Featured Research
Each month we will bring to you abstracts from the newest research on adolescent and sexual health. Don't miss these important findings!
Added June 2008
New Findings on Youth and Oral Sex
A popular theory about young people having oral sex to preserve their virginity was debunked last month when the results of a new study found that it is teens who have had vaginal sex who are more likely to have had oral sex. Slated for publication in the July issue of the Journal of Adolescent Health, the study examined data from the National Survey of Family Growth and found that teens initiate a range of sexual activities around the same time, rather than substituting one for another.
Slightly over half of teens (54 percent of teen girls and 55 percent of teen boys ages 15-19) reported having had oral sex, and by 6 months after first vaginal intercourse, 82 percent of teens had also had oral sex. White teens were more likely than African American or Hispanic teens, and teens of higher socioeconomic status were more likely than those of lower socioeconomic status, to have had oral or anal sex.
In a Washington Post article on the study, James Wagoner said: "More than half of our teens are having sex -- vaginal and oral. We can't afford the luxury of denial. Abstinence-only programs are the embodiment of denial. They have been proven not to work, and it's time to invest in real sex education, including condoms."
Read the study here: http://www.guttmacher.org/pubs/JAH_Lindberg.pdf
CDC Healthy Youth - School Health Profiles
This Centers for Disease Control and Prevention (CDC) report aggregates data from surveys on prevention efforts in schools, including HIV, STD, and pregnancy prevention. One can select a state and learn about that state's specific results here: http://www.cdc.gov/healthyyouth/profiles/topic_facts.htm Or, read the full report here: http://www.cdc.gov/healthyyouth/profiles/pdf/Profiles_2006.pdf
Understanding the HPV Vaccine Debate
This useful article is a round-up of the arguments on both sides of the HPV debate, with citations for the claims made by both sides. It greatly assists with understanding and answering opposition to mandatory vaccination for HPV.
The HPV Vaccine: Framing the Arguments FOR and AGAINST Mandatory Vaccination of All Middle School Girls Journal of School Health
Other Recent Research in Adolescent Sexual and Reproductive Health
Added May 2008
Estimated Pregnancy Rates by Outcome for the United States, 1990-2004
National Vital Statistics Reports
This report from the Centers for Disease Control and Prevention tabulates the pregnancy statistics for women in all age groups from 1990-2004. There were a number of important findings:
- In 2004, the pregnancy rate for teenagers age 15-17 was 42 per 1000.
- The pregnancy rate for teenagers ages 18-19 was 119 per 1000 - more than one in ten 18-19 year old women experienced a pregnancy in 2004.
- Racial disparities in teen pregnancy persist. The rate for white women ages 18-19 was 79.3; for black women ages 18-19 was 203; and for Hispanic women ages 18-19, 210. This means about 1 in 5 black or Hispanic 18-19 year old women experienced pregnancy, compared to 1 in 12 white 18-19 year olds. In addition, the pregnancy rate for Hispanic teens ages 18-19 rose slightly in 2004 - the only racial/ethnic group whose pregnancy rate rose in that period.
- Teen abortion rates and pregnancy rates have both declined steadily since 1990. The teen birth rate had been declining, but showed a rise in 2006 in all racial/ethnic groups for the first time in over a decade. Since pregnancy data is not yet available for 2006, this change can't yet be explained - but almost certainly indicates that the teen pregnancy rate has risen since 2004.
- There was a decline in rate specifically among sexually active teenagers - suggesting an increase in contraceptive use, a decrease in frequency of sex, or both.
Read the full report here: http://www.cdc.gov/nchs/data/nvsr/nvsr56/nvsr56_15.pdf
Parenting Practices, Parents' Underestimation of Daughters' Risks, and Alcohol and Sexual Behaviors of Urban Girls
Journal of Adolescent Health
Researchers interviewed 700 girls, mostly under age 12, about their alcohol use and sexual behaviors. (Alcohol use and early sexual behaviors are associated with early loss of virginity.) They then interviewed the girls' parents and found that parents greatly underestimated their daughter's involvement in these behaviors - only 4 parents total thought their daughters had used alcohol, while 22 percent had of the girls had; only 5 percent thought their daughters had kissed a boy for a long time, while 38 percent of girls actually had.
This study re-emphasizes the importance of parental communication with youth about values and safety. Girls who report that their parents oversee their activities, set rules, and communicate disapproval of risky behavior were less likely to engage in alcohol use, disapproved conduct, and early heterosexual behaviors related to early sexual initiation.
Other Recent Research in Adolescent Sexual and Reproductive Health
Added April 2008
Research Shows Yet Again That Comprehensive Sexuality Education is Effective and What Parents Want
April's Journal of Adolescent Health (JAH) included an editorial and two important studies on sexuality education. In the first, researchers studied the National Survey of Family Growth to determine the impact of sexuality education on youth sexual risk-taking for young people ages 15-19. There are a number of important findings in this article.
- Abstinence-only education has no impact on reducing teen pregnancy, delaying sexual initiation, or reducing STIs.
- Youth who received comprehensive sex education had significantly lower involvement in teen pregnancy.
- Youth who received comprehensive sex education were not more likely to have sex or get an STI.
This study adds to the body of research that has showed time and time again that abstinence-only programs do not work and that comprehensive sexuality education is effective and does not increase sexual risk taking. Read more here: Abstinence-Only and Comprehensive Sex Education and the Initiation of Sexual Activity and Teen Pregnancy
In a second study published in the Journal of Adolescent Health, researchers surveyed parents of school-age children in Minnesota to determine what kind of sexuality education they preferred for their children. Nine out of ten parents responded that their children should be taught about both abstinence and contraception. Even among Catholics, born-again Christians, and those who identified as "politically very conservative," a majority wanted their children to have comprehensive sex education. This is by no means the first time parents have articulated their children's need for information that can help protect them from pregnancy, HIV, and other sexually transmitted diseases. Read more here: Support for Comprehensive Sexuality Education: Perspectives from Parents of School-Age Youth (Read about two other nationwide studies here and here.)
JAH's editorial describes the sexuality education most young people receive in schools as "fragmented, incomplete, and frequently based on ineffective approaches and curricula." It urges parents, the general public, and adolescent health professionals to speak more assertively about the need for comprehensive sexuality education. Read the editorial here: Converging Evidence Leaves Policy Behind: Sex Education in the United States
Important New Information from the CDC
The CDC recently released important information about sexually transmitted infections (STIs) and HIV among young people. One presentation at the 2008 National STD Prevention Conference found that one in four young women has an STI. The most common STI was cancer- and genital wart-associated HPV (18.3 percent), followed by Chlamydia (3.9 percent), trichomoniasis (2.5 percent), and HSV-2 (1.9 percent). Among the teenage girls who had an STI, 15 percent had more than one. By race, African American teenage girls had the highest prevalence, with an overall STI prevalence of 48 percent compared to 20 percent among both whites and Mexican Americans.Read more about this study.
Also in March, the CDC posted a slide show of new statistics about HIV among men who have sex with men (MSM). The statistics include alarming increases in AIDS cases diagnosed among MSM in all racial/ethnic groups between 2001-2005 and an 80 percent increase in cases among young African American MSM.
View the slide show here: http://www.cdc.gov/hiv/topics/surveillance/resources/slides/msm/index.htm
Other Recent Research in Adolescent Sexual and Reproductive Health
Added March 2008
PSEXINFO: A Sexual Health Text Messaging Service for San Francisco Youth
American Journal of Public Health
This article describes the text messaging service created by Internet Sexuality Education Services (ISIS), a group Advocates has worked with to reach youth with new technologies. The service allows San Francisco residents to request and receive information about pregnancy and STDs via text message. The article describes the development and rollout of the service and describes what focus groups had to say about it.
