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Nine to Nineteen

What Doctors Know


About Your Child’s Sexual Health
That You Don’t ... And Should
The PRCH Mission
Physicians for Reproductive Choice and
Health exists to ensure that all people
have the knowledge, access to quality
services, and freedom to make their own
reproductive health decisions.
The PRCH Mission
PRCH mobilizes pro-choice physicians to
promote, educate, and advocate about the
importance of comprehensive
reproductive healthcare.
PRCH
founding board
member Dr.
Richard
Hausknecht
marches in
Washington.
What Teens Say
"A lot of teens have unprotected sex due
to the lack of education. We need to make
public displays all over the media about
how to prevent pregnancy, like they do for
marijuana."
—Rada, 17
What Teens Say
"Teens think they will never get pregnant
because they are young and nothing bad
will ever happen to them. The [pregnancy]
rate can be decreased if they are taught
that this isn't true. Education is the only
way to stop ignorance."
—Sandy, 17
What Teens Say
"Teens get pregnant because schools aren't
teaching us everything we need to know about
not getting pregnant. In some places, kids just
learn that they shouldn't have sex, but don't get
told what to do to be safe if they do have sex.
Condoms should be made available for teens
everywhere—at school, at home, and at the
doctor's."
—Serenity, 18
Dr. George Tiller prepares for work at his Kansas clinic. Before he puts
on his lab coat and stethoscope, he dons a bulletproof vest.
(From PRCH’s 2003 documentary film, Voices of Choice)
Teen Sexual Activity
• By age 15, only 13% of teens have ever
engaged in sexual intercourse.
• By the time they reach 19, 70% of teens
have had sex.
• Nearly half (46%) of all 15- to 19-year-olds
in the U.S. have had sex at least once.
Sexual Intercourse
Rates by Age and Sex
100%
90% Males
80% 15-17
70%
Females
60% 15-17
50%
Males
40%
18-19
30%
20% Females
18-19
10%
0%
Sexual Intercourse Rates
by Grade in High School

100%
90%
80%
70%
60%
50%
40%
30% 12th
11th
20% 10th
9th
10%
0%
Sexual Intercourse Among
High School Students
After declining in the 1990s, rates leveled off.

60

50

High school
40 females

30 High school
males
20
High school
students
10

0
1991 1993 1995 1997 1999 2001 2003 2005
Teen Sexuality
A large study of 9th to 12th graders in
Vermont found that
– 1% of students described themselves as gay
or lesbian.
– 3% described themselves as bisexual.
– 3% were not sure.
– 2% reported having had same-sex
intercourse.
Teen Sexuality
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Have Had Currently Intercourse 4 or More Have Been
Intercourse Sexually Before Age Partners Forced to
Active 13 Have Sex
Teen Sexual Activity

Among teenagers ages 15-19, about 12%


of males and 10% of females had had
heterosexual oral sex but not vaginal
intercourse.
Sexual Activity,
15- to 19-Year-Olds
100%
90%
80% Male
70% Female
60%
50%
40%
30%
20%
10%
0%
Intercourse Oral Sex Anal Sex

*With partner of the opposite sex


PRCH
physician
member
Dr. Anne Davis
and
her husband
march in
Washington.
Teen Pregnancy

• 82% of teen pregnancies are unplanned.


• A sexually active teen who does not use
contraceptives has a 90% chance of
becoming pregnant within a year.
• Each year, almost 750,000 women aged
15-19 become pregnant.
Teen Pregnancy
U.S. teen pregnancy rates are the second
highest among 46 developed countries
and are
• Twice as high as England and Wales
combined and Canada
• Eight times as high as the Netherlands
and Japan
Teen Pregnancy Rates,
Industrialized Nations
U.S.
Sweden
Per 100,000 France
Population Britain
200 Netherlands
Canada

150

100

50

0
14 15 16 17 18 19

Age
Teen birth rates rise
for the first time since 1991.

