Reproductive and Sexual Health
Sexual development is an integral part of adolescence. It is a period of time when young people are changing physically, emotionally and socially. It is important at this developmental period for adolescents to have access to accurate information, examine their attitudes and develop skills to manage their reproductive behavior responsibly. Despite the potential risks associated with unsafe sexual behaviors, most adolescents form a positive sexual identity and a sense of sexual well-being.
In 2009, there were 47,811 births to California residents’ ages 15-19, 3,893 fewer than in 2008. This represents over a 50% drop in the 15 to 19 year old teen birth rate from 70.9 per 1000 in 1991 to 32.1 per 1000 in 2009. Although there still are disparities in teen birth rates among ethnic groups, all teens decrease their birth rates. In 2009, birth rates per 1000 teens ages 15 to 19 were: white 11.9, African American 37, Latino 50.8, Asian/Pacific Islander 8.5, and American Indian 25.8. There are also geographic and income disparities in teen birth rates. Teen birth rates are particularly high in more rural areas, such as much of the Central Valley, Imperial and Del Norte counties (1).
Factors related to reductions in teen birth rates in California include comprehensive sex education, increasing access to contraceptive services, particularly Family PACT, laws and policies to facilitate access to contraceptive information and services, and involvement of the private sector such as a number of private foundations investing heavily in teen pregnancy prevention efforts over the last decade increasing services, outreach services, and media campaigns. According to a 2006 analysis conducted by the Guttmacher Institute, California ranked first among states in overall efforts to help women avoid unintended pregnancy (2).
Sexually Transmitted Infections (STI)
In general the rates of reportable bacterial sexually transmitted infections (STI) among California’s youth 15 – 19 years old have increased from 2000 – 2009, while racial/ethnic disparities persisted for African American teens.
Chlamydia rates increased slightly between 2000 -2009 among youth ages 15 to 19. The vast majority of chlamydia cases occur in the 15 to 24 year old age group (65% of chlamydia cases among all age groups), the target group for recommended annual screening. The chlamydia rate for 15-19 year old African American females is 8 times higher than their white counterparts; these differences may be partially due higher levels of screening, sexual networks with higher prevalence, or differential care by public sector providers who tend to comply with reporting regulations.
Overall, gonorrhea rates for 15 – 19 years old females have decreased from 2000-2009, but for the same age group of males there has been an overall upwards trend in gonorrhea rates over the last 10 years. Again, of great concern is the large decade-long disparity in gonorrhea rates for African Americans females and males 15 – 19 year old. In 2009, the rate for African American females was over 24 times higher than for white females 15-19 years old. The rate for African American males was over 31 times higher than for white males 15-19 years of age.
Primary and secondary (PS) syphilis rates have increased between 2000 and 2009 for both female and male 15 – 19 year olds. This is contrast to the overall profile of PS syphilis cases who tend to be males having sex with males of age under 30 years. Rates for adolescent females increased slightly while males experienced a more dramatic increase in 2009. Yet again, of most concern is the 2009 rate among 15 – 19 year old African American males is nearly 7 times higher than for adolescent white males (3).
Although the number of actual AIDS cases among teens is low, HIV infection during these years is significant. Since 2000, there was a slight decreased in rates for females while males experienced a slight increased rate. In 2009, the Living HIV/AIDS rates for youth ages 15 – 19 was male 66.7 per 100,000 and for females 23.9 per 100,000. Of concern, is the tremendous disparity for African American youth ages 15 – 19. The rate for African American males was 295.2 per 100,000 and for females 103.8 per 100,000 (4).
Data and research are essential tools for raising awareness of adolescent health issues, to plan programs and service delivery, and to formulate policy at the state and local levels. CAHC is committed to maintaining a website that serves as a gateway to a wide array of resources, and regularly updating our site to include the most up-to-date research. Direct links are provided when possible, and abstracts are provided for journal articles.
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(1) No Time for Complacency, Public Health Institute, Center for Research on Adolescent Health and Development (http://teenbirths.phi.org/)
(2) Heather D. Boonstra, Policy Review, Winning Campaign: California’s Concerted Effort To Reduce Its Teen Pregnancy Rate, Guttmacher, Spring 2010 | Volume 13 | Number 2.
(3)Sexually Transmitted Diseases in California, 2009. California Department of Public
Health, STD Control Branch, November 2010. (http://www.cdph.ca.gov/data/statistics/Documents/STD-Data-2009-Report.pdf)