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Section 1

Unwanted pregnancies arising from unsafe sexual practices are considerable health problems for most teenagers and the rest of society. In adolescence, formation of a sexual identity is a crucial developmental task for both boys and girls. From adolescence to young adulthood, teenagers begin the process of sexual exploitation, a search for their sexual identities. Statistics of sexual behaviour show a rapid increase in the number of sexually active teens, and this is evident in the consistently high rates of adolescent pregnancies, which has caused an increasing public concern. To explore the issue of teenage sexuality and their birth control choices, this report will appraise and compare research studies and reports on teenage sexual practices and their use of birth control methods. The report will seek to answer whether contraceptive use or non-use affects pregnancy, abortion and sexually transmitted infections rates among teenagers.

In Australia, a 2006 study conducted from1997 to 2002 showed an increase in students engaging in sex in grade 10-12, with the increase being more prominent in the 10th grade. The study also reported a raise in sexual partners (Agius et al. 2006). Agius et al. (2010) reported a further increase in sexually active teenagers. In the United States, the “Youth Risk Behaviour Surveillance (YRBS)” reported that 64% students aged 12 and 44% of 10 years had sex no less than one time (Danice et al. 2008). These statistics are comparable to Australia where 56 % of Year 12 and 27% of Year 10 have had sex at least once in their lifetime (Agius et al. 2010). This indicates that the number of teenagers having sex is significant and has been on the rise, as indicated by Danice et al. (2008) and Agius et al. (2010) study with the age of first sexual experience decreasing.

These statistics suggests that most teenagers are at increased risk of unplanned pregnancies as well as sexually transmitted diseases. From 2006 to 2010, some 93% of male teenagers and 86% of female teenagers reported using contraceptives during the last sex incident in the US (Martinez et al. 2011). This shows, there is an increased use of birth control choices among teenagers in the US. This is not the case in Australia, as most teenagers do not practice safe sex. Danice et al. (2005) study indicated that 54% of Year 12 and 66% of Year 10 learners used a condom during their most recent sexual incident. Agius et al. (2010) reported that 61% of Year 12 and 70% of Year 10 learners used condom in their most recent sexual incidents.

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Sexually Transmitted Diseases, pregnancy, and childbirth are some of the main health concerns for most teenagers. In Australia, abortion/pregnancy termination is the second most frequent procedure for teenage girls. It is the second most common reason for young women admission in the hospital (Simpson, 2003). Australia ranks among the highest rated nations with teenage pregnancies as well as abortions with about twenty-two terminations for every one thousand teenagers every year, relative to 19 live births (Simpson, 2003). According to Agius et al. (2010), the teenage pregnancy incidences in Australia are amongst the highest in the developed worlds. The National Centre in HIV Epidemiology & Clinical Research (2009) reported that there is an extremely high occurrence of STIs (sexually transmitted infections) amongst the teenagers, and it has risen significantly in the last ten years. Sexual health and contraception issues are also some of the most common issues for which most teenagers visit their family doctors.

The issue of “teenager sexuality and birth control choices” is thus crucial, since teenagers are at a stage of their development where they take risks believing they will not be harmed. Teenagers also like experimenting, especially when it comes to sex, and they seek approval of their friends through this. Nevertheless, some teenagers are increasingly becoming cautious in using birth control; nonetheless, there is still a high rate of risky sexual behaviours among them hence the high abortion rates in teenage (Crooks & Baur 2011). Most of these teenage pregnancies are unintended, mostly because of the inconsistent or no use of contraceptives.

Some of the most preferred contraception methods by teenagers are condoms, the pill and withdrawal, whereas some teenagers opt not to use any contraception. Nonetheless, there are issues, which arise from the use of contraception (Better Health Fact Sheet 2011). For instance, a New South Wales research study showed that about 86% of the teenagers in relationship up to one year fails to use condoms each occasion, as they engage in sex. In addition, in above half of the relationships where the girl uses pills, condoms are not used for protection and hence the teenagers do not protect themselves from sexually transmitted diseases and infections. In addition, approximately 50% of the adolescents are usually active sexually for a year prior to visiting their doctors for prescription contraceptive. About half of all teenagers become pregnant in the first six months after becoming active sexually. The group that mostly uses the morning after pill in family clinics is young people, in Australia. According to Better Health Fact Sheet (2011), majority of teenagers are not practicing safe sex.

