Adolescent sexuality and the resulting consequences have always been a concern to many societies across numerous generations. Teenage pregnancy, teenage parenthood and teenage infections with sexually transmitted diseases brings with it unique burdens not only to the adolescent affected, but also the society as a whole.
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In North America, every year more than 45000 teenagers aged 19 and below become pregnant (Martin, Park, & Sutton, 2002). These rates have dropped compared to their recent peak in 1990, with the decline said to be a result increased use of contraceptives amongst the youth. Nevertheless, these adolescent pregnancy rates range from about 50 percent to 550 percent more than the rates in other European societies (Darroch, Singh, & Frost, 2001). Every year 1 in every four sexually experienced teens (3 million teens) contract sexually transmitted disease and the teen pregnancy result in over two hundred thousand abortions each year. For those who carry their pregnancy to term, Eighty-three percent occur out of wedlock. Even in controlled studies adolescent mothers have been found to have lower education attainment levels.
The most disturbing thing, however, is the evidence that the burden of adolescent parenthood accrues the greatest impact to members of the next generation. Problems normally start at birth: Documented evidence have shown that pregnant adolescents risk giving birth weight baby and these children of adolescent mothers are more likely to exhibit poor cognitive functioning and school adjustment than children born to older mothers. In adolescents, researchers have found massive delinquency, failure and risk for early parenthood amongst children of adolescent mothers.
Teen Sexuality and Pregnancy Prevention amongst Adolescents
If sexuality is a lightning rod in the community, then adolescent sexuality reflects that point where the charges are highest and most unstable. There is tension within societies around the meaning of adolescent sexuality either as a marker or moral decay or as a normal, healthy and natural growth process. The culture revolving around adolescent sexuality has relied heavily on sex education as a preventive measure. There are two opposing line of theory that had been developed earlier. One perspective stated that on a simple empirical basis, a sizeable percentage of adolescents become sexually active before reaching 18 years. It further states that educating them about the nature of sexual and its consequences would be one of the most effective means of curbing teenage pregnancies. In this perspective, teenage pregnancy is best prevented by accepting a role for teenage sexual activity as healthy, but certainly requiring direct and open discussions, accompanied by moral prescriptions.
The other view posits that any educative activity that was based on the assumption that adolescents may become sexually active as teens cannot help but implicitly support such behavior. Thus, “ explicit” sex education that includes teaching in topics such as birth control would lead to an increase in the view of adolescents on sexual activity as a viable option. Even though, explicit sex education programs might not necessarily encourage such behaviors, they were perceived as at least providing a “nod” suggesting that it is expected. Explicit sex education was see at worst as suggesting that sexual activity is a normative behavior to naïve teenagers who would have otherwise not considered it. At a minimum, educational programs have been seen as reducing the teenager’s sense that sexual activity is universally seen by adults as inappropriate before marriage or adulthood. In either case, programs like these were seen as likely to increase the levels of teenage sexual activity, with a very likely chance that these increases would lead to higher rates of sexually transmitted infections and pregnancies as well.
Prevention Programs that work- Common elements
There has been one approach to sexual education programs that have been effective. It combines educational material with a notable amount of skills that revolve around assertive and sexual behaviors. For example, skill based prevention measures against HIV have been implemented in Colorado schools and has been shown to lead to contribute to increasing the use of condoms reduce number of multiple sexual partners. Similarly, a successful HIV prevention study in which the education program used included training in social skills was compared to education only approach, and found the latter clearly superior.
Research has also shown that combining of information-based programs with other development oriented programs did much better than interventions that focused on information alone in reducing irresponsible sexual behavior and teenage pregnancy rates. Interventions that seek to develop skills in self-efficacy together with the provision of information did much better than programs that provide information alone. Programs that teach about safe sex, while placing a lot of emphasis on responsibility and pride in decision making also seem to do better than programs that only teach safer sex behaviors (Jemmott & Fong, 1998). Finally, programs that narrowly focus on abstinence only are yet to yield any findings. The interpretation of these findings is that emotional and social development components of these prevention programs function as catalysts that help leverage the impact of abstinence or education-based approaches.
