TEEN SEX IN THE BLUFF CITY: TEEN SEX IN THE BLUFF CITY CENTER FOR RESEARCH ON WOMEN, U OF M 12/1/05 NANCY HARDT MD, UT


CONTACT INFORMATION: CONTACT INFORMATION NANCY HARDT, MD UNIVERSITY OF TENNESSEE HEALTH SCIENCE CENTER BEEPER: 1-888-961-8912


INTRODUCTION: INTRODUCTION TEEN SYSTEM FORMATION TEEN SEXUALITY YOUTH BEHAVIORAL RISK FACTOR SURVEY FOR MEMPHIS TEEN PREGNANCY SEXUALLY TRANSMITTED DISEASES RECOMMENDATIONS


ADOLESCENT LOGIC: ADOLESCENT LOGIC BEHAVIORS ADULTS CHARACTERIZE AS SELF-DESTRUCTIVE SEEM LOGICAL TO THE ADOLESCENT BEHAVIORS ARE THE NATURAL OUTCOMES OF THE PERSONAL HISTORY, SENSE OF SELF, AND DAY TO DAY REALITIES OF THAT ADOLESCENT


SOME OF THESE CONDITIONS FORM THEIR “SYSTEM”: SOME OF THESE CONDITIONS FORM THEIR 'SYSTEM' FEAR OF ABANDONMENT BY THEIR MOTHER ABSENSE OF PROTECTIVE FATHER OR FATHER SURROGATE LACK OF CONSISTENT GUIDANCE BY AN ADULT FEW POSITIVE ROLE MODELS INADEQUATE INFORMATION


ELEMENTS OF OUR SYSTEM: ELEMENTS OF OUR SYSTEM HOME ENVIRONMENT MEDIA INFLUENCE PEER INFLUENCE SCHOOL AS A SOURCE OF INFORMATION CHURCH AS A SOURCE OF INFORMATION, GUIDANCE, AND SUPPORT


MEDIA PORTRAYS TEENS AS SEXUAL BEINGS: MEDIA PORTRAYS TEENS AS SEXUAL BEINGS IF WE CAN’T CHANGE MEDIA INFLUENCE, WE MUST ARM TEENS WITH INFORMATION ORAL SEX IS A BIG PART OF TEEN SEXUAL LIVES


TEENS AND ORAL SEX: TEENS AND ORAL SEX MOST TEENS DO NOT CONSIDER ORAL SEX THE SAME AS SEX (DID THEY GET THIS IDEA FROM ADULTS?)


2002 NATIONAL SURVEY OF FAMILY GROWTH: 2002 NATIONAL SURVEY OF FAMILY GROWTH 10,000 TEENS SURVEYED CDC CONDUCTED THE SURVEY ORAL SEX MORE COMMON AMONG TEENS THAN SEXUAL INTERCOURSE


TEENS AND ORAL SEX: TEENS AND ORAL SEX 54% OF TEEN GIRLS, 55% TEEN BOYS HAVE HAD ORAL SEX ¼ OF TEENS WHO HAVE NOT HAD INTERCOURSE HAVE HAD ORAL SEX LIKELIHOOD INCREASES WITH AGE: 42% 15-17 YEAR OLD GIRLS HAD ORAL SEX, 72% 18-19 YEAR OLD GIRLS


TEENS WHO HAVE NOT HAD INTERCOURSE GIVE REASONS FOR ORAL SEX: TEENS WHO HAVE NOT HAD INTERCOURSE GIVE REASONS FOR ORAL SEX 19% GIVE RELIGIOUS OR MORAL REASONS TO AVOID INTERCOURSE, YET THEY HAVE HAD ORAL SEX 38% SAID THE TIME WAS NOT RIGHT FOR SEXUAL INTERCOURSE, YET THEY HAD HAD ORAL SEX


TEEN SEXUAL NETWORKS: TEEN SEXUAL NETWORKS CHAINS OF AFFECTION: THE STRUCTURE OF ADOLESCENT ROMANTIC AND SEXUAL NETWORKS DATA FROM THE NATIONAL LONGITUDINAL STUDY OF ADOLESCENT HEALTH (ADDHEALTH) BEARMAN, MOODY, STOVEL, AM.J.SOCIOLOGY VOL110 NO1, JULY04:44-91


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LOST CHILDREN OF ROCKDALE COUNTY: LOST CHILDREN OF ROCKDALE COUNTY ATLANTA SUBURB CHILDREN ENGAGING IN GROUP SEX SYPHILIS OUTBREAK


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TENNESSEE DATA: TENNESSEE DATA HIGH SCHOOL OF 300 OUTBREAK OF TEEN GONORRHEA 26 TEENS IN SEXUAL NETWORK RANGING IN AGE FROM 15-18, 11 ADULTS (19-30) 10 INFECTED FEMALES 8 INFECTED MALES FIVE MALES HAD SEX WITH INFECTED WOMEN BUT WERE (-)


