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 diseases and the lack of effective sex education programs. The AAFP believes that an evidence-based, a comprehensive approach to sexuality education will be effective in reducing unintended pregnancy and sexually transmitted diseases. The AAFP recommends that:

The AAFP defines effective sexuality education, pregnancy prevention and sexually transmitted disease prevention programs as those using a comprehensive approach to sexuality education that includes medically accurate information on contraception and abstinence.
Family physicians should stress abstinence which, when practiced consistently, is the most effective method of preventing unplanned pregnancy and the transmission of sexually transmitted disease(s). Responsible sexual behavior is also an effective method of preventing pregnancy and sexually transmitted diseases.
Adolescents receiving contraceptive services should be accorded strict patient confidentiality
All family physicians should take an active role in the prevention of unintended teenage pregnancies and prevention of STDs, by providing appropriate guidance/counseling and effective sex education to their adolescent patient population.
Family physicians should counsel adolescent patients as defined in (a) above and include discussion about vaginal and anal intercourse and oral sex. Adolescents should be made aware of the implications of vaginal, anal and oral sex and how they might respond if pressured. Each discussion should also address sexually transmitted diseases and likely symptoms of those diseases.
Family physicians should encourage family members to be involved in sex education efforts. It is from the family that an adolescent’s values and concept of sexual responsibility arise.
Family physicians should be actively involved in community efforts in initiating and implementing effective education and prevention programs for unintended teenage pregnancy and sexually transmitted diseases. The AAFP supports health education programs in elementary to high schools to include age appropriate sex education.
Family physicians should be aware that their adolescent patients may be dealing with issues of sexual orientation that impact their psychosocial and physical health. Asking open questions about sexuality rather than assuming a teen is heterosexual can open a dialogue on family relationships, safe sex, suicide risks and other issues confronting gay, lesbian, bisexual, and transgender adolescents, in a sensitive and accepting atmosphere.

(1987) (2006)