The idea of preventing adolescent pregnancies, repeat pregnancies, or failures in parenting, by focusing on something else other than sexual behavior may at first seem to be avoidant, foolish or hopelessly indirect. However, on a closer look of research done on adolescent sexual behavior show that this approach may yield much better results than programs that focus solely on sexual behaviors. It has long been recognized that irresponsible sexual activity tends not to happen in isolation, to occur together with higher levels of substance abuse. This approach states that it makes less sense to view a single behavioral problem in isolation; rather, the problem should be seen as part of a unified syndrome that has an underlying risk manifesting itself in many different forms (Bell, 1986). This approach is thought to apply to patterns of delinquent behavior even in adulthood and starts to shed some light into the research findings discussed above.
The impact of programmatic interventions on behaviors such as adolescent sexuality, start to be more plausible if we understand teenage sexual behavior as reflecting underlying problems that might lead to the emergence of a host of other problematic behaviors. In short, seeing an adolescent as a “whole person” may be fundamental in solving the problem.
A lot can be learned from this programs and research that address teenage sexual behavior. The first is that adolescent pregnancy prevention is possible byways that may seem to be very indirect routes. A lot of evidence has emerged showing that by assisting teenagers to achieve educational success and be in control of their fertility, we are preventing teenage pregnancy in the coming generation. The most important implication is that currently there are several tools that can be used to prevent negative consequence of teenager’s sexual behavior.
It may make little sense to think that giving extensive sex education will lower teenage pregnancy rates; it seems equally not viable that focusing on abstinence without looking at the broader aspects of social development will have an effect. Long-term interventions can help by helping the youth to have a higher sense of connection to the larger community, for example, by increasing their sense of self-efficacy, assertiveness, their impulse control and their hope about the future. Teens who are craving for a sense of connection and intimacy are more likely to engage in sexual behavior for which they are not ready for (Allen, 2002). The use of the nutritional model may be particularly appropriate here as these teenagers may be starving for a place within the social world and a sense of connection to the broader society.
In short, when we focus on the development of a teenager as a whole person may precisely target those behaviors and developmental factors that are directly connected to preventing risky sexual behavior and its consequences. These programs are likely to build the capacity of youth and can greatly increase their motivation and skill at avoiding risky sexual behavior (Kirby & Coyle, 1997) even if they may not be addressing sexual behavior directly. By giving the youth opportunity to talk about their feelings, interests and concerns about sexuality, as well as practice negotiation and decision making skills, we will be enabling them to develop their moral framework about sexuality.
Allen, J. P. (2002). Observed Autonomy And Connection With Parents And Peers As Predictors Of Early Adolescent Sexual Adaptation. Paper presented at the Biennial Meetings of the Society for Research in Adolescence, New Orleans, LA.
Bell, R. Q. (1986). Age Specific Manifestations in Changing Psychosocial Risk. In D. C. Farran & J. D. McKinney (Eds.), The concept of risk in intellectual and psychosocial development. New York: Academic Press.
Darroch, J. E., Singh, S., & Frost, J. J. (2001). Differences in teenage pregnancy rates among five developed countries: the roles of sexual activity and contraceptive use. Family Planning Perspectives, 33(6), 244-250.
Jemmott, J. B., III, Jemmott, L. S., & Fong, G. T. (1998). Abstinence and safer sex HIV risk-reduction interventions for African American adolescents. Jama: Journal of the American Medical Association, 279(19), 1529-1536.
Kirby, D., & Coyle, K. (1997). School-based programs to reduce sexual risk-taking behavior. Children & Youth Services Review, 19(5-6), 415-436.
Martin, J. A., Park, M. M., & Sutton, P. D. (2002). Births: Preliminary Data for 2001. National Vital Statistics Reports, 50, Number 10.