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• Concerns about confidentiality limit access to sexual and reproductive health care, especially when young people rely on their parents’ health insurance.
In 2013–2015, 18% of all adolescents aged 15–17 and 12% of young adults aged 18–19 covered by their parents’ insurance reported that they would not seek sexual or reproductive health care because of concerns that their parents might find out.
• There has been a shift toward evidence-based interventions in the United States over the last few decades.
The first dedicated federal funding stream for evaluation of adolescent sexual health programs was established in 2010 and has contributed to improvement in the quality and quantity of evaluation research.
• According to the Centers for Disease Control and Prevention (CDC), instruction on sexual health topics (including human sexuality and prevention of STDs and pregnancy) is more commonly required in high school than in middle or elementary school. • At the middle-school level, 38% of schools taught pregnancy prevention as part of required instruction; 50% taught that abstinence is the most effective method to avoid pregnancy, HIV and STDs; 26% taught about contraceptive efficacy; and 10% taught students how to correctly use a condom.
• Both the American Medical Association and the American Academy of Pediatrics recommend that adolescents’ primary care visits include time alone with health care providers to discuss sexuality and receive counseling about sexual behavior.
• Despite these recommendations, only 45% of young people aged 15–17 reported in 2013–2015 that they spent time alone with a doctor or other health care provider during their most recent visit in the previous year.
• Abstinence-only-until-marriage programs threaten fundamental human rights by withholding information about human sexuality and potentially providing medically inaccurate and stigmatizing information.
• Most evaluations of sexual health programs focus on reducing levels of adolescent pregnancy, STIs and the behaviors that lead to them.
Digital media offer opportunities for youth to confidentially search for information on sensitive topics, and thus are a likely source of sexual health information for young people.