Preventing sexual risk behaviors and pregnancy among teenagers: Linking research and programs
Preventing sexual risk behaviors and pregnancy among teenagers: Linking research and programs
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DOI：
10.1111/j.1931-2393.2003.tb00110.x
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发表时间：
2003-03-01
影响因子：
5.8
通讯作者：
Cassell, C
中科院分区：
文献类型：
--
作者：
Kalmuss, D;Davidson, A;Cassell, C
青少年性行为的最新趋势提供了复杂的信息。令人鼓舞的是，青少年的性活动、怀孕和生育的总体比率正在下降，而避孕药具和安全套的使用率正在上升。 1 然而，青少年中过早发生性行为的比例有所增加。 2 此外，虽然青春期女性在第一次性行为时使用避孕药具的情况有所增加，但最近一次性行为时使用避孕药具的情况却在下降。 3 人们普遍认为，从事可能导致怀孕、感染艾滋病毒和其他性传播感染 (STI) 的行为的青少年比例仍然过高。每年，大约有 100 万 15-19 岁的年轻女性（占该年龄段所有性活跃女性的五分之一）怀孕；这些怀孕绝大多数是计划外的。 4 在美国，青少年感染性传播感染的风险高于成年人。 5 此外，美国青少年的无保护性行为、性传播感染、怀孕和生育率仍然远高于类似工业化国家的年轻人。 6研究还开始强调年轻人中非自愿性行为的比例高得惊人。在 1995 年全国家庭成长调查中，13% 的 15-19 岁女性表示她们曾被迫发生性行为。 7 当被问及她们的第一次性经历时，在 15 岁之前发生性行为的 15-44 岁女性中，有 22% 的人表示这种行为是非自愿的，而在 16 岁之前第一次发生性行为的女性中，有 16% 的人也表示这种行为是非自愿的。非自愿性行为通常是不受保护的，因此使受害者面临怀孕和性传播感染的极高风险。最后，最近的研究和临床观察表明，很大一部分青少年，包括那些自称从未进行过阴道性交的青少年，正在进行口交。 8 这种趋势对青少年的性健康产生负面影响，因为许多人似乎没有意识到性传播感染可以通过无保护的口交而感染。青少年卫生专业人员面临着如何完善规划和研究工作以保持已取得的进展，同时减少那些仍然过于普遍的危险行为的困境。解决方案可能部分在于弥合研究和项目之间的差距。 30多年来，研究人员一直在研究青少年高风险性行为的前因，服务提供商也设计了预防这些行为的计划。然而，他们的努力通常是独立进行的，每个专业团体的工作通常不会相互通报。
Recent trends in adolescent sexual behavior offer mixed messages. It is very encouraging that teenagers' overall rates of sexual activity, pregnancy and childbearing are decreasing, and that their rates of contraceptive and condom use are increasing. 1 However, the proportion of young people who have had sex at an early age has increased. 2 More-over, while adolescent females' contraceptive use at first sex is rising, their use at most recent sex is falling. 3 There is general consensus that the proportion of teenagers who engage in behaviors that put them at risk of pregnancy and of HIV and other sexually transmitted infections (STIs) remains too high. Each year, approximate-ly one million young women aged 15-19-or one-fifth of all sexually active females in this age-group-become pregnant; the vast majority of these pregnancies are unplanned. 4 In the United States, the risk of acquiring an STI is higher among teenagers than among adults. 5 Moreover, rates of unprotected sexual activity, STIs, pregnancy and childbearing continue to be substantially higher among US ado-lescents than among young people in comparable indus-trialized countries. 6Research has also begun to highlight an alarmingly high rate of involuntary sex among young people. In the 1995 National Survey of Family Growth, 13% of 15-19-year-old females reported that they had been forced to have sex. 7 When asked about their first sexual experience, 22% of 15-44-year-old women for whom it occurred before age 15 reported that the act was involuntary, as did 16% of those who first had sex before age 16. Involuntary sexual activity is typically unprotected and thus puts its victims at very high risk of pregnancy and STIs. Finally, recent research and clinical observations suggest that a substantial proportion of teenagers, including those who report having never had vaginal sex, are engaging in oral sex. 8 This trend has negative implications for teenagers' sexual health because many seem unaware that STIs can be acquired through unprotected oral sex. Adolescent health professionals are faced with the dilemma of how to refine programmatic and research efforts to maintain the progress that has been made while reducing those risk behaviors that remain too prevalent. The solution may lie, in part, in bridging the gap between research and programs. For more than 30 years, researchers have studied the antecedents of teenagers' high-risk sexual behaviors, and service providers have designed programs to prevent those behaviors. Their efforts have typically proceeded independently, however, and each professional community's work has not routinely informed that of the other.