Read the abstract here:
http://www.ajph.org/cgi/content/full/98/3/393
Sexuality Education Among Latinas: Experiences, Preferences, Attitudes and Risk Behavior
American Journal of Sexuality Education
Researchers surveyed a sample of Latinas to explore their sexual behaviors and what methods and sources of sexuality education were most effective. From the abstract: "Nearly half of sexually active women (having ever had sex) reported condom use and 36.7% reported discussing sexual history with new sexual partners. Self-discovery, friends and media were the most commonly reported sources of sexuality education. Almost 60% of participants thought that both parents and teachers should be responsible for their children's sexuality education. Lower education and lower acculturation were related to reporting peers and media as primary sources of sexuality education. Participants whose parents discussed at least one sexuality related topic with them reported higher frequency of condom use."
Read the abstract here:
http://www.ingentaconnect.com/content/haworth/ajse/2008/00000002/00000004/art00003
Check out other new research or go directly to the article abstracts:
Added February 2008
Public Funding for Family Planning, Sterilization and Abortion Services, FY 1980-2006
Guttmacher Institute
Through various methods researchers examined the level of family planning funding in the United States, finding that although funding levels have risen from a drop in the 80s, expensive new contraceptive technologies and drops in funding in individual states mean that in many areas family planning is still underfunded. The report includes tables detailing each state's expenditures sources of funding. The report names Medicaid and Title X as important sources of funding for these services.
Read the report here: http://www.guttmacher.org/pubs/2008/01/28/or38.pdf
What Schools Teach Our Patients About Sex
Obstetrics and Gynecology
Sexual Behavior, Knowledge and Information Sources of Very Young Adolescents in Four Sub-Saharan African Countries
African Journal of Reproductive Health
Association of intimate partner physical and sexual violence with unintended pregnancy among pregnant women in Peru
International Journal of Gynecology & Obstetrics
Intimate partner violence and unplanned pregnancy in the Pacific Islands Families Study
International Journal of Gynecology & Obstetrics
The contraceptive vaginal ring: female adolescents' knowledge, attitudes and plans for use
Contraception
Correlates of HIV-Related Risk Behaviors in African American Adolescents from Substance-Using Families: Patterns of Adolescent-Level Factors Associated with Sexual Experience and Substance Use
Journal of Adolescent Health
Variations in Coital and Noncoital Sexual Repertoire among Adolescent Women
Journal of Adolescent Health
HIV and STD Status Among MSM and Attitudes About Internet Partner Notification for STD Exposure
Sexually Transmitted Diseases
Added January 2008
Contraceptive Use by 15-Year-Old Students at Their Last Sexual Intercourse
Archives of Pediatrics and Adolescent Medicine, January 2008
Researchers examined survey data from the WHO’s 2002 international Health Behaviour in School-aged Children (HBSC) study and report the information for 24 countries. Overall, 13.2% of students used no method at last sexual intercourse, while 58% report using condoms and 16% report using more than one method.
Read the abstract here: http://archpedi.ama-assn.org/cgi/content/abstract/162/1/66
Transnational Comparisons of Adolescent Contraceptive Use
Archives of Pediatrics and Adolescent Medicine, January 2008
Commentary from Dr John Santelli on the above study. He explains differences in US and European data on contraception use and sexual risk behavior.
Read an extract here: http://archpedi.ama-assn.org/cgi/content/extract/162/1/92
Prevalence, Correlates, and Efficacy of Selective Avoidance as a Sexually Transmitted Disease Prevention Strategy Among African American Adolescent Females
Archives of Pediatrics and Adolescent Medicine, January 2008
“Selective avoidance” is not having sex with someone when you think they might have an STD or when you yourself do. Researchers examined sexual behavior and STD rates of young African-American women. They found that about 1/3 practiced selective avoidance and that those who used SA to prevent acquisition were more likely to have had unprotected sex. However, use of SA was not associated with STD rate.
Read the abstract here: http://archpedi.ama-assn.org/cgi/content/abstract/162/1/60
Unplanned sexual activity as a consequence of alcohol use: a prospective study of risk perceptions and alcohol use among college freshmen
Journal of American College Health
This study asked students to estimate their drinking and their unplanned sexual activity, as a way of examining their own assessment of their risk for unplanned sex. Researchers found that both students who believed they were at high risk, and students who did not believe they were at high risk, drank alcohol and had unplanned sex.
Read the abstract here: http://www.ncbi.nlm.nih.gov/
Understanding the relationship between alcohol and sex: Latino and white college students and problematic sexual experiences while drinking
Journal of American College Health
Authors examined whether or not drinking affects sexual behavior differently for whites than for Latinos and found that for this study, behaviors were not significantly different between the two ethnic groups. However, given the high degree to which alcohol does influence sexual behavior, researchers recommend further research on the topic.
Read the abstract here: http://www.ncbi.nlm.nih.gov/
Jamaican Youth and Resiliency Behaviour Survey 2006: Community-based survey on risk and resiliency behaviours of 15-19 year olds
Researchers surveyed a representative sample of Jamaican youth ages 15-19 on a variety of health topics, including reproductive health. Among other findings, researchers learned that 60% of these teens were sexually active (with percentages higher among older teens) and 80% of those reported condom use. Twenty five percent of young women reported having experienced pregnancy.
Read the report here: http://www.cpc.unc.edu/measure/publications/pdf/tr-07-64.pdf
Are Africans Practicing Safer Sex? Evidence from Demographic and Health Surveys for Eight Countries
Economic Development and Cultural Change, January, 2008
Researchers examined a great deal of demographic data from 8 countries in Africa to determine if Africans are practicing safer sex. They discovered that people are reporting more condom use, but express the concern that new social mores are making people respond positively to questions about condom use even if they are not using condoms. Schooling and wealth were found to correlate with increased likelihood of condom use but also with more sex partners.
Read the abstract here: http://www.journals.uchicago.edu/doi/abs/10.1086/522893
Supplement: Poverty, HIV, and AIDS in Southern Africa
AIDS Journal
This special issue of the journal examines the issue of wealth in Africa and its relationship to HIV statistics and behavior. Researchers present evidence that while living with HIV/AIDS is harder for the poor than for the wealthy and middle class, the poor are not more likely to be exposed to HIV than other classes. Researchers recommend broad-based prevention efforts.
Read the abstracts in the supplement here: http://www.aidsonline.com/
Ethical Issues in Reproductive Health
Studies in Family Planning
This issue of Studies in Family Planning includes a number of essays and reports on pertinent reproductive rights topics. James Trussell and others examine the provision of EC, contending that access is not just a matter of public health but of rights. Another writer contends that AIDS activists should support routine HIV testing as encouraging an atmosphere of disclosure of HIV status to partners. Finally, one author discusses the issues around reproductive health confidentiality for adolescents.
Read the rest of the abstracts here: http://www.blackwell-synergy.com/toc/sifp/38/4
Generation XXX: Pornography Acceptance and Use Among Emerging Adults Journal of Adolescent Research
This article found high rates of pornography acceptability and use among young adults (ages 18-26). "Results revealed that roughly two thirds (67%) of young men and one half (49%) of young women agree that viewing pornography is acceptable, whereas nearly 9 out of 10 (87%) young men and nearly one third (31%) of young women reported using pornography."
Read the abstract here: http://jar.sagepub.com/cgi/content/abstract/23/1/6
Added December 2007
UNAIDS 2007 AIDS Epidemic Update
UNAIDS, November, 2007
UNAIDS released its 2007 statistics for the HIV/AIDS epidemic worldwide. Because of improvements in reporting, there were dramatic changes to numbers from 2006, including 1) the estimated number of people living with HIV in India dropped by more than half, from 5.7 million to 2.5 million and 2) estimates for 6 sub-Saharan countries dropped significantly and 3) the number of people worldwide living with HIV dropped from 39.5 million to 33.2 million, with 22.5 million of these in Africa. UNAIDS attributes the change partially to prevention efforts and partially to improvements in methodology. People aged 30-49 represent the majority of cases, while 18% of reports of new HIV cases were in people ages 20-29.
