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Across the United States, young people are at risk for unintended pregnancy and sexually transmitted infections (STIs) including HIV. Colorado’s teen pregnancy and HIV rates are lower than the national average. However, Colorado’s minority youth are at disproportionate risk for negative sexual health outcomes, and there are alarming trends in HIV, STI, and teen pregnancy rates among young people. Comprehensive sexuality education and access to contraception are more important than ever to the health of Colorado’s youth.

Colorado’s Youth Population

• There are over 750,000 young people living in Colorado between the ages of 15 and 24, making up over 14 percent of the total population. ^[1,2]
  
  
• According to the 2010 Census, 70 percent of Coloradans are White (non-Hispanic), 4 percent are Black, 20.7 percent are of Latino origin and 2.8 percent are Asian.^[3]
  
  
• The Hispanic/Latino population in Colorado grew by 41 percent between 2000 and 2010. ^[4]

Sexual Health Outcomes in the State of Colorado: Successes and Areas Needing Improvement

• The teen pregnancy rate in Colorado in 2005 was 69 pregnancies per 1000, on par with the national rate of 70 pregnancies per 1000. ^[5]
  
  
• Forty percent of Colorado high school students report having sexual intercourse in their lifetime, compared to 46 percent of students nationwide; 58 percent of Colorado’s high school seniors report ever having sex, compared to 62 percent nationwide. ^[6,7]
  
  
• Twenty-seven percent of high school students report having sex in the past 3 months compared to 32 percent nationwide; of these individuals, one-quarter report using drugs or alcohol before their last sexual encounter compared to 21.6 percent nationwide. Close to two-thirds report using a condom the last time they had sex, on par with the national average. ^[6,7]
  
  
• In 2006, 18 percent of Colorado’s HIV cases were diagnosed among 13-24 year olds. ^[8]
  
  
• Between 2006 and 2010, 2.1 percent of all new cases of HIV were diagnosed in youth ages 13-19 years old. 28.9 percent of all new cases were diagnosed in people age 20-29, making them the age group with the second highest incidence rates. ^[9]
  
  
• Colorado has comparatively low STI rates, with an infection rate of 1.90 cases per 1,000 compared to the national rate of 4.52 cases per 1,000. ^[10]
  
  
• From 2007 to 2008 in Colorado, the rate of Chlamydia infection among youth ages 15–19 increased by 12 percent, while the rate of gonorrhea infection increased by 15.2 percent. ^[11]

Socio-cultural Factors Put Colorado’s Racial and Sexual Minority Youth at Risk

• Racial minority teens in Colorado are more likely to experience teen pregnancy.
  
  
  • The pregnancy rate among young African American/Black women ages 15-19 in Colorado is 89 pregnancies per 1000 young women; for Hispanics, 151 pregnancies per 1000 young women; and for whites, 40 pregnancies per 1000 young women. ^[5]
    
    
  • Barriers to contraceptive access, poverty, and structural exclusion and disadvantage all contribute to young people’s ability and motivation to prevent unintended pregnancy.
    
    
• Lesbian, Gay, Bisexual, and Transgender (LGBT) Youth in Colorado are marginalized and at risk for HIV.
  
  
  • The vast majority of LGBT students in Colorado, like youth around the nation, have experienced verbal harassment because of their sexual orientation. ^[12,13]
    
    
  • Many LGBT youth have experienced physical harassment and physical assault at school: nearly 2 in 5 were physically harassed (e.g., pushed or shoved) because of the way they expressed their gender and 3 in 10 were physically assaulted (e.g., punched, kicked or injured with a weapon) because of their sexual orientation. ^[14]
    
    
  • Of all HIV/AIDS cases diagnosed in Colorado, 89.4 percent are found in men. 71.2 percent of those cases have been transmitted through male-to-male sexual contact. 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. ^[15]
    
    
• African Americans are at disproportionate risk for HIV and STIs.
  
  
  • 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. ^[16,17]
    
    
  • As such, the HIV rate per 100,000 for Blacks (20.6) in Colorado in 2003 was nearly four times the rate of Whites. Blacks are the only racial group that saw an increase in AIDS rate per 100,000 in the last 5 years.
    
    
  • African American/Black women have rates per 100,000 that are 24 times higher than white women in recently diagnosed HIV cases. ^[18]
    
    
  • In 2007 African Americans accounted for 9.1 percent of reported Chlamydia cases and 25 percent of gonorrhea cases, but only represented 3.7 percent of the state’s population. ^[19]

Sexuality Education and Access to Youth-Friendly Services in Colorado

• In 2007, the Colorado state legislature passed House Bill 1292. Under this law, when sexuality education is offered, curricula used must be science-based, age-appropriate, culturally sensitive, medically accurate, and address both abstinence and contraception, including emergency contraception. ^[20]
  
  
• Colorado chose not to participate in the Title V abstinence-only-until-marriage program in Fiscal Year 2009. The state was eligible for approximately $488,314 in funding. However, community-based organizations in Colorado received $3,727,332 in federal funds for abstinence-only-until-marriage programs in Fiscal Year 2009. Four organizations in Colorado received $2,201,689 in Community Based Abstinence Education (CBAE) funding, and three public and private entities in Colorado received $1,525,643 in Adolescent Family Life Act (AFLA) funding. ^[10]
  
  
• The Colorado Department of Human Services received $793,058 in Personal Responsibility Education Program (PREP) funding in Fiscal Year 2010. PREP is the first federal funding stream for programs that teach about both abstinence and contraception for the prevention of pregnancy and sexually transmitted infections (STIs).
  
