11 states have a higher teen pregnancy rate than Florida).
• Florida’s teen abortion rate ranks 2nd in the U.S., with a rate of 24 abortions per 1,000 young women ages 15–19 compared to the national rate of 19 abortions per 1,000.
• Florida has the second-highest AIDS rate in the nation. In Florida, 15 percent of all new infections of HIV are among youth under the age of 25. [5]
• Florida’s young people ages 15-24 experience higher rates of gonorrhea and Chlamydia than the national average. In 2010, there were over 50,000 cases of Chlamydia and over 12,000 cases of gonorrhea among Florida’s young people.
• According to the 2009 Youth Risk Behavior Survey, 50.6 percent of Florida’s high school students have had sex by the time they graduate, a number higher than the national average of 46 percent. Of those students, 35 percent did not use a condom at last intercourse and 84 percent did not use birth control pills.

Social Factors Put Florida’s Racial and Sexual Minority Youth At Risk

• Among young women ages 15-19, white women have the highest number of births (almost 9,000). But African American and Hispanic teens have a higher rate of births - African American teens are more than twice as likely as whites to give birth and Hispanic teens, nearly twice as likely as whites.
  
  
• Barriers to contraceptive access, poverty, and structural exclusion and disadvantage all contribute to young people’s ability and motivation to prevent unintended pregnancy.
  
  
• African Americans are greatly overrepresented in Florida’s HIV epidemic. The HIV rate in Florida is four times as high among African American men as white men, and 15 times as high among African American women as white women. Seventy percent of HIV/AIDS cases among young people ages 13-24 in Florida, are among African American youth. [5]
  
  
• A person’s HIV and STI risk is not solely dependent on their personal behaviors. Because of high rates in the community in general, an individual African American/Black youth has a higher risk of acquiring HIV or STIs even when they have the same or fewer risk behaviors than white youth.
  
  
• Lesbian, gay, bisexual, and transgender (LGBT) youth in Florida are marginalized and at risk for HIV
  • Seventy-six percent of Florida’s young people report hearing homophobic slurs in school, while 41 percent report that bullying, name-calling, and harassment are somewhat serious problems at their school.
    
    
  • Young men who have sex with men account for 35 percent of HIV/AIDS cases among Florida’s young people ages 13-24, even though gay men represent less than five percent of Florida’s population. Nationwide, HIV rates for young men ages 13-24 who have sex with men have risen. African Americans in this category experienced the sharpest rise. [5]

Sex Education Varies By District in Florida, But Most Parents Want Comprehensive Sex Ed

• In Florida, each school district has the discretion to create health education curricula which “reflect local values and concerns” – meaning states have the freedom to implement Department of Education guidelines recommend selecting an evidence-based and medically accurate curriculum, and gathering input from the community to determine what type of curricula is appropriate for its schools.
  
  
• Where districts have not created a policy, they use Florida’s state statutes. These require health instruction that emphasizes abstinence, and whenever instruction on human sexuality is given, it must emphasize that abstinence until heterosexual marriage is the expected standard for school age students. [15]
  
  
• A survey of Florida parents found that 74 percent want schools to offer sex education that includes information about contraception and condoms. [15]
  
  
• Even though school districts have the discretion to create health education curricula which reflect the local values and concerns of their communities, and a vast majority of Florida parents support a comprehensive approach to sex education, Florida’s legislature recently did not allow its department of health to accept funding for comprehensive sex education programs.
  
  
• Florida did accept over $2.6 million in funding for Title V abstinence-only-until-marriage programs permitted under the Patient Protection and Affordable Care Act of 2010 (also known as health care reform). [16]
  
  
• Recent research on abstinence-only programs found them ineffective, with no impact on reducing teen pregnancy, delaying sexual initiation, or reducing STIs.
• Recent research on comprehensive sexuality education has shown that young people who receive complete and accurate information about abstinence, condoms, and contraception were not more likely to acquire an STI, but were significantly less likely to be involved in teen pregnancy and were significantly more likely to use condoms once sexually active. [18]

Conclusion

Florida’s Youth are at serious risk for pregnancy, HIV and STIs; youth of color and LGBT youth are at disproportionate risk for negative sexual health outcomes. Research shows that comprehensive sexuality education and access to contraceptive services can help young people protect their health and well-being.19 But in addition to helping youth choose healthier behaviors, protecting these young people will also require the dismantling of barriers to health equity (including poverty, lack of insurance, and disparities in education) and support of structural interventions that help make the entire population healthier.

Written by Lauren Kalina

Advocates for Youth © October 2011

References

1. U.S. Census Bureau. “2005-2009 American Community Survey. Florida.” Accessed from http://factfinder.census.gov/servlet/STTable?_bm=y&-geo_id=04000US12&-qr_name=ACS_2009_5YR_G00_S0101&-ds_name=ACS_2009_5YR_G00_ on June 22, 2011.
2. U.S. Census Bureau. “Florida State and County Quick Facts.” Accessed from http://quickfacts.census.gov/qfd/states/12000.html on June 22, 2011.
3. U.S. Census Bureau. “Florida’s populations Projections: 1995 to 2025.” Accessed from http://www.census.gov/population/projections/state/9525rank/flprsrel.txt on June 22, 2011.
4. Guttmacher Institute. “U.S. Teenage Pregnancies, Births and Abortions: National and State Trends and Trends by Race and Ethnicity.” Accessed from http://www.guttmacher.org/pubs/USTPtrends.pdf on June 24, 2011.
5. Florida Department of Health, Bureau of HIV/AIDS. “Florida HIV/AIDS 2009 Update.” Accessed June 24, 2011 from http://www.doh.state.fl.us/disease_ctrl/aids/Docs/Florida_HIVAIDS_Update_2009.pdf
6. Centers for Disease Control and Prevention. “STDs in Adolescents and Young Adults.” Accessed October 7, 2011 from http://www.cdc.gov/std/stats09/adol.htm.
7. Centers for Disease Control and Prevention. “Rates of Reportable STDs among Young People 15-24 years of age, Florida, 2009.” Accessed October 7, 2011 from http://www.cdc.gov/std/stats/by-age/15-24-all-STDs/state/2009/FL09.pdf]
8. Florida Department of Health, Bureau of STD control and Prevention. “Gonorrhea State Total by Year, Sex and Age.” Accessed from http://www.doh.state.fl.us/disease_ctrl/std/trends/florida/Gostate.pdf on June 24, 2011.
9. Florida Department of Health, Bureau of STD control and Prevention. “Chlamydia State Total by Year, Sex and Age.” Accessed from http://www.doh.state.fl.us/disease_ctrl/std/trends/florida/Chstate.pdf on June 24, 2011.
10. Centers for Disease Control and Prevention. Youth Risk Behavior Surveillance — United States, 2009 Surveillance Summaries. MMWR 2010;59(No. SS-5).
11. The National Campaign to Prevent Teen and Unplanned Pregnancy. “State Profile: Florida.” Accessed June 24, 2011. from http://www.thenationalcampaign.org/state-data/state-profile.aspx?state=florida
12. Millett et al. Explaining disparities in HIV infection among black and white men who have sex with men: a meta-analysis of HIV risk behaviors. AIDS 21 (15) 2083-2091.
13. Hallfors DD et al. “Sexual and drug behavior patterns and HIV and STD racial disparities: the need for new directions.” American Journal of Public Health 2007; 97(1) : 125-132.
14. Gay Lesbian Straight Education Network. “From Teasing to Torment a report on school climate in Florida.” Accessed from http://www.glsen.org/binary-data/GLSEN_ATTACHMENTS/file/000/000/513-1.pdf on June 24, 2011.
15. Florida Department of Education. Florida’s Sexual Health Education Community Outreach Toolkit, 2010.
16. Lopez A. “Florida legislature loses $2.8million in sex ed funds over abstinence-only squabble with feds.” The Washington Independent, September 12, 2011. Accessed from http://washingtonindependent.com/111494/florida-legislature-loses-2-8million-in-sex-ed-funds-over-abstinence-only-squabble-with-feds on September 15, 2011.
17. Trenholm et al. Impacts of Four Title V, Section 510 Abstinence Education Programs. Princeton: Mathematica Policy Research, 2007. Accessed from http://www.mathematica-mpr.com/publications/PDFs/impactabstinence.pdf on June 29, 2011.
18. Kohler et al. “Abstinence-only and Comprehensive Sex Education and the Initiation of Sexual Activity and Teen Pregnancy.” Journal of Adolescent Health, 42(4): 344-351.
19. Alford S. Science and Success: Sex Education and Other Programs That Work to Prevent Teen Pregnancy, HIV & Sexually Transmitted Infections. Washington, DC: Advocates for Youth, 2003.
20. Isbell MT. HIV Prevention for Gay Men and Men who have Sex with Men: Development of a Comprehensive Policy Agenda. amfAR and Trust for America’s Health, 2010.
21. DiClemente RJ, Salazar LF, Crosby RA. A Review of STD/ HIV Preventive Interventions for Adolescents: Sustaining Effects Using an Ecological Approach. Journal of Pediatric Psychology 2007; 32(8): 888-906.