New data from the Centers for Disease


Control and Prevention show that teen
births rose 3% in 2006, reversing a
downward trend.
PRCH Physicians Meet with
Senator Sheldon Whitehouse
“Abstinence Only” Curricula
Flawed
A Congressional report found that 80% of
federally-funded “abstinence only” programs
contain false or misleading information, such as
• “the popular claim that condoms prevent the
spread of STDs is not supported by the data”
• “[i]n heterosexual sex, condoms fail to prevent
HIV approximately 31% of the time”
Virginity Pledgers

• Delayed onset of intercourse for up to 18 months


(but most did not wait until marriage)
• Were 1/3 less likely than non-pledgers to use
contraception when they did have intercourse
• 88% had intercourse before marriage
Virginity Pledgers

• Had same rates of sexually transmitted infection


as non-pledgers
• Were less aware of their STI status
• Were less likely to use condoms during most
recent intercourse
• Were six times more likely to have oral/anal sex
than virgins who did not pledge
PRCH Marches in Washington, DC
“Here in Texas, we need to wake up and
recognize that teaching our children about
contraception is the best way to prepare them
to be healthy adults. It is no coincidence that
our state denies teens information about birth
control and has the highest teen birth rate in
the nation.”
—Dr. Herbert Brown
Access to Healthcare
• 3.3 million (1 in 8) adolescents ages 12-17
lack health insurance.
• 8 million (1 in 4) youths ages 18-24 are
uninsured.
• The chances of being uninsured double
when a teen turns 19.
Access to Contraceptive Services

• Twenty-one states and the District of Columbia


explicitly allow all minors to consent to
contraceptive services without a parent's
involvement (as of April 2008).
• Two states (Texas and Utah) require parental
consent for contraceptive services in state-
funded family planning programs.
Parental Consent for
Contraception
• Sixty percent of teens under 18 who use a clinic
for sexual health services say their parents know
they are there.
• Among those whose parents do not know, 70%
would not use the clinic for prescription
contraception if the law required that their
parents be notified.
Parental Consent for
Contraception

• Only 1% of adolescents who use sexual health


services say they would stop having sex if there
were a law requiring their parents' involvement
for prescription contraception.
“As a physician who treats many adolescents, I
encourage my patients to involve their parents in
decisions regarding their healthcare. But that should not
preclude schools from providing their students with the
health resources they need, including medically
accurate health education, and yes, if needed, reliable
contraception."
—Dr. Willie Parker
Sexually Transmitted Infection
• 18.9 million new cases of STIs each year
– Half occur in people ages 15-24
– Most are asymptomatic and remain
undiagnosed
• By age 25, at least half of sexually active
people will have contracted an STI
• Economic costs of treatment ~ $6.5 billion
per year
Sexually Transmitted Infection

• One in four (26 percent) young women ages


14-19 in the U.S. is infected with at least one
of the most common sexually transmitted
diseases.
• Among African-American teenage girls, the
rate is nearly 50%.
Gonorrhea by Age
70,000
Men
60,000
Women
Cases (per 50,000
100,000 40,000
Population)
30,000
20,000
10,000
0
4

9
9

4
-2
-1

-1

-2

-3
20
10

15

25

30
Chlamydia by Age
3,500
3,000
Rate (per Men
100,000
2,500
Women
Population) 2,000
1,500
1,000
500
0
4

9
-1

-1

-2

-2
10

15

20

25
HPV: The Facts
• Human papillomavirus (HPV) infections account
for about half of STIs among 15- to 24-year-olds
each year.
• HPV is extremely common, often asymptomatic,
and generally harmless. However, certain types,
if left undetected and untreated, can lead to
cervical cancer, penile cancer, cancer of the
anus, and other cancers.
PRCH Physicians Lobby on
Capitol Hill
HPV: The Facts
• In June 2006, the FDA approved the vaccine
Gardasil as safe and effective for use among
girls and women aged 9-26. The vaccine
prevents infection with the types of HPV most
likely to lead to cervical cancer.
• Men can also be affected by HPV; Gardasil is
being considered for boys as well as girls,
primarily to prevent transmission.
“Physicians have an obligation to provide the
best evidence-based care to our patients. As
individuals, we may have differing opinions
about the morality of sexual behavior, but those
opinions should not play a role in how we
practice medicine.”
—Dr. Suzanne T. Poppema,
PRCH board chair

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