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High Cost of Adolescent Sex

National Physicians Center for Family Resources

The Physicians Consortium

American Association of Pro-Life Obstetricians and Gynecologists

Prior to 1970 the rates of both teen pregnancy and sexually transmitted diseases (STDs) were decreasing. However, with the advent of school-based contraceptive education programs, the rates of teen pregnancy and STDs increased dramatically. Between 1970 and 1990 the birth rate among females ages 15-19 nearly doubled and STD rates soared. The facts are clear: When adolescents have sex, the physical, emotional and economic costs are high.

Sexually Transmitted Diseases (STDs):

  • There are over 25 STDs commonly reported and more than eight new STDs, including HIV/AIDS, have been identified since 1980.[i]
  • Five of the top 10 reportable infectious diseases in 1997 were STDs, including the top four (chlamydia, gonorrhea, HIV and syphilis).[ii]
  • Every day in the United States 8,000 adolescents contract an STD. Adolescents and young adults (15-24) are the age groups at the greatest risk for acquiring an STD. Approximately two-thirds of all people who acquire STDs are under 25.[iii]
  • Between 100,000 and 150,000 women become infertile each year as a result of STDs.
  • Chlamydia is a major cause of infertility. Youth has been recognized as the single most important factor in Chlamydial infection, with as many as one in 10 adolescent girls infected according to the Centers for Disease Control (CDC). [iv]
  • The risk of pelvic inflammatory disease (PID) is as much as 10 times greater for 15-year-old females than for 24-year-old females. PID can cause sterility.[v]
  • The most common STD is Human Papillomavirus (HPV). It is estimated that there are 5.5 million new HPV infections each year and that as many as 20 million people may have active HPV infections at any given time. [vi]
  • The typical prevalence of HPV for women under the age of 25 is between 28 and 46 percent.[vii]
  • Human Papillomavirus has been shown to be the cause of essentially all (99.7 percent) cancer of the cervix. It has also been implicated in cancer of the rectum, anus, vulva, vagina and penis.[viii]
  • Adolescent females are at increased risk for HPV infection because of cellular changes taking place in the cervix during puberty. Studies show that young age at first intercourse is strongly associated with a risk for invasive cancer. Women who reported having had their first intercourse before age 18 years were at a five-fold increased risk as compared with women who waited until after age 22. [ix]
  • For adolescents, condoms fail about four out of 10 times when used to prevent STDs.[x]
  • The direct annual medical costs for diagnosing and treating STDs is nearly 8.4 billion dollars.[xi]

Adolescent Pregnancy:

  • About 900,000 adolescents become pregnant each year. One-third of these end in abortion. Eighty-five percent of adolescent births are out-of-wedlock.[xii]
  • According to the Robin Hood report Kids Having Kids:[xiii]

    • Seven out of 10 adolescent mothers drop out of high school.
    • The long-term wage earning power of adolescent fathers is greatly reduced.
    • The sons of adolescent mothers are 2.7 times more likely to spend time in prison than the sons of mothers who delay childbearing until their early 20s.
    • The daughters of adolescent mothers are 50 percent more likely to bear children out of wedlock.
    • More than 80 percent of single mothers under age 18 years of age will be classified in the poverty level and will be reliant on welfare assistance.

Adolescent Sexual Activity and Other High-Risk Behaviors:

  • Adolescents who have had sex or who anticipate becoming sexually active are more likely to participate in other health risk behaviors.[xiv]
  • As sexual experience increases, adolescents are more likely to have been jailed, to have had five or more alcoholic drinks at one time or to have used alcohol, cigarettes and/or marijuana in the past year.[xv]
  • High-risk youth are more likely to communicate poorly with their parents and less likely to report liking school, desiring to achieve high levels of education, having a high grade point average or being involved with religious groups or organizations.[xvi]
  • Adolescents who initiate health-risk behaviors such as sexual intercourse and substance abuse at an early age frequently have poorer health later in life, lower educational attainment and less economic productivity than their peers.[xvii]
  • According to the National Center on Addiction and Substance Abuse at Columbia University[xviii]
    • Adolescents who drink alcohol are seven times more likely to have sexual intercourse than those who do not.
    • Adolescents who use drugs are five times more likely to have sexual intercourse
    • Adolescents who use alcohol or drugs are two and three times as likely, respectively, to have had more than four sexual partners.

