Current understanding of the risk factors related to adolescent initiation of sexual activity, use of contraception, pregnancy, and STDs is examined. From recent research on adolescent fertility, findings that have particular relevance to school health or reflect new understandings of adolescent sexuality are summarized. In selected cases, prevention programs that build directly on an understanding of these risk factors are cited.
PIP: It is important to understand the risk factors related to adolescent initiation of sexual activity, use of contraception, pregnancy, and sexually transmitted diseases (STD). This understanding is important in identifying and caring for youths at risk and designing primary and secondary prevention programs for schools and communities. The current understanding of these risk factors and recent findings are summarized in this paper. Intermediate determinants of fertility are broadly discussed with closer attention given to specific biopsychosocial risk factors affecting fertility and the potential for contracting STDs. The roles of demographics, geography, poverty and ethnicity, religion, school performance, family factors, peer influences, puberty, risk-taking behavior, drugs, sexual abuse, self-esteem and psychological variables, school health education, and school-based clinics are considered. The social determinants of contraceptive use/STD protection, pregnancy continuation or abortion, and STDs are also discussed.