The impact of using contraceptives by teenagers is mostly beneficial, and this is evident in the US cases where increased use of birth control has reduced teenage pregnancies and abortions. Santelli et al. (2007) study attributes increased contraceptive usage to reduction in pregnancy risk. In the study, developments in the contraceptive use entailed increased condoms usage, birth withdrawal, control pills, several methods, as well as a reduction in non-use cases. There was an overall pregnancy reduction risk of 38% with 86% of the reduction attributed to increased use of contraceptives. Amid adolescents of 15 to 17 years, 77% of the reduction in pregnancy risks was attributed to contraceptives use (Santelli et al. 2007). The researchers concluded that the reduction in the pregnancy rates among the US adolescents seems similar to the patterns evident in developed nations, where an increased usage of contraceptives has been the key cause of reducing numbers in pregnancy risks.

There is thus a need to encourage sexually active teenagers, as well as those planning to engage in sexual activities, to be cautious and use birth control methods, in order to reduce the large rate of teenage pregnancies. Simpson (2003) pointed out that medical officers are urging for improved sex-education in primary schools, in Australia, and contraception should be availed for teenagers, in order to cut the number of teenage pregnancies and abortion cases. The sexual behaviours as well as sexual health related domain are areas, which require more attention considering the adverse public health effects, to which uninformed and risky sexual practices lead (Agius et al. 2010). There is a need in additionaldependable and earlier sex education in primary schools and contraception services. Most young people in Australia do not easily access health care services, and hence dedicated teenager services on reproductive and sexual health may be useful for teenagers to enable them access contraceptives, so as to prevent unwanted pregnancies (Simpson et al. 2003).

The issue of unwanted pregnancies and abortions among teenagers can also be reduced through comprehensive sexual health education programs. Countries like the Netherlands and others in Europe have adopted such programs and as a result, have lower rates of teenage pregnancies, abortions, as well as sexually transmitted infections. Deficiency of all-inclusive education on sexual health lead to considerably high rates of teenage pregnancies and sexually transmitted infections (Kina et al. 2008). Sexual health education programs enable teenagers to make safe sexual practices choices, resist social, and peer pressure. Easy access to contraceptives is also an essential method of promoting safe sex practices.

As teenagers work their way through the second decade of their life, through puberty, as well as the onset of the functioning on their reproductive systems, they face unique challenges’ in learning and understanding the ways to deal with their sexuality. With most of teenagers entering sexual maturity at the age of 12 and changing attitudes worldwide regarding their sexuality and pregnancy, the healthy, medical, and social communities have to acknowledge the need to pay careful attention to teenagers, as well as their reproductive health needs.

The above analysis answers the research question: it shows that an increased use of contraceptives among teenagers who are sexually active reduce pregnancy, abortion and sexually transmitted infections rates among teenagers whereas non-use causes the increase of these rates. This answer was reached after review of various databases containing research studies on the issue of teenage contraceptive use and pregnancy, abortion and STIs contraction.

The database used were the “Australian and New Zealand Journal of Public Health (Aust NZ J Public Health)”, “American Journal of Public health”, “Perspective on Sexual and Reproductive Health” and the “Youth Risk Behaviour Surveillance” (YRBS). The Aust NZ J Public Health database was used to access empirical and reliable research studies on Australian teenagers’ sexual practices, as well as their use of contraceptives. ‘The American Journal of Public Health’ database was used to identify teenagers’ sexual practices and contraceptives use, in the US. The ‘Perspective on Sexual and Reproductive Health’ and the YRBS databases were used to identify different statistics on teenagers’ use of contraceptives.

Section 2-Article Review

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“Agius, P, Pitts, M, Smith, A & Mitchell, A 2010, ‘Sexual behaviour and related knowledge among a representative sample of secondary school students between 1997 and 2008’, Aust NZ J Public Health, vol. 34, pp. 476-81”.

