Outlook on teens’ sexual health is troubling

The issue: Getting meaningful information to youths demands new approaches and new messengers

Two reports out last month reveal a troubling outlook on teen sexual health in the United States.

FIRST, A NEW POLICY from the American Academy of Pediatrics suggests members consider routinely prescribing emergency contraception to teen girls “to have on hand in case of future need” as part of sexual health counseling and that boys get the same information regardless of current or intended sexual behavior.

Then, a report from the Centers for Disease Control and Prevention said that more than 1,000 young people ages 13 to 24 are being infected with human immunodeficiency virus each month — about a quarter of all infections in the U.S. Surveys suggest 60 percent of them don’t know they’re infected.

Both documents point to a health system struggling to protect teens.

More than 300,000 U.S. teenage girls gave birth last year, with 80 percent of the pregnancies unintended. While the teen pregnancy rate has declined in the past few years, it’s still higher than in any other developed nation.

The pediatricians say advance prescribing has been shown to increase use of emergency contraception and the odds that it will be used in the critical first 48 hours after unprotected sex. They also say there’s no evidence that access to backup contraception increases teen sexual activity.

PUBLIC HEALTH officials have been recommending for several years that children as young as 11 get vaccinated against sexually transmitted human papillomavirus. Yet the nation’s top health officials have overruled efforts to make “morning-after pills” available to girls younger than 17 without a prescription.

That leaves it to doctors to try and protect their younger patients not just from unintended pregnancy, but also from HIV and other sexually transmitted diseases.

The odds of that care being delivered are daunting. Teens tend to drop out of health care as they age, and particularly avoid pediatricians and family doctors. Teen girls may find their way to gynecologists or women’s health clinics, but the availability of care for the gay and bisexual male teens, who make up the majority of the new HIV infections, is much less certain, particularly outside major cities.

MORE THAN 30 years into the AIDS epidemic, awareness of the risks of unprotected sex remains low even among gay and bisexual teens. Only 13 percent of all high school students have been tested for HIV. Getting meaningful warnings and information to the teens most at risk demands new approaches and new messengers.