Contraception and Adolescents

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Abstract
Pediatricians should be active participants in the effort to reduce the negative consequences of adolescent sexual activity. Preventive measures include counseling teenagers and their families on responsible sexual decision-making, including abstinence, and providing contraceptive services for sexually active patients, when requested. In previous statements, the American Academy of Pediatrics has addressed the impact of adolescent pregnancy,1 counseling the pregnant adolescent,2 and management of sexually transmitted diseases.3 This statement provides information on adolescent sexual and contraceptive behavior, and it presents guidelines for counseling teenagers on sexual activity and contraceptive methods, including abstinence. Because of differences in the needs and circumstances of each adolescent, the practitioner should use these guidelines to develop an individualized approach suitable for young persons. Due to concern about acquired immunodeficiency syndrome, among other risks, a renewed emphasis on careful and informed decision-making regarding sexual activity is reflected in this revised statement. ADOLESCENT SEXUAL AND CONTRACEPTIVE BEHAVIOR Since 1970, there has been a distinct increase in the percentage of adolescents reporting nonmarital sexual activity. By 14 years of age, 10% to 20% of boys and 5% to 10% of girls report having had sexual intercourse. By 17 years of age, approximately half of all adolescents are reported to have had intercourse at least once. By 19 years of age, the majority are reported to have done so.4 The factors most strongly associated with age at first intercourse appear to be biology (age at onset of puberty), opportunity (dating behavior), peer group influences, personal expectations (academic achievement, educational goals, religiousness), and family characteristics (parental support and controls).5

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