Read the full text here: http://data.unaids.org/pub/EPISlides/2007/2007_epiupdate_en.pdf
District of Columbia HIV/AIDS Epidemiology Annual Report
District of Columbia Department of Health, November 2007
The District of Columbia released its first ever report on the HIV/AIDS epidemic in November 2007. The report showed that one in 20 city residents is believed to be HIV positive, and 80% of HIV cases were among African Americans. Thirty seven percent of cases were attributable to heterosexual sex, 25% to men having sex with men, and 14% to IV drug use.
Read the report here: http://doh.dc.gov/doh/
Inspiring Healthy Adolescent Choices: A Rationale for and Guide to Strength Promotion in Primary Care
Journal of Adolescent Health, December, 2007
In this article authors recommend that primary health care providers use certain youth development methods to better assess youth health needs and empower youth as “autonomous beings who make responsible decisions about their own health.” Guidelines for assessing youth, communicating with them, and providing good care as well as good advice are provided, with an emphasis on determining and building on the youth’s strengths.
Read the full text here: http://www.jahonline.org/article/PIIS1054139X07002406/fulltext
Giving Girls Today and Tomorrow. Breaking the Cycle of Adolescent Pregnancy
UNFPA, November, 2007
This UNFPA report focuses on adolescent childbearing and pregnancy in developing countries, providing statistics around the issue; describing the risks; examining the causes; outlining the costs; and advocating for change.
Read the report here:
http://www.unfpa.org/upload/lib_pub_file/722_filename_adol_eng.pdf
Helping Parents In Developing Countries Improve Adolescents’ Health
World Health Organization, November, 2007
In this report WHO identifies and describes five characteristics of parenting that can help adolescents maintain good health: connection; behavior control; respect for individuality; modeling of appropriate behavior; and provision and protection. For each desired parenting skill WHO provides an example of a program that develops that skill. The UN examines the challenges associated with implementing these programs, and provides recommendations for programmers and developers to begin to address the issues. NOTE: the Jamaican “Good Parenting Calendar,” which Advocates helped to develop, appears in this report!
Read the report here: http://www.who.int/child-adolescent-health/New_Publications/ADH/ISBN_978_92_4_159584_1.pdf
Health Disparities in HIV/AIDS, Viral Hepatitis, Sexually Transmitted Diseases and Tuberculosis in the US: Issues, Burden and Response
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control, November, 2007
Data reported to CDC demonstrates that some population groups continue to be disproportionately affected by HIV/AIDS, viral hepatitis, STDs, and TB. HIV/AIDS and sexually transmitted diseases disproportionately affect men who have sex with men (MSM), blacks and Hispanics. TB is more prevalent among foreign-born persons and US-born blacks. Rates of hepatitis B remain highest among non-Hispanic blacks. Rates of hepatitis C continue to occur in adult age groups, with injection drug use as the most commonly identified risk factor for hepatitis C infection.
Read the report here: http://www.cdc.gov/nchhstp/healthdisparities/docs/NCHHSTPHealthDisparitiesReport1107.pdf
Abortion Surveillance – United States, 2004
MMWR Surveillance Summaries, November 23, 2007
In 2003, over 839,000 induced legal abortions were reported in the U.S. The abortion rate remains 16 per 1000 women, the same since 2000. White women under age 25 had the highest percentage of abortions. Of those who provided their marital status, 80% reported being unmarried. Abortion rates have declined over time; researchers say several factors may potentially have contributed to the decline, including increased use of contraceptives; decreased number of unintended pregnancies; and reduced or limited access to abortion services, including parental consent/notification laws and mandatory waiting periods.
Read the report here: http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5609a1.htm
Ten myths and one truth about generalised HIV epidemics
Lancet, December 1, 2007
In this Lancet op-ed, the author addresses various myths around the cause of and perceived solutions to the HIV pandemic, reinforcing the idea that there is no “silver bullet” and stressing that prevention efforts must focus on behavior change (the reduction of concurrent partnerships).
You can read the article for free by registering here: http://www.thelancet.com/journals/lancet/article/PIIS0140673607617553/fulltext
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