  
• Colorado law does explicitly allow minors to access confidential contraceptive services as well as STI and HIV testing and treatment, an important step toward reproductive freedom. ^[21] Colorado also requires parental notification of a minor’s parents before she is permitted to have an abortion. ^[22]

Conclusion

Although Colorado’s state rates in many sexual health issues are slightly better than the national rates, Colorado’s youth are still at risk for pregnancy, HIV, and STIs, and youth of color and LGBT youth are at disproportionate risk for negative sexual health outcomes. Research shows that comprehensive sex education and access to contraceptive services can help young people protect their health and well-being. Further, there are a number of culturally relevant science-based programs than can successfully assist youth of color to reduce sexual risk taking.

Written by Lauren Kalina
Advocates for Youth © 2011

References

1. Colorado Division of Local Government State Demography Office. “Population by Age and Gender” Accessed from https://dola.colorado.gov/demog_webapps/pag_category.jsf on June 16 2011.
   
   
2. US Census Bureau. “Census 2000 Summary File.” Accessed from http://factfinder.census.gov/servlet/QTTable?_bm=n&_lang=en&qr_name=DEC_2000_SF1_U_DP1&ds_name=DEC_2000_SF1_U&geo_id=04000US08 on June 16 2011.
   
   
3. US Census Bureau. “Colorado State and County QuickFacts.” Accessed from http://quickfacts.census.gov/qfd/states/08000.html on June 16 2011.
   
   
4. Colorado Division of Local Government. “Population by Race and Hispanic Origin.” Accessed from http://dola.colorado.gov/dlg/demog/2010data/race%20and%20hispanic%20origin%20state_2000%202010.pdf on June 16 2011.
   
   
5. The National Campaign to Prevent Teen and Unplanned Pregnancy. “State Profile: Colorado” Accessed from http://www.thenationalcampaign.org/state-data/state-profile.aspx?state=colorado on June 16 2011.
   
   
6. Colorado Department of Education. “Overview of the 2009 Health Kids Survey Results.” Accessed from http://www.cde.state.co.us/cdeprevention/download/pdf/CCHS/YRBSFactSheetV2.pdf on June 16 2011.
   
   
7. Eaton, K et al. Youth Risk Behavior Surveillance - United States, 2009. Centers for Disease Control and Prevention. MMRW 2010: 59, SS-5.
   
   
8. Colorado Department of Public Health and Environment “HIV and AIDS in Colorado” Accessed from http://www.cdphe.state.co.us/dc/hivandstd/HIV&AIDS%20Epi%20Profile%20Proof_3.pdf on June 27 2011.
   
   
9. Colorado department of Public Health and Environment. “Colorado HIV Surveillance Report 4th Quarter 2010 Table 1” Accessed from http://www.cdphe.state.co.us/dc/HIVandSTD/HIV_STDSurv/HIV.AIDS.Surv.rpt.4thQuarter.2010.pdf on June 16 2011.
   
   
10. SEICUS. “Colorado State Profile Fiscal Year 2009” Accessed from http://www.siecus.org/index.cfm?fuseaction=Page.ViewPage&PageID=1209#_edn17 on June 16 2011.
    
    
11. Colorado Youth Matter. “The State of Adolescent Sexual Health in Colorado 2010” Accessed from http://www.coloradoyouthmatter.org/images/stories/SASH2010.pdf on June 16 2011
    
    
12. Gay Lesbian Straight Education Network. “School Climate in Colorado Research Brief” Accessed from http://www.glsen.org/binary-data/GLSEN_ATTACHMENTS/file/000/001/1829-3.pdf on June 17 2011.
    
    
13. GLSEN. The 2009 National School Climate Survey. Accessed from http://www.glsen.org/binary-data/GLSEN_ATTACHMENTS/file/000/001/1675-2.pdf on June 27, 2011.
    
    
14. Gay Lesbian Straight Education Network. “School Climate in Colorado Research Brief” Accessed from http://www.glsen.org/binary-data/GLSEN_ATTACHMENTS/file/000/001/1829-3.pdf on June 17 2011.
    
    
15. Colorado Department of Public Health and Environment. “HIV and AIDS in Colorado Surveillance Report.” Accessed from http://www.cdphe.state.co.us/dc/hivandstd/HIV_STDSurv/MonitortheEpiSep08.pdf on June 17 2011.
    
    
16. 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.
    
    
17. 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.
    
    
18. Colordao Department of Health and Environment “HIV & AIDS in Colorado: Integrated Epidemiological Profile of HIV and AIDS Prevention and Care Planning reported through June 2004- SUMMARY” Accessed from http://www.cdphe.state.co.us/dc/hivandstd/cwt/EpiSummary.pdf on June 27 2011
    
    
19. Colorado Department of Public Health and Environment. “Sexually Transmitted Infection Surveillance Report Through December 31st 2007” Accessed from http://www.cdphe.state.co.us/dc/hivandstd/HIV_STDSurv/07SurvReport.pdf on June 27 2011
    
    
20. Alan Guttmacher Institute. “ Sex and HIV Education [State policies in Brief].” Accessed from http://www.guttmacher.org/statecenter/spibs/spib_SE.pdf on June 17 2011.
    
    
21. Alan Guttmacher Institute. “Minors’ Access to Contraceptive Services [State Policies in Brief].” Accessed from http://www.guttmacher.org/statecenter/spibs/spib_MACS.pdf on June 17 2011.
    
    
22. Alan Guttmacher Instititute. State Facts About Abortion: COLORADO. Accessed from http://www.guttmacher.org/pubs/sfaa/colorado.html on 6/20/2011.