Question

Does economic analysis predict that increased condom availability for teenagers will have the definite effect of reducing teen pregnancy?

Could it possibly increase teen pregnancy?

Explain your answer, using economic analysis

Answer 1

1. More recently, use of condoms together with hormonal contraception has been advocated as the optimal approach to preventing unintended pregnancy, STDs, and HIV infection in those who are sexually active. Data indicate that some, but not many, adolescents use this approach. In a 1995 study, 8% of adolescent females in the United States reported using a condom and the birth control pill at last intercourse, and 21% of those using the pill reported that they also used a condom. Clearly, this is less than the 37% reporting condom use overall in the same study, indicating that additional efforts are required to remind those who use birth control pills or other methods of hormonal contraception that condom use is also required for STD and HIV prevention.

Efforts aimed at increasing condom use by adolescents have taken place in clinical, community, and school settings. Several organizations have provided official guidelines for clinicians who have adolescents patients. These include the American Academy of Pediatrics, American Medical Association, Maternal and Child Health Bureau of the Health Resources and Services Administration, American Academy of Family Physicians, and US Department of Health and Human Services. Each of these guidelines recommends that counseling about the use of contraceptives, including the condom, be offered to sexually active adolescents as part of preventive health care in clinical settings. There have been multiple studies, however, which have shown that clinicians are inconsistent in following these recommendations.

By far the most common, most effective, and best studied efforts aimed at increasing condom use among adolescents, as well as the most controversial, have taken place in school settings. These efforts fall into 2 main categories: education about condom use as part of sex education and HIV prevention programs and direct condom availability programs.

School-based sex education programs during the past few years have generally been of 3 types: 1) abstinence-only programs, which generally do not include information on condoms or other contraceptive methods (except their failure rates); 2) pregnancy prevention programs, which focus on the use of contraception, including the condom, for those who are sexually active; and 3) HIV prevention programs, which focus on condom use as a major component of the incorporation of safer sex strategies.

Multiple studies evaluating the effects of these programs on sexual activity and contraceptive use have been performed during the past few years. These studies have failed to show a delay in the initiation of intercourse, a decrease in frequency of intercourse, or a decrease in the number of sexual partners for abstinence-only programs, when used alone. Studies have shown beneficial effects of some pregnancy and HIV prevention programs, and no studies have shown an increase in intercourse (by hastening onset, increasing frequency, or increasing number of partners) for any of the programs. Increased contraceptive use, including increased use of condoms, has been reported in the evaluation of some pregnancy and HIV prevention programs, with HIV prevention programs having the greatest influence on condom use. It is not yet clear whether this important difference is attributable to the different messages delivered by the programs, the greater impact of HIV infection as opposed to pregnancy for males, better funding or evaluation methods for more recent HIV prevention programs, or other as yet unknown factors.

• Abstaining from intercourse should be encouraged for adolescents, because it is the surest way to prevent STDs, including HIV infection, and pregnancy. Adolescents who have been sexually active previously should also be counseled regarding the benefits of postponing future sexual relationships.
• Pediatricians are urged to actively support and encourage the correct and consistent use of reliable contraception and condoms by adolescents who are sexually active or contemplating sexual activity. The responsibility of males as well as females in preventing unwanted pregnancies and STDs should be emphasized. Pediatricians need to be actively involved in community programs directed toward this goal.
• In the interest of public health, restrictions and barriers to condom availability should be removed.
• Schools should be considered appropriate sites for the availability of condoms, because they contain large adolescent populations and may potentially provide a comprehensive array of related educational and health care resources.
• To be most effective, condom availability programs should be developed through a collaborative community process and accompanied by comprehensive sequential sexuality education, which is ideally part of a K-12 health education program, with parental involvement, counseling, and positive peer support.
• Pediatricians can actively help raise awareness among parents and communities that making condoms available to adolescents does not increase the rate of adolescent sexual activity and that condoms, despite their limitations, can decrease rates of unintended pregnancy and acquisition of STDs and HIV infection.
• Research is encouraged to identify methods to increase correct and consistent condom use by sexually active adolescents and to evaluate effectiveness of strategies to promote condom use, including condom education and availability programs in schools.

2. Although parents do not like to admit it, teens everywhere are having sexual relations. Parents try their best to raise children: to teach them right and wrong, and the difference between appropriate behavior and inappropriate behavior. However, teenage sexual relations have little to do with parents, and much more to do with teenage culture and pressures from peers. The world of teenagers is governed by different norms and 'rules' than that of parents or mixed groups. Within the teenage group, it is normal to be rebellious and to want to explore things that seem exciting, grown up, or 'cool'. Sex is, and will always be, one of these things. Since the desire to explore sex is a given, the best thing we can do is to provide teens with access to birth control, including condoms. With this, a considerable amount of teenage pregnancy can be prevented, although unfortunