Safe sex and pregnancy prevention: a guide for health practitioners working with adolescents.

Abstract

Although adolescents are initiating sexual activity at steadily decreasing ages, only an estimated 31% of females less than 15 years of age at the time of 1st intercourse and 52% of those 15-17 years of age used a contraceptive on this occasion. To decrease the risks of unplanned pregnancy and the transmission of sexually transmitted diseases (STDs), new ways are needed to motivate adolescents to practice self-protective sexual behaviors. Primary prevention measures for STDs include judicious selection of sexual partners, the use of mechanical and chemical barriers during intercourse, and avoidance of sex practices such as those in which bodily fluids are exchanged. Although oral contraceptives are popular among teenagers and are very effective in preventing pregnancy, they have little effect on the prevention of STDs. Thus, teens who use this method should also be counseled in the use of condoms or spermicides. Professionals who work with adolescents must be able to identify those at high risk, accept adolescent decisions and behaviors that conflict with their own value systems, provide educational activities aimed at prevention, and provide clinical services designed with the special needs of this population in mind. The form of contraception prescribed to an individual adolescent should be based on an assessment of the number of sexual partners, the frequency of sexual intercourse, cognitive maturity, and the level of comfort with handling the genitals. Adolescents at greatest risk for early sexual activity tend to be of low socioeconomic status, have low educational attainment, less parental supervision in terms of dating, less overall involvement with parents, lower personal aspirations, higher alcohol and marijuana use, no sex education, and traditional views on sex roles.