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Over the last century, the transition from childhood to adulthood has been radically, and probably irrevocably, altered. Many of the traditional markers of adulthood, such as full-time employment, economic independence, marriage and childbearing, now generally occur at later ages than in past generations. At the same time, young people initiate sexual intercourse much earlier than in the past, and long before they marry. Most adolescents today begin to have intercourse in their middle to late teens. More than half of women and almost three-quarters of men have had intercourse before their 18th birthday; in the mid-1950s, by contrast, just over a quarter of women were sexually experienced by age 18. As sex has become more common at younger ages, differences in sexual activity between gender, racial, socioeconomic and religious groups have narrowed considerably.

Despite these trends, teenagers generally do not initiate sexual intercourse as early as most adults believe. Nor do all teenagers have sex. Although the likelihood of having intercourse increases steadily with age, nearly 20% of adolescents do not have intercourse at all during their teenage years. Moreover, many of the youngest teenagers who have had intercourse report that they were forced to do so.

Most adolescents who are sexually experienced try to protect themselves and their partners from the negative consequences of sex--namely, sexually transmitted diseases (STDs) and unintended pregnancy--even the first time they have intercourse. Two-thirds of adolescents use some method of contraception--usually the male condom--the first time they have sex, and between 72% and 84% of teenage women use a method of contraception on an ongoing basis. Although their contraceptive use is often less than perfect, a large majority of these young people succeed in avoiding unintended pregnancy. In fact, teenagers use contraceptives as effectively as or even better than adults; adolescents have lower rates of unintended pregnancy, for example, than unmarried method users in their early 20s.

For adolescents who are not effective contraceptive users or who do not use a method, the consequences can be serious, especially for young women. Every year, 3 million teenagers acquire an STD, which can imperil their ability to have children or lead to serious health problems, such as cancer and infection with the AIDS virus. In addition, i million teenage women become pregnant every year, the vast majority unintentionally. Pregnancy rates among sexually experienced teenagers have declined substantially over the last two decades, but because the proportion of teenagers who have had intercourse has grown, the overall teenage pregnancy rate has increased. Older teenagers and adolescents who are poor or black are more likely to get pregnant than are their younger, more advantaged and white counterparts.

Teenagers who become pregnant almost always have an abortion or give birth and raise the child themselves; placing a child for adoption is rare. About half of adolescent pregnancies end in birth, slightly over a third in abortion and the rest in miscarriage. The way in which adolescent women resolve their pregnancies is determined largely by their socioeconomic status. Young women who come from advantaged families generally have abortions. Childbearing, on the other hand, is concentrated among teenagers who are poor and low-income; in fact, more than 80% of young women who give birth fall into one of these income categories.

Young mothers tend not only to be disadvantaged economically, educationally and socially at the time of their child's birth, but also to be at risk of falling further behind their more advantaged peers who postponed childbearing to obtain more education and to advance their careers. Teenage mothers, for example, obtain less education and have lower future family incomes than young women who delay their first birth. Many are poor later in life, and while it is clear that their initial disadvantaged background is a major reason for their subsequent poverty, it is also clear that early childbearing has a lasting impact on the lives and future opportunities of young mothers and of their children.

Current trends in sexual behavior among U.S. teenagers are similar to trends both among U.S. adults and among teenage and adult women and men in other countries. For example, the proportion of births to U.S. women in their 20s that were out of wedlock has increased fourfold in the last 20 years. In fact, adult women, not teenagers, account for large majorities of the unintended pregnancies, abortions and out-of-wedlock births that occur each year. Furthermore, even though nearly 70% of births to adolescents occur outside of marriage, teenagers account for a smaller proportion of out-of-wedlock births today than they did in 1970.

If adults are going to help teenagers avoid the outcomes of sex that are clearly negative--STDs, unintended pregnancies, abortions and out-of-wedlock births--they must accept the reality of adolescent sexual activity and deal with it directly and honestly. Certain interventions are needed by all teenagers. All adolescents, for example, need sex education that teaches them communication skills that will help them postpone sex until they are ready and that provides information about specific methods to prevent pregnancy and STDs. All young people also need clear and frequent reminders from their parents, the media and other sources about the importance of behaving responsibly when they initiate sexual intercourse. Sexually experienced teenagers need accessible contraceptive services, STD screening and treatment, and prenatal and abortion services, regardless of their income status.

As important as these interventions are, they do not address the entrenched poverty that is a major cause of early childbearing among disadvantaged teenage women. Only when their poverty is alleviated, and these young women--and their partners--have access to good schools and jobs and come to believe that their futures can be brighter, is real change in their sexual behavior and its outcomes likely to occur.

Other industrialized countries are also dealing with issues related to adolescent sexual activity, but teenage pregnancy, abortion and childbearing are bigger problems in this country, for several reasons: Elsewhere in the industrialized world, there is a greater openness about sexual relationships; the media reinforce the importance of using contraceptives to avoid pregnancy and STDs; and contraceptives are generally more accessible to teenagers because reproductive health care is better integrated into general health services. We can learn from the successes of other countries, as well as from programs in this country that have had a positive impact on teenagers' initiation of sexual intercourse and contraceptive use, to better help young people avoid being adversely and needlessly affected by sexual behavior.
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Title Annotation:adolescents and sexual behavior
Publication:Sex and America's Teenagers
Article Type:Statistical Data Included
Geographic Code:1USA
Date:Jan 1, 1994
Previous Article:Acknowledgments.
Next Article:Rites of passage.

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