Adolescents' Sexual and Reproductive Health Needs

Background Information from the The Alan Guttmacher Institute

For more information contact: Rebecca Wind 212-248-1111 ext. 2203; Jennifer Nadeau 212-248-1111 ext. 2209

For Policy information contact: Susan Cohen 202-296-4012

The United Nations General Assembly Special Session for Children is being held in New York from May 8-10. Meeting adolescents' needs for sexual and reproductive health education and services has become a major area of contention in the session's outcome document, largely due to opposition from the United States delegation. Here are some facts about adolescents' sexual and reproductive health, abortion around the world, and different approaches to sexuality education:

Teenage Sexual Behavior

· In most countries, many young women and men become sexually active during adolescence. For example, in many Sub Saharan African countries more than 70% of young women have had intercourse before age 20. Similarly, in the United States, nearly 70% of women and nearly 80% of men begin sexual intercourse before age 20.

· Often this sexual activity occurs within a marriage, especially among young women. In many developing countries, 40-70% of women marry or start a union and 30-67% have had their first child by age 20.

Teenage Pregnancy

· Many women in developing countries have children in their teenage years, when they are physically immature and often malnourished, conditions that increase their risk of experiencing a difficult delivery and obstetric complications. In Nepal, for example, where 52% of women give birth before age 20, teenage mothers are almost twice as likely to die in childbirth as are women giving birth in their early 20s.

· The U.S. teenage birthrate of 49 per 1,000 women aged 15-19 in 2000, down roughly 20% from 1990, remains about twice as high as rates in Great Britain and Canada, and five times as high as in Sweden and France.

· Approximately one-quarter of the decline in teenage pregnancy in the United States between 1988 and 1995 was due to increased abstinence. (The proportion of all teenagers who had ever had sex decreased slightly, but nonsignificantly, during this period, from 53% to 51%.) Approximately three-quarters of the drop resulted from changes in the behavior of sexually experienced teens. (The pregnancy rate among this group had fallen 7%, from 211 per 1,000 to 197.)

Contraceptive Use

· The likelihood of pregnancy in the absence of contraceptive use is so great that the 7% of American women aged 15-44 using no method while at risk of unintended pregnancy account for nearly half (47%) of all unintended pregnancies.

· Almost 230 million women worldwide lack effective contraceptive methods and services.

· In Sweden, France, Canada and Great Britain, easy access to contraceptives and other reproductive health services contributes to better contraceptive use and therefore lower teenage pregnancy rates than in the United States.

Sexually Transmitted Diseases and HIV

· More than 300 million cases of curable sexually transmitted diseases (STDs) occur worldwide each year.

· Both men and women are most likely to contract chlamydia and gonorrhea in their teens and 20s.

· For a variety of physiological, economic and cultural reasons, adolescents are particularly vulnerable to HIV infection. This is especially true for young women, who are at least twice as likely to become infected as young men in many African countries.

· Recent estimates indicate that 6,000 young people aged 15-24 are newly infected with HIV each day.

Abortion

· 46 million women around the world have abortions each year. Of these women, 78% live in developing countries and 22% in developed countries.

· Worldwide, the lifetime average is about 1 abortion per woman.

· About 26 million women have legal abortions each year, and 20 million have abortions in countries were abortion is restricted or prohibited by law.

· Abortion mortality is low in developed countries, where the procedure is usually legal (0.2-1.2 deaths per 100,000 abortions). But in developing regions (excluding China), where abortion is often illegal or highly restricted, abortion mortality is hundreds of times higher than in developed countries (330 deaths per 100,000 abortions).

· The World Health Organization defines "unsafe abortion" as a "procedure for terminating an unwanted pregnancy [carried out] either by a person lacking the necessary skills or in an environment lacking minimal medical standards, or both." It estimates that almost 20 million unsafe abortions occur each year--19 million in developing countries and the remainder mostly in Eastern Europe.

· Lowering a country's abortion rate has more to do with using contraception than with whether abortion is legal.

Comprehensive vs. Abstinence-Only Sexuality Education

· Societal acceptance of sexual activity among young people, combined with comprehensive and balanced information about sexuality an

d clear expectations about commitment and prevention of childbearing and STDs within teenage relationships, are hallmarks of countries with low levels of adolescent pregnancy, childbearing and STDs.

· Abstinence-only messages are not only unproven in their effectiveness but also may have harmful health consequences by deterring use of contraceptives when teens become sexually active.

· While politicians promote abstinence-only education in the United States, teachers, parents and students want young people to receive far more comprehensive information about how to avoid unintended pregnancy and STDs, and about how to become sexually healthy adults.

· Abstinence-only education programs in the United States teach that sex outside of marriage for people of all ages is likely to have harmful physical and psychological effects. These programs are not allowed to advocate contraceptive use or even to discuss contraceptive methods, except to emphasize their failure rates.

· Currently, there are three federal programs in the United States dedicated to restrictive abstinence-only education, together funded at well over half a billion dollars since 1997.

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