Pregnancy

Although adolescent pregnancy rates have declined since 1991, teenage birth rates in the United States are higher than most industrialized countries. In 2020, females aged 15–19 years experienced a birth rate of 15.4 per 1,000 women (Martin et al., 2020). This is a drop of 8 percent from 2019. It appears that adolescents who are sexually active are using birth control.

Risk Factors for Adolescent Pregnancy

Miller et al. (2001) found that parent-child closeness, parental supervision, and parents’ values against teen intercourse (or unprotected intercourse) decreased the risk of adolescent pregnancy. In contrast, residing in disorganized or dangerous neighborhoods; living in family with a lower socioeconomic status; living with a single parent; having older, sexually active siblings or pregnant/parenting teenage sisters; going through early puberty; and being a victim of sexual abuse place adolescents at an increased risk of adolescent pregnancy.

Consequences of Adolescent Pregnancy

After a child is born, life can be difficult for teenage parents. Only 40 percent of teenagers who have children before age 18 graduate from high school. Without a high school degree, job prospects are limited, and economic independence is difficult. Teen mothers are more likely to live in poverty, and more than 75 percent of all unmarried teen mothers receive public assistance within 5 years of the birth of their first child. Approximately, 64 percent of children born to an unmarried, teenage high-school dropout live in poverty. Further, a child born to a teenage mother is 50 percent more likely to repeat a grade in school and is more likely to perform poorly on standardized tests and drop out before finishing high school (March of Dimes, 2012).

Sexually Transmitted Infections

Sexually transmitted infections (STIs), also referred to as sexually transmitted diseases (STDs) or venereal diseases (VDs), are illnesses that have a significant probability of transmission by means of sexual behavior, including vaginal, anal, and oral sex. Some STIs can also be contracted by sharing intravenous drug needles with an infected person, through childbirth, or through breastfeeding. Common STIs include chlamydia, gonorrhea, syphilis, genital herpes, human papillomavirus (HPV), and human immunodeficiency virus (HIV) (Figure 12.4).

Please note that this table is not exhaustive, and there are other STIs not listed here. It’s important to practice safe sex, get regular screenings, and seek medical attention if any symptoms or concerns arise.

During adolescence, the risk of acquiring sexually transmitted infections (STIs) increases as young people explore their sexuality and engage in sexual relationships. Adolescents may be particularly vulnerable to STIs due to a combination of factors, such as lack of comprehensive sex education, inconsistent condom use, multiple sexual partners, and limited access to healthcare services. These infections can have serious health consequences, including infertility, chronic pain, cervical or anal cancer, and increased risk of HIV transmission. Therefore, it is crucial for adolescents to be educated about safe sexual practices, the importance of regular STI testing, and the use of barrier methods (e.g., condoms) to reduce the risk of transmission. Open communication with healthcare providers, access to confidential healthcare services, and awareness of one’s own sexual health are vital for reducing the spread of STIs and promoting a healthy sexual life during adolescence and beyond.

According to the Centers for Disease Control and Prevention (CDC) (2023), there was an increase in Chlamydia, Gonorrhea, and HPV in 2021. Those most affected by STIs include racial and ethnic monitories, adolescents and young adults, and men who have sex with men. The most effective way to prevent transmission of STIs is to practice abstinence, (not participating in sexual intercourse), safe sex, and to avoid direct contact of skin or fluids, which can lead to transfer with an infected partner. Proper use of safe-sex supplies, such as male condoms, female condoms, gloves, or dental dams, reduces contact and risk and can be effective in limiting exposure. However, some disease transmission may occur even with these barriers.

Contracting sexually transmitted infections (STIs) during adolescence can have significant long-term health consequences. For females, certain STIs, such as chlamydia and gonorrhea, can lead to pelvic inflammatory disease (PID), resulting in damage to the reproductive organs and potential infertility. Chronic pelvic pain can persist due to untreated or recurrent STIs, impacting quality of life. Human papillomavirus (HPV), a common STI, can increase the risk of cervical, anal, vulvar, vaginal, penile, and oropharyngeal cancers. STIs can also complicate pregnancy, leading to premature birth, low birth weight, neonatal infections, and congenital disabilities. Some STIs, such as genital herpes and syphilis, increase the risk of HIV transmission. Chronic STIs like genital herpes and HIV require ongoing management, causing recurrent outbreaks, immune system suppression, and the need for lifelong medication. Understanding these long-term consequences highlights the importance of safe sex practices, early diagnosis, treatment, regular STI testing, and open communication with health-care providers.

Contraceptive Methods and Protection From Sexually Transmitted Infection

There are many methods of contraception that sexually active adolescents can use to reduce the chances of pregnancy (Figure 12.5).

In choosing a birth control method, dual protection from the simultaneous risk for HIV and other STIs also should be considered. Although hormonal contraceptives and IUDs are highly effective at preventing pregnancy, they do not protect against STIs, including HIV. Consistent and correct use of the male latex condom reduces the risk for HIV infection and other STIs, including chlamydial infection, gonococcal infection, and trichomoniasis.

Licenses and Attributions for Sexual Development

“Sexual Development” by Terese Jones is licensed under CC BY 4.0.