Summary: Teen Sexual Health

Spotlight on Key Indicators: Teen Sexual Health

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Teen Sexual Health
Intimate Partner Violence
Pupil Support Services
Health Care
Youth Alcohol, Tobacco, and Other Drug Use
Teen Births
Why This Topic Is Important
There is much pressure, biological and social, for young people to be sexually active, yet sexual activity can have serious negative consequences, including sexually transmitted infections (STIs). It is estimated that although youth ages 15-24 represent only 25% of the sexually active population in the U.S., they account for half of the 20 million new STI cases each year (1). Chlamydia and gonorrhea are the most frequently reported bacterial STIs in the U.S., with young people (ages 15-24) and some racial/ethnic minority populations experiencing the highest rates of infection (1, 2).

Once an STI is contracted, detection and treatment can be difficult because the majority of chlamydia and gonorrhea cases in women are asymptomatic (1). For this reason, education and routine screening are crucial (1, 3). If untreated, chlamydia and gonorrhea can lead to pelvic inflammatory disease and, in the long term, to infertility and adverse pregnancy outcomes (1, 2).

STIs also have serious economic consequences. In 2013, the CDC estimated that, overall, STIs cost the U.S. health care system about $16 billion annually (3).
For more information on teen sexual health, see’s Research & Links section.

Sources for this narrative:

1.  Centers for Disease Control and Prevention. (2016). Sexually transmitted disease surveillance 2015. Retrieved from:

2.  Guttmacher Institute. (2016). American teens’ sexual and reproductive health. Retrieved from:

3.  Centers for Disease Control and Prevention. (2013). Incidence, prevalence, and cost of sexually transmitted infections in the United States. Retrieved from:
How Children Are Faring
According to a 2011-12 survey, about 82% of California teens ages 14-17 reported that they had not had sex; this figure is similar to estimates from previous years.

Some teens who engage in sexual activity contract infections such as chlamydia and gonorrhea. In California, chlamydia rates increased steadily between 2000 and 2008, but have decreased overall since 2011, from 813 cases per 100,000 youth ages 10-19 to 709 per 100,000 in 2015. The state’s rate of gonorrhea infection among youth, which is lower than the chlamydia rate, has fluctuated between 93 and 139 per 100,000 since 2000; in 2015, there were 121 cases of gonorrhea per 100,000 youth. Statewide and in most counties, data from 2015 and previous years show that female youth are diagnosed with chlamydia and gonorrhea at higher rates than males. Similarly, African American/black and Hispanic/Latino youth have higher rates of infection than their white and Asian/Pacific Islander peers. Although teens ages 15-19 account for the vast majority of chlamydia and gonorrhea cases among youth in California, there were also 862 cases involving children ages 10-14 in 2015.
Policy Implications
Teens need accurate information and access to health care to make safe, informed choices about sexual activity and to receive appropriate care. California law now requires integrated, comprehensive sexual health and HIV prevention education, and mandates that instruction and materials be appropriate for students of all races, genders, sexual orientations, and ethnic and cultural backgrounds (1). Families also play an important role in teen sexual health; teens who grow up in stable families with good parent-child relationships (including communication about sex) are more likely to delay sexual intercourse and to use contraception (2).

California youth have the right to talk to their doctor confidentially about sexual health (with limitations regarding sexual assault and statutory rape), but some teens, doctors, and parents/guardians may not fully understand those rights (3). In addition, insurance coding and reimbursement is a challenge to confidentiality as it can reveal the nature of the doctor visit to parents or guardians.

Policy options to improve teen sexual health include:
  • Informing health care providers and youth about state confidentiality laws concerning sexual health and contraception (3)
  • Expanding insurance reimbursement to cover comprehensive psychosocial assessments (often known as the HEEADSSS exam) as a separate service in order to ensure that sexuality and other important components of adolescents’ histories are discussed (4)
  • Adapting public health and reimbursement policies to encourage broader screening of youth for chlamydia and other sexually transmitted diseases (5)
  • Exploring technologically innovative methods (such as text messages and online interactives) of communicating sexual health education as they offer confidentiality and are consistent with adolescents’ new-media communications style (6)
  • Supporting school-based health centers to ensure accessible preventive and ongoing services for teens (7)
For more policy ideas and research on this topic, see’s Research & Links section, or visit The National Campaign to Prevent Teen and Unplanned Pregnancy, or the Guttmacher Institute. Also see Policy Implications on under Teen Births, Intimate Partner Violence, and Health Care.

Sources for this narrative:

1.  California Department of Education. (n.d.). California Healthy Youth Act: Comprehensive sexual health education & HIV prevention education. Retrieved from: Healthy Youth Act 2016_Final Compatibility Mode.pdf

2.  Markham, C. M., et al. (2010). Connectedness as a predictor of sexual and reproductive health outcomes for youth. Journal of Adolescent Health, 46(Suppl. 3), S23-S41. Retrieved from:

3.  Duplessis, V., et al. (2010). Understanding confidentiality and minor consent in California (2nd ed.). Adolescent Health Working Group & California Adolescent Health Collaborative. Retrieved from:

4.  Marcell, A. V., et al. (2011). Male adolescent sexual and reproductive health care. Pediatrics, 128(6), e1658-e1676. Retrieved from:

5.  Adams, S. H., et al. (2009). Adolescent preventive services: Rates and disparities in preventive health topics covered during routine medical care in a California sample. Journal of Adolescent Health, 44(6), 536-545. Retrieved from:

6.  Levine, D. (2011). Using technology, new media, and mobile for sexual and reproductive health. Sexuality Research and Social Policy, 8(1), 18-26. Retrieved from:

7.  Ethier, K. A., et al. (2011). School-based health center access, reproductive health care, and contraceptive use among sexually experienced high school students. Journal of Adolescent Health 48(6), 562-565. Retrieved from:
Websites with Related Information
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