Slide17: females males Red = Positive Green = Negative Yellow = Untested/Unknown


ASSOCIATION BETWEEN ADVERSE CHILDHOOD EXPERIENCES AND ADOLESCENT PREGNANCY: ASSOCIATION BETWEEN ADVERSE CHILDHOOD EXPERIENCES AND ADOLESCENT PREGNANCY HILLIS, ET AL. PEDIATRICS 2004 KAISER PERMANENTE INSURED WERE PREGNANT BETWEEN AGES 11-19 77% WHITE AND 72% ATTENDED COLLEGE


8 RISK FACTORS: 8 RISK FACTORS EMOTIONAL ABUSE PHYSICAL ABUSE SEXUAL ABUSE OBSERVED MOTHER AS VICTIM HOUSEHOLD SUBSTANCE ABUSE HOUSEHOLD MENTAL ILLNESS HOUSEHOLD MEMBER INCARCERATED PARENTAL SEPARATION OR DIVORCE


RISK : RISK ANY ONE OF THE EIGHT INCREASES RISK RISKS ARE ADDITIVE IF NO RISK FACTORS, 16% (NOT PER THOUSAND) BECOME PREGNANT IF EIGHT RISK FACTORS, 53% BECOME PREGNANT


THE RESULTS: THE RESULTS THE PERCENT OF GIRLS WHO BECOME PREGNANT BY THE AGE OF 19 IS HIGHER IN THE US THAN ELSEWHERE TEEN PARENTS ARE MORE LIKELY TO DROP OUT OF SCHOOL, HAVE MINIMUM WAGE JOBS, AND REMAIN ON PUBLIC ASSISTANCE


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THE CHILDREN OF TEEN PARENTS: THE CHILDREN OF TEEN PARENTS ARE LESS LIKELY TO BE HEALTHY ARE LESS LIKELY TO ENTER SCHOOL READY TO LEARN ARE LESS LIKELY TO READ AT GRADE LEVEL ARE LESS LIKELY TO GRADUATE FROM HIGH SCHOOL ARE LESS LIKELY TO BE SELF-SUFFICIENT


WHY THESE OUTCOMES FOR TEEN PARENTS?: WHY THESE OUTCOMES FOR TEEN PARENTS? TEENS ARE STILL DEVELOPING THEIR SENSE OF 'SELF' THEY ARE INWARDLY FOCUSED FOR THEM TO FOCUS ON AN INFANT IS NOT IMPOSSIBLE, BUT REQUIRES ADDITIONAL SUPPORT IF THEY HAD THAT SUPPORT, THEY WOULD BE LESS LIKELY TO BE TEEN PARENTS


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TEEN CONFIDENTIALITY: TEEN CONFIDENTIALITY 13 Y/O ARE EMANCIPATED MINORS WHEN SEXUALLY ACTIVE IF LESS THAN 13, REPORTABLE CHILD ABUSE IF SEXUALLY ACTIVE NO PARENTAL PERMISSION NEEDED TO TEST OR TREAT CHILD HAS RIGHT TO CONFIDENTIALITY


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YOUTH RISK FOR HIV (ST. JUDE DATA): YOUTH RISK FOR HIV (ST. JUDE DATA) MEAN AGE 17 FOR ADOLESCENTS WITH HIV WHO GOT IT THROUGH SEX 49% FEMALES HAD BEEN SEXUALLY ABUSED 30% ABANDONED OR NEGLECTED BY PARENTS 46% PARENTAL SUBSTANCE ABUSE 41% JUVENILE DETENTION


RISK FOR HIV IN MEMPHIS YOUTH: RISK FOR HIV IN MEMPHIS YOUTH 52% REPORTED 3 OR MORE SEX PARTNERS 20% DISCOVERED HIV AT TIME OF TEEN PREGNANCY 60% REPORTED PRIOR STI


DATA SUMMARY: DATA SUMMARY WHEN IT COMES TO RISKS, OUR CHILDREN ARE VULNERABLE (EARLY SEX, MULTIPLE PARTNERS, FORCED SEX, DATING VIOLENCE, NOT USING CONTRACEPTION) WHEN IT COMES TO PROTECTIONS, OUR CHILDREN ARE LACKING (HIV EDUCATION, CONTRACEPTION)


HOW WELL CONDOMS WORK: HOW WELL CONDOMS WORK DO NOT ADD TO DISINFORMATION REFERENCE: CONTRACEPTIVE TECHNOLOGY COMPARE DATA ON VARIOUS CONTRACEPTIVE METHODS


THEIR SUCCESS WITH PERFECT USE: THEIR SUCCESS WITH PERFECT USE ABSTINENCE 100% MIRENA 99.9% STERILIZATION 99.5% PILL 99.7% CONDOMS 98 % DIAPHRAGM 94% NO METHOD 15%


WITH IMPERFECT USE: WITH IMPERFECT USE ABSTINENCE GOES TO THE BOTTOM OF THE LIST PILLS, CONDOMS, DIAPHRAGMS WORK 85%


CONDOMS FOR STI: CONDOMS FOR STI EFFECTIVENESS DEPENDS ON TWO THINGS: IS THE RIGHT ORIFICE COVERED? DOES THE TRANSMISSION OF THE DISEASE REQUIRE MUCOUS MEMBRANE TO MUCOUS MEMBRANE CONTACT? (CONTRAST LOW RISK AND HIGH RISK HPV)


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THE FOLLOWING DEPEND ON MUCOUS TO MUCOUS MEMBRANE CONTACT: THE FOLLOWING DEPEND ON MUCOUS TO MUCOUS MEMBRANE CONTACT PREGNANCY GONORRHEA HIV CHLAMYDIA SYPHILIS HIGH RISK HPV


YOUTH RISK BEHAVIORAL SURVEILLANCE SURVEY: YOUTH RISK BEHAVIORAL SURVEILLANCE SURVEY 2003


YOUTH RISK BEHAVIORAL SURVEILLANCE SURVEY: YOUTH RISK BEHAVIORAL SURVEILLANCE SURVEY SCHOOL BASED SURVEY IN CONJUNCTION WITH THE CENTERS FOR DISEASE CONTROL IN ALL STATES IN SELECTED URBAN AREAS


PURPOSE OF YRBSS: PURPOSE OF YRBSS IDENTIFY LEADING CAUSES OF MORBIDITY AND MORTALITY THESE ARE INTERRELATED AND PREVENTABLE POLICIES AND PROGRAMS CAN ADDRESS THESE RISKS


MEMPHIS YRBSS DATA 2003: MEMPHIS YRBSS DATA 2003 MEMPHIS 2005 DATA NOT YET RELEASED STATE DATA 2005 INCLUDES MEMPHIS DATA 2003 DATA FOR 9-12 GRADES, BOYS AND GIRLS COMPARE PINK/BLUE BARS FOR SEX DIFFERENCE COMPARE LAST 4 BARS FOR AGE DIFFERENCE


2003 ORANGE BARS: 2003 ORANGE BARS COMPARE MEMPHIS 2003 DATA TO OTHER SOUTHERN URBAN AREAS AND THE US


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2003-2005 CHANGES IN FEMALES--TN: 2003-2005 CHANGES IN FEMALES--TN 47 NOW 55% EVER HAD SEX 36 NOW 41% SEX IN LAST 3 MONTHS 12 NOW 15% SEX WITH MORE THAN 4 9 NOW 11% DATING VIOLENCE 13 NOW 15% FORCED TO HAVE SEX 4 NOW 13% SEX BEFORE 13 90 NOW 91% TAUGHT HIV IN SCHOOL


YEAR TO YEAR CHANGE…: YEAR TO YEAR CHANGE… 48 NOW 30% USED CONDOM LAST TIME 17 NOW 11% USED BCP


DISTURBING NEWS: DISTURBING NEWS SEX IS INITIATED EARLIER MONOGAMY IS NOT PRACTICED LESS CONDOM PROTECTION (LESS FEAR OF AIDS?) WE UNDERESTIMATE EXPOSURE BY NOT INCLUDING ORAL SEX IN THE CATEGORY OF SEXUAL ACTIVITY


RECOMMENDATIONS: RECOMMENDATIONS THINK OF ALL CHILDREN AS SEXUAL BEINGS (THE MARKET DOES!) UNHEALTHY RELATIONSHIPS REMOVE CHOICE-WARN THEM, GIVE EXAMPLES ABSTINENCE IS THE BEST OPTION MAKE SURE THE DEFINITION OF ABSTINENCE INCLUDES ORAL AND ANAL SEX!


RECOMMENDATIONS: RECOMMENDATIONS THEY MUST HAVE A BACKUP PLAN IN PLACE BEFORE ABSTINENCE IS OVER CONDOMS WORK WELL IF THEY ARE USED EVERY TIME AND THEY ARE APPLIED AND REMOVED CORRECTLY NON 'INTERCOURSE' SEX IS NOT SAFE SEX


RECOMMENDATIONS: RECOMMENDATIONS HAVE KIDS ANSWER THESE: WHAT FACTS DO THEY WANT? WHAT INFO WOULD THEY USE? WHO SHOULD DELIVER INFO? WHAT MEDIA WOULD APPEAL (DRAMA, MUSIC, POSTERS, PSA)?


RECOMMENDATIONS: RECOMMENDATIONS START DISCUSSIONS OF RISKS OF SEX IN MIDDLE SCHOOL (STATE CURRICULUM REVIEW? ) URINE SCREEN FOR CHLAMYDIA/GONORRHEA AS 'GATEWAY' STI, AND HAVE SPECIAL INTERVENTION TO PREVENT HIV IN THOSE TESTING POSITIVE