The study objective was to account for the sexual health awareness as well as risk behaviours of 12, as well as 10 year students in Australia, from 1997 to 2008. The issue of teenage sexuality and birth control choices are clearly stated, as it offers the reader a stark picture or context on the research problem. The authors of this article presented data of 1997-2008 regarding students’ sexual behaviour, related knowledge, as well as use of condoms; research also explored the manner in which student behaviour has improved. The study findings are valid and significant as the four researchers used a large sample size- a total sample of 333 schools across governmental, Catholic and independent schools- the sample was nationally representative. The study was also conducted in a period of 11 years. From these schools, the researchers selected clusters of Year 12 and Year 10 scholars from secondary schools in three intervals- 2008, 2002, and 1998. This was the only comprehensive, representative research in Australia on teenage sexual awareness and health.

The research methodology of the study was also valid. The researchers measured the teenagers’ sexual intercourse experience by asking them whether they have started having sex, which the researcher cross-referenced with categorical question answers on students’ age during their first sex incident with or with no condom. The researchers also evaluated the number of sexual partners that these teenagers have had by requesting the students to remember the partner (s), with whom they had sex during the last year. The researchers also measured the students’ condom use consistency in their last sex encounter and over the last one year. By means of using the responses gotten from these respondents, the researchers were able to reach their objective in assessment of risk behaviour of Year 12 and Year 10 students. They also achieved the objective of assessing the student sexual health knowledge by measuring knowledge across three domains-STIs, hepatitis and HIV/AIDS.

The study findings indicated that the number of sexually active students has risen since 1997, and though most of these students persist reporting continued use of condoms, this percentage is constant and has not risen for a while. The researchers compared this study findings to other previous studies in the US and New Zealand and noted:the rates of sexually active persons reported in this study were either higher or lower. For instance, Abel and Brunton study of both Year 13 and Year 12 students in New Zealand indicated that 49% had engaged in sex. Abel and Brunton findings were lower compared to 56% of Year 12 Australian findings. The Australian findings were also higher compared to those of Scotland (in Henderson et al study); however, the researchers argued that this difference can be attributed to the lower mean age of 14.2 Years.

Agius et al. also compares condom use consistency across the same studies. The Australian findings indicated 70% and 61% condom use consistency among Year 10 and 12 learners respectively. These statistics were higher compared to the US study in YRBS findings, where condom use consistency was 54% and 66% of Year 12 and Year 10 respectively. In Henderson et al. study, 60% of the adolescents’ had used a condom during their most recent sex incident; this was lower as the Australian findings in Agius et al. study was 62%. In Henderson et al. study, only 45% of the students indicated that they consistently use condoms which compared to over half of the Australian data.

The study findings also indicated that student STIs and Hepatitis ratios had improved since 2002, although the student HIV awareness appeared to have stopped, by 2008. The researchers expressed concerns that, although the study recorded that the students appeared better eeducated on HIV in relation to hepatitis or STIs, there are still remarkably higher prevalence of STIs and hepatitis among adolescents in Australia. The study also reported that there are gender related differences about health knowledge on STIs, Hepatitis, and HIV, as young women had considerably higher knowledge levels compared to young men. The researchers called for gender-particular sex health instruction, so as to address this disparity in knowledge. In addition, the study findings noted that there were lower STIs knowledge levels in Year-10 students in relation to those in Year-12. The researchers indicated that this was noteworthy given that the Year-10 students, as well as Year-12 students, have sexual partnerships, which are comparable especially after Year 10 students become sexually active.

The researchers also noted that although there have been significant improvements in hepatitis and STI knowledge among students, the rate of awareness is still low, and this needs a more focused attention on the domain of public health awareness and support. After this point, the researchers refer to the various studies, which have indicated that knowledge levels do not essentially prevent teenagers from taking part in risky sexual behaviours. Further to this, researchers argue that sound knowledge usually offers the starting point for these teenagers to make knowledgeable choices about their general health and sexual lives, especially before they become sexually active. The study also noted a noticeable rise in students, especially ones in Year 12, engaging in sex with many people. Aspects such as relationship formation, early age of sex entrance and increased use of alcohol are linked with the increase in sexual activity observed in the study.

These points indicate that this study achieved its objective.

Section 3

Agius et al. (2010) noted that the use of condoms has not increased since 1997 although there have been increases in sexual encounters among teenagers. There have also been increasing rates of STIs among this group and this point towards the need for educating teenagers on safe sex practices using birth control measures, such as condoms. There has been a considerable escalation in number of teenagers having sex; however, this number might increase in the future. Therefore, in order to ensure that these young person’s do not engage in risky sexual behaviour, which leads to unplanned pregnancies and STIs, there is a need to educate them to make sure that they make knowledgeable choices regarding sexual lives. According to Agius et al. (2010), sound knowledge usually offer the foundation for adolescents’ to make well-versed choices about their sexual lives, especially prior to becoming sexually active, and about their general health. This report thus proposes early sex education on pregnancy, sexually transmitted infection risks, and safe sex practices to influence the teenagers’ first and early sexual activity.

Teenagers require accurate information regarding sex and sexuality to negotiate sexual alliances in a safe and responsible manner. Education on sex and sexuality should cover a wide range of topics such as sexuality, contraception, and sexually transmissible infections (STIs) with the most significant roles models being the parents and carers. The best sexuality education approach is being ‘sex positive’ and not just preaching abstinence. There is need to acknowledge the fact that teenagers choose to be or not to be sexually active, and this is a healthy and normal part of their growing up (Crooks & Baur 2011). Adolescence is also a time for sexual development and experimentation, and there is a need to support the teenagers to develop respectful, healthy, and sexual relationships. There is also need to talk about the teenagers’ sexual preference in a positive manner. There should thus be a typology of programs for addressing the issue of teenager sexuality in both school and the community, which should focus on abstinence and safe sex practices.

Curriculum-based education programs.

  • Sex and HIV education programs.
  • Abstinence-only programs.

Schools based or clinic programs designed to offer reproductive health care or to improve access to contraceptives such as condoms.

  • School condom availability programs.
  • Family planning clinics and services.
  • “School-linked or school-based clinics”.
  • “School-linked or school-based clinics”.

There is also a need in multi-components, community wide initiatives for sex education, as well as affording condoms, pills and other contraceptives.

 

These programs will reduce sexual risk taking and pregnancy. Agius et al (2010) study showed that, in spite of sexual activity and moderate livers regarding knowledge about sexually transmitted infections among teenagers, the levels of safe sex practices have not increased. It is thus crucial for these programs not only to focus on abstinence but also talk to the teenagers about contraception and ways of practicing safe sex. According to Harper et al. (2010), there is little impact of abstinence-only education on teenagers’ sexual behaviours in spite of the significant funding and policy efforts.

In future, research on teenager sexuality and birth control measures should focus on the impact of safe sex practices education on rate of teenage practices and sexually transmitted infections, so as to establish the link between the two. Most of the studies focus on the entrance age and rate of sexual activity among the teenagers. There is a need to show that reducing conservatism in respect towards the issues on sexual behaviour and health can enable teenagers to explore and use contraception freely, hence reducing pregnancy and STIs. These changes might be achieved in sexual health clinic by encouraging the teenagers to express their sexual preferences and evidence freely and educating them on contraception choices, which can reduce their exposure to STIs and prevent them from becoming pregnant. Some teenagers are usually not comfortable talking about their sexual experiences and hence may lie or fail to disclose such information (Shaffer 2009). To overcome these problems, there is the need to be open and honest with the child. Once a connection with a child is established over time, eventually, child will be more likely to offer accurate information and answers regarding sex. The problem can also be overcome by assuring the teenager that all the information offered will be confidential and will not even be disclosed to the parents. Such comprehensible sexuality and contraceptives education can facilitate lower risk of unplanned pregnancies and delay some of the teenagers’ first sexual experience.

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