Sexual and Reproductive Health (SRH)

Teen Pregnancy and STIs Have Long-Term Consequences

More than 270,000 babies were born to teen mothers in 2013.1 Although recent data shows a decrease in teen births—driven by increased contraceptive use and increased use of effective contraception—there is still room for significant improvement2 as the U.S. continues to lag among developed countries.3 Teen births have been linked with poorer outcomes for teen mothers and their children. Teen mothers have lower educational attainment,4 are more likely to rely on government benefits,5 and often have less stable family structures.5

Sexually transmitted infections (STIs), such as chlamydia, gonorrhea, and HIV, pose a large burden for adolescents and young adults, with those aged 15-24 accounting for half of all new STIs in the U.S.6 While STIs are preventable and many are treatable, if untreated some types can have long-term consequences including infertility and increased risk for cancer and HIV.

Adolescents need access to high quality, comprehensive, and confidential sexual and reproductive health services and education. Research shows that adolescents face barriers to receiving sexual and reproductive health care including “lack of familiarity with the health care system, limited ability to pay for services, fear of disclosure of confidential information to family and friends, and uncertainty about their ability to access services without the consent of a parent or guardian.”7

SBHCs Provide Critical Reproductive Health Care

Many school-based health centers (SBHCs) provide confidential, developmentally appropriate reproductive health services, education, and referrals for adolescents. SRH services provided by SBHCs in the 2013-14 school year included pregnancy testing (80 percent), STI diagnosis and treatment (70 percent), abstinence counseling (83 percent), and Papanicalou testing (45 percent), among others.8

Research has shown that SBHCs effectively address reproductive health needs. SBHCs provide STI screening/treatment to adolescents who often have no other source of care.9, 10 SBHCs effectively deliver HPV vaccinations to adolescents, including those who are uninsured.11 Adolescent girls with SBHC access are more likely to get reproductive preventive care, use hormonal contraception, and to have been screened for an STI, than are similar girls without an SBHC.12 Urban high school students with access to comprehensive reproductive health services from an SBHC have greater use of hormonal contraception and exposure to education and counseling.13 SBHCs can reduce the unplanned pregnancy rate among adolescents.14, 15

Alliance Resources

School-Based Health Alliance Sexual and Reproductive Health Services Policy Statement: Sexual and reproductive health is an important aspect of normal adolescent growth and development that encompasses biological sex, gender roles and identity, sexual orientation, sexual behavior, and reproduction. The Alliance believes that SBHCs should adhere to nationally established pediatric and adolescent health care standards in accordance with federal, state, and local laws. Read more in our policy statement.

Learn More

It’s Your Sex Life Campaign

The Kaiser Family Foundation and MTV partnered to create the It’s Your Sex Life campaign. The campaign includes youth-friendly, online resources on preventing pregnancySTDs and testing, and relationships.

Sexual Health: An Adolescent Provider Toolkit

The Adolescent Health Working Group has recently released Sexual Health: An Adolescent Provider Toolkit. It includes screening tools, counseling guidelines, and health education materials for teens and their adult caregivers.

Birth Control Implants

The California Family Health Council (CFHC) has a website and resources on long-acting reversible contraception (LARCs). You can learn more by downloading the following PDFs:

Centers for Disease Control and Prevention

The CDC has resources devoted to what health care providers can do to prevent teen pregnancy.

References

(1) Hamilton, B.E., Martin, J.A., Osterman, M.J.K., & Curtin, S. C. (2015). Births: Final Data for 2013. Hyattsville, MD: National Center for Health Statistics. Retrieved fromhttp://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_01.pdf
(2) Guttmacher Institute. (2012). New Government Data Finds Sharp Decline in Teen Births: Increased Contraceptive Use and Shifts to More Effective Contraceptive Methods Behind This Encouraging
(3) United Nations. (2014). 2013 Demographic yearbook. New York, New York. Accessed from http://unstats.un.org/unsd/demographic/products/dyb/dybsets/2013.pdf
(4) Child Trends. Fact Sheet: Diploma Attainment Among Teen Mothers. http://www.childtrends.org/Files/Child_Trends-2010_01_22_FS_DiplomaAttainment.pdf. Accessed October 2011.
(5) Hoffman SD, Maynard RA. Kids having kids: Economic costs & social consequences of teen pregnancy: The Urban Insitute; 2008.
(6) Centers for Disease Control and Prevention. Reported STDs in the United States. Atlanta, GA 2014.
(7) Ralph LJ, Brindis CD. Access to reproductive healthcare for adolescents: establishing healthy behaviors at a critical juncture in the lifecourse. Current Opinion in Obstetrics and Gynecology. 2010;22(5):369-374.
(8) Schelar, E., Lofink Love, H., Taylor, K., Schlitt, J., & Even, M. (2016). Trends and Opportunities for Investment in Student Health and Success: Findings from the 2013-2014 Census of School-Based Health Centers (SBHCs). Washington, D.C.: School-Based Health Alliance.
(9) Braun RA, Provost JM. Bridging the gap: using school-based health services to improve chlamydia screening among young women. American Journal of Public Health. 2010;100(9):1624-1629.
(10) Crosby RA, Lawrence JS. Adolescents’ Use of School‐Based Health Clinics for Reproductive Health Services: Data from the National Longitudinal Study of Adolescent Health. Journal of School Health. 2000;70(1):22-27.
(11) Gold R, Naleway AL, Jenkins LL, et al. Completion and timing of the three-dose human papillomavirus vaccine series among adolescents attending school-based health centers in Oregon. Preventive Medicine. 2011;52(6):456-458.
(12) Ethier KA, Dittus PJ, DeRosa CJ, Chung EQ, Martinez E, Kerndt PR. School-based health center access, reproductive health care, and contraceptive use among sexually experienced high school students. Journal of Adolescent Health. 2011;48(6):562-565.
(13) Minguez M, Santelli JS, Gibson E, Orr M, Samant S. Reproductive health impact of a school health center. The Journal of Adolescent Health. Mar 2015;56(3):338-344.
(14) Koo HP, Dunteman GH, George C, Green Y, Vincent M. Reducing adolescent pregnancy through a school-and community-based intervention: Denmark, South Carolina, revisited. Family Planning Perspectives. 1994:206-217.
(15) Ricketts SA, Guernsey BP. School-based health centers and the decline in black teen fertility during the 1990s in Denver, Colorado. American Journal of Public Health. Sep 2006;96(9):1588-1592.

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