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Toward a new paradigm on adolescent sexual health.


 Society often sends strong and contradictory messages about sexuality to teenagers. Few existing educational strategies, including those based on fear, consider adolescents to be responsible sexual persons or promote healthy sexual development, Yet, sex education programs must emphasize decreasing the risk of unprotected intercourse (delay of first intercourse and increasing the number of acts of protected intercourse). Family planning and sexuality specialists need a new definition of adolescent sexual health which can help them better deal with healthy adolescent sexual development. During the 1980s, public policies in the US revolved around sexual abstinence. Yet, normative adolescent sexual behavior was and continues to be sexual intercourse. The US Centers for Disease Control reports that 54.2% of students in grades 9 through 12 have had sexual intercourse during the last 3 months and, by 12th grade, 71.9% have had sexual intercourse. 16.1 years is the median age froM first intercourse for males and 16.9 years for females. Further, adolescents are practicing more preventive sexual behaviors. For example, adolescents were more likely to use a contraceptive at first intercourse in 1988, compared to 1979, 65% vs. 48%. Males were more likely to use a condom during their last intercourse (almost 60% vs. almost 30%). Nevertheless, many adolescents are still becoming pregnant and acquiring sexually transmitted diseases, including HIV/AIDS. Most adolescents have positive attitudes about sexual experiences. For example, 1 study shows that 87% of males and 64% of females did not feel pressured to have their first intercourse. Further, sexually experienced teenagers, except less than 15-year-old-females, tend to have higher self-esteem than the unexperienced. The Sex Information and Education Council of the US (SIECUS) promotes a comprehensive sexuality education program with a positive approach which helps adolescents develop a sexual identity. Such a program needs to affirm adolescents' sexual rights and advocate easy access to sexual health care services without parental consent. These programs must support virgins as well as adolescents who have sexual intercourse.