Emotional Costs of Adolescent Sexual Activity:

  • According to a recent national survey of sexually active adolescents ages 12 to 17:[xix]
    • Sixty-three percent of sexually active adolescents reported wishing they had waited longer before becoming sexually active.
    • Seventy-eight percent of all adolescents surveyed believed adolescents should not be sexually active.
    • Eighty-nine percent of those surveyed would advise their own brother, sister or friend not to have sex until at least after finishing high school.
  • Sexual activity among adolescents is most often a result of unhealthy influences such as peer pressure, pressure from an older and more experienced partner, parental disengagement, use of alcohol or drugs, loneliness, desire for pregnancy or previous sexual abuse.[xx]
  • Non-voluntary first sex is particularly common among very young girls. Among girls who had sex before age 13, nearly a quarter (22 percent) reported that first sex was non-voluntary and an additional 49 percent categorized it as unwanted.[xxi]
  • The Alan Guttmacher Institute writes: “Having sex can engender a sense of shame or guilt; push a couple apart; raise unrealistic expectations of further commitment and marriage; or be a form of abuse.”[xxii]
  • Numerous studies reveal that married couples who had not engaged in premarital sex enjoyed higher levels of sexual satisfaction after marriage than couples that were sexually active before marriage.[xxiii]
  • A review of ten studies on cohabitation showed couples that cohabitated prior to marriage reported lower levels of marital quality and a 50 percent higher divorce rate than couples that did not cohabitate before marriage.[xxiv]

Socioeconomic Costs of Adolescent Sexual Activity:

  • Violent criminals are overwhelmingly males who grew up without fathers. This includes 60 percent of America's rapists, 72 percent of adolescent murderers and 70 percent of long-term prison inmates.
  • Every year in the United States approximately 900,000 teens become pregnant. Of those teens that complete their pregnancy and deliver a child, 70 percent do not finish high school before age 30.
  • The direct annual cost of adolescent pregnancy in the U.S. is nearly seven billion dollars, and the indirect costs exceed $29 billion.
  • Seventy-five percent of adolescent mothers are on welfare within five years of giving birth.[xxv]
  • Living in a single parent family (often a direct result of adolescents giving birth) approximately doubles the risk that a child will drop out of high school.
  • Sixty-three percent of families headed by unmarried mothers are on welfare and are living below poverty.[xxvi]
  • Seventy-five percent of children raised in single parent homes will experience poverty before age 11 compared with only 20 percent of children in two parent homes.
  • Twenty-five percent of children in single parent homes are likely to repeat a grade in school as compared with 14 percent in two parent families.

What Works:

  • Adolescents rate their parents as the most influential factor in their decisions about sex.[xxvii]
  • Adolescents ages 14 to 17 who live in a two-parent family are less likely to have ever had sexual intercourse than adolescents living in any other family arrangement.[xxviii]
  • Significant factors associated with delaying sexual debut include high levels of parent-family connectedness, parental disapproval of their adolescent's being sexually active and parental disapproval of their adolescent's using contraception.[xxix]
  • Studies show that a pledge of sexual abstinence was more strongly tied to an adolescent's decision to abstain from sexual intercourse than any other factor.[xxx]

Conclusion:

The evidence is overwhelming: To continue suggesting that contraceptive-based education will protect the overall health of America's adolescents is a prescription for continued disaster.

Issued by:

The National Physicians Center for Family Resources

Dianna Lightfoot, President; Jane Anderson, MD Executive Board Member; John Whiffen, MD Board Chairman

The Physicians Consortium

Hal Wallis, MD Director

American Association of Pro-Life Obstetricians and Gynecologists

Byron Calhoun, MD President; Joseph L. DeCook, MD Vice-President

Endnotes:

[i] Source: Institute of Medicine. (1997). The Hidden Epidemic - Confronting Sexually Transmitted Disease (edited by Thomas R. Eng and William T. Butler). Washington, DC: National Academy Press.

[ii] Centers for Disease Control and Prevention. (1998, September). Summary of Notifiable Disease, United States 1997. Morbidity and Mortality Weekly Report 46(54)

[iii] Source: Centers for Disease Control and Prevention. (1996, September). Sexually Transmitted Disease Surveillance 1995. Morbidity and Mortality Weekly Report, 45(53). Institute of Medicine.

[iv] Source: Centers for Disease Control and Prevention. (1996, September). Sexually Transmitted Disease Surveillance 1995. Morbidity and Mortality Weekly Report, 45(53).

[v] Source: Westrom, L. (1980). Incidence, Prevalence, and Trends of Acute Pelvic Inflammatory Disease and Its Consequences in Industrialized Countries. American Journal of Obstetrics and Gynecology, 138, 880-92.

[vi] Kaiser Family Foundation Report, from American Social Health Assn., 1998.

[vii] Burk, R.D., etal, Journal of Infectious Disease, 1996.

[viii] Walboomer, J.M., et al. Journal of Pathology 189(1):12-19, 1999. Ellerbrock, Ted. New England Journal of Medicine 338:992,1999.

[ix] (Cancer 1986; 58: 935-941)

[x] “Safe Sex.” Medical Institute for Sexual Health. 1995.

[xi] Institute of Medicine. (1997). The Hidden Epidemic–Confronting Sexually Transmitted Disease (edited by Thomas R. Eng and William T. Butler). Washington, DC: National Academy Press.

[xii] Donovan, Patricia. (1998 October). Falling Teen Pregnancy, Birthrates: What's Behind The Decline? The Guttmacher Report on Public Policy.

[xiii] Maynard, R.A. (ed.). (1996). Kids Having Kids: A Robin Hood Foundation Special Report on the Costs of Adolescent Childbearing. New York: Robin Hood Foundation.

[xiv] Whitaker DJ, Miller KS, Clark LF. Reconceptualizing adolescent sexual behavior: Beyond did they or didn't they? Fam Plan Persp. 2000;32:111-117.

[xv] ibid

[xvi] ibid

[xvii] Warren DW, Kann L, Small ML, Santelli JS, Collins JL, Kolbe LJ. Age of initiating selected health-risk behaviors among high school students in the United States. Journal of Adolescent Health 1997; 21(4);225-231.

[xviii] Dangerous Liaisons: Substance Abuse and Sex. (1999, December) The National Center on Addiction and Substance Abuse at Columbia University.

[xix] The National Campaign to Prevent Teen Pregnancy. Not just another thing to do: Teens talk about sex, regret, and the influence of their parents.

[xx] Institute for Youth Development

[xxi] Moore KA, Driscoll AK, Ooms T. Not just for girls: The role of boys and men in teen pregnancy prevention. Washington, DC: National Campaign to Prevent Teen Pregnancy; 1997.

[xxii] Sexual activity drops among teen-age girls. The Washington Post 1997 May 2; Sect A:1.

[xxiii] Robert J. Levin, “The Redbook Report on Premarital and Extramarital Sex: the End of the double Standard?” Redbook. October, 1975, p. 40.

[xxiv] DeMaris, Alfred and Rao, KV. “Premarital Cohabitation and Subsequent Marital Stability in the United States: A Reassessment” Journal of Marriage and the Family 1992; 54: 178.

[xxv] “Percent Distribution of Families by Reason for Deprivation of the Youngest Child” Aid to Families with Dependent Children, HHS, 1994)

[xxvi] ibid

[xxvii] The National Campaign to Prevent Teen Pregnancy. Not just another thing to do: Teens talk about sex, regret, and the influence of their parents.

[xxviii] Santelli JS, Lowry R, Brener ND, Robin L. The association of sexual behaviors with socioeconomic status, family structure and race/ethnicity among U.S. adolescents. Am J Pubic Health. 2000;90:1582-1588.

[xxix] ibid

[xxx] Bearman and Bruckner. American Journal of Sociology, January 2001.

The National Physicians Center for Family Resources is a 501 (c ) (3) organization established to produce and promote family-friendly educational resources, public policy and model legislation with the assistance of a national network of physicians as project advisors.