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Abstract

Background: The US has higher rates of teen births and sexually transmitted infections (STI) than other developed countries. Texas youth are disproportionately impacted. Purpose: To review local, state, and national data on teens’ engagement in sexual risk behaviors to inform policy and practice related to teen sexual health. Methods: 2009 middle school and high school Youth Risk Behavior Survey (YRBS) data, and data from All About Youth, a middle school study conducted in a large urban school district in Texas, were analyzed to assess the prevalence of sexual initiation, including the initiation of non-coital sex, and the prevalence of sexual risk behaviors among Texas and US youth. Results: A substantial proportion of middle and high school students are having sex. Sexual initiation begins as early as 6th grade and increases steadily through 12th grade with almost two-thirds of high school seniors being sexually experienced. Many teens are not protecting themselves from unintended pregnancy or STIs – nationally, 80% and 39% of high school students did not use birth control pills or a condom respectively the last time they had sex. Many middle and high school students are engaging in oral and anal sex, two behaviors which increase the risk of contracting an STI and HIV. In Texas, an estimated 689,512 out of 1,327,815 public high school students are sexually experienced – over half (52%) of the total high school population. Texas students surpass their US peers in several sexual risk behaviors including number of lifetime sexual partners, being currently sexually active, and not using effective methods of birth control or dual protection when having sex. They are also less likely to receive HIV/AIDS education in school. Conclusion: Changes in policy and practice, including implementation of evidence-based sex education programs in middle and high schools and increased access to integrated, teen-friendly sexual and reproductive health services, are urgently needed at the state and national levels to address these issues effectively.

Key Take Away Points

  • 7% of Texas 9th graders have sex before age 13.
  • An estimated 689,512 out of 1,327,815 students in Texas public high schools are sexually experienced –over half (52%) of the total high school population.
  • Implementation of evidence-based sex education programs in middle and high schools and increased access to reproductive health services are urgently needed to reduce the burden of teen pregnancy and STIs/HIV.

Author Biography

Christine Markham, PhD, Assistant Professor of Health Promotion and Behavioral Sciences at the University of Texas School of Public Health and Deputy Director at the University of Texas Prevention Research Center, has over 20 years’ experience in child and adolescent sexual health research including family- and school-based programs.

Melissa Peskin, PhD, Assistant Professor of Health Promotion and Behavioral Sciences at the University of Texas School of Public Health and Associate Director of Dissemination at the University of Texas Prevention Research Center, is an expert in the development, implementation, evaluation, and dissemination of adolescent sexual health programs.

Belinda F. Hernandez, MPH, CHES, PhD candidate in Health Promotion and Behavioral Science at the University of Texas School of Public Health, has research experience with minority populations, adolescents, program dissemination, and intervention-based research.

Kim Johnson, MPH, PhD candidate in Health Promotion and Behavioral Science at the University of Texas School of Public Health, has research experience in sexual health disparities, program dissemination, and community-based participatory research, specifically involving youth as investigators.

Robert Addy, PhD, Data Analyst, Center for Health Promotion and Prevention Research, University of Texas School of Public Health, is an expert in behavioral sciences, biostatistics, and epidemiology. He is data analyst for studies on childhood & adolescent health, sexual and reproductive health, and the social determinants of health.

Paula Cuccaro, PhD, Associate Director of Research for the University of Texas Prevention Research Center, is Project Director for Healthy Passages, a longitudinal adolescent health study following a group of youth over a 10-year period. She is an expert in adolescent protective and risk factors, mental health, the needs of foster care youth, and the human-animal bond.

Ross Shegog, PhD, Assistant Professor of Behavioral Science at the University of Texas School of Public Health and Associate Director of Communication at the University of Texas Prevention Research Center, is an expert in the application of instructional technology in health promotion and disease prevention to optimally impact adolescent health behavior.

Susan Tortolero, PhD, Associate Professor of Health Promotion and Behavioral Sciences, and Epidemiology at the University of Texas School of Public Health, and Director of the Center for Health Promotion and Prevention Research and the University of Texas Prevention Research Center, has over 20 years’ experience researching risk and protective factors for adolescent physical and mental health. She is Vice Chair for the Texas Campaign to Prevent Teen Pregnancy.

Acknowledgements

The All About Youth study was funded by the Centers for Disease Control and Prevention (CDC) (#5U48DP000057) and The Department of Health and Human Services (DHHS), Adolescent Family Life (90XF0036). The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC.

Responses to this Article:

Jane D. Brown, Adolescents’ Sexual Health Matters: Texas Should Get on Board (October 2011)