By Yolanda Evans, MD
This article first appeared on Seattle Children’s Teenology 101 blog.
While the rate of teen pregnancy in the United States has declined in recent years, it remains the highest among industrialized nations.
More than 750,000 high-school-age girls become pregnant every year, according to the Centers for Disease Control and Prevention.
Now, a new study suggests that intervention approaches that combine contraception and condom education with leadership training, one-on-one coaching, and peer engagement can help reduce the risk of pregnancy and sexually transmitted infections in teen girls.
The study, published Feb. 25 in JAMA Pediatrics, followed more than 200 high-risk 13- to 17-year-old girls for two years. The girls were coached in everything from choosing the right birth control to developing better relationships with their parents to asking a partner to use a condom.
Multifaceted approach to reducing teens’ risky sexual behaviors
“It’s important for girls to be knowledgeable and to know how to advocate for themselves,” she says. “You can have birth control, but you have to take it. You can have condoms, but you have to be comfortable enough to ask your partner to put one on.”
The study showed that girls who receive one-on-one and peer counseling, in addition to education about how to prevent pregnancy felt more connected to their families and more confident in refusing unwanted sex. They also placed less importance on having sex than their peers who did not receive coaching and education.
Evans says that girls’ self-esteem and their openness with their families can make all the difference: “Research shows that families who communicate about sex and reproductive health have teens who wait longer to start having sex. That’s really huge. If you can delay your sexual debut, you’re going to be less likely to engage in risky behaviors.”
50 percent of U.S. teens have sex before they finish high school
According to Evans, one of the reasons that the U.S. teen pregnancy rate remains higher than other countries may be Americans’ lack of openness about the topic.
“In the United States, we don’t talk about sexual activity, yet it’s portrayed in our media,” she says. “No parent in any country wants their child to have sex unless they’re absolutely ready. The difference is talking with our kids about it and our expectations about sexual behavior.”
Evans acknowledges that for many parents, talking with their kids about sex is an intimidating task. But, she says, the payoff is huge.
“About half of teens have sex before age 18,” she explains. “For us as adults and parents, we’re not helping the situation if we ignore the behavior. We need to be open about it, talk about it, tell them our expectations, discuss the consequences, really teach them to protect themselves, and teach them why waiting is a good idea.”
5 tips for talking to teens about sex
To help get the conversation started, Evans offers these tips for parents:
- Educate your teen about condoms and birth control. Teens need to know not only where to get condoms and birth control, but also about how to choose the best method and how to use them. Whether you have boys or girls, make sure they know how to protect themselves if they decide to become sexually active.
- Encourage your kids to get involved in youth leadership activities. Your child will develop skills that will help them talk with partners, negotiate relationships and speak up for themselves.
- Open up family communication channels. The more your teen feels comfortable talking to you, coming to you with questions, and knowing what your values and expectations are, the less likely she’ll be to engage in high-risk sex.
- Talk about consequences. Sex can come with consequences like unwanted pregnancy and STDS, as well as the emotional attachment that comes with having a sexual relationship with somebody. If you are open to teaching your teens about the consequences of having sex, they may be more willing to wait.
- Describe and model healthy romantic relationships. Point out healthy relationship behaviors and coach your teens about how to stand up for themselves in relationships. Girls should feel comfortable asking a partner to use a condom or turning down unwanted sex.
If you’re not comfortable talking to your teens about sex and relationships, Evans recommends bringing up the topic with your child’s doctor .
About Yolanda Evans, MD, MPH
My work is a ‘dream come true’ and it’s what I’ve wanted to do for as long as I can remember. I have the privilege of getting to know some amazing teens and hearing things about them that they may not have told anyone before. When I’m not working, I like trying new foods, traveling around the world, spending time with family and friends, and enjoying the fresh Washington air (though not quite as fresh as Alaska where I grew up, but very close!) – Yolanda Evans, M.D., Adolescent Medicine at Seattle Children’s
Learn more on our Teenology 101 blog:
Why teens choose to have sex
The big talk: Part 1, Talking to your teen about sex (video)
The big talk: Part 2, The birds and the bees (video)
10 tips for talking to your teen about sex
Teen girls, boyfriends, money, and sex