Adolescent Health Care, Sexuality and Contraception

The American Academy of Family Physicians is concerned about the sexual health of adolescents in the United States, particularly in regard to the high incidence of teenage pregnancies, the high rate of sexually transmitted infections, and the lack of comprehensive and effective sex education programs, and the increasing rates of sexual assault. The AAFP believes that an evidence-based approach to sexual health education will be effective in reducing unintended pregnancy, sexually transmitted infections, and the incidence of sexual assault. The AAFP recommends that:

  1. Effective reproductive health education, pregnancy prevention and sexually transmitted infection (STI) prevention programs such as those using a comprehensive approach to sex education includes medically accurate information on contraception and abstinence.
  2. Family physicians can educate patients that abstinence, when practiced consistently, is the most effective method of preventing unplanned pregnancy and the transmission of sexually transmitted infection(s). Responsible sexual behavior is also an effective method of preventing pregnancy and STIs.
  3. Adolescents receiving family planning services deserve patient confidentiality, and practitioners should be aware of any state laws where they provide care that may impact them and the reproductive rights of their patients.
  4. Family physicians can take an active role in the prevention of unintended teenage pregnancies and prevention of STIs, by providing appropriate guidance/counseling and effective sex education to their adolescent patient population. Each discussion could also address STIs, likely symptoms of those infections, and the need for testing even when patients are asymptomatic.
  5. Comprehensive education and counsel regarding sexual practices with adolescent patients as defined in (a) above would include discussion about vaginal, anal, oral, same-sex, and other types of sexual contact. Another critical piece of counsel is the concept of consent to sexual activity and what to do if sexual contact takes place against one’s consent.
  6. Family physicians are in an ideal position to encourage family members to be involved in sex education efforts. It is primarily from the family that an adolescent’s values and concept of sexual and reproductive responsibility arise.
  7. Family physicians can be actively involved in community efforts that initiate and implement effective education and prevention programs for unintended teenage pregnancy, STIs, and sexual assault. Health education programs from elementary to high schools should include age appropriate reproductive health education.
  8. Family physicians are in an ideal position to be aware that their adolescent patients may be dealing with issues of sexual identity or orientation that impact their psychosocial and physical health. Asking open questions about sexual identity and orientation can open a dialogue on family relationships, safe sexual practices, suicide risks and other issues confronting gay, lesbian, bisexual, transgendered and questioning adolescents in a sensitive and accepting atmosphere.
  9. If the family physicians is uncomfortable providing these services, the patient should be referred to another physician or provider who is willing to provide the education and/or services.

(1987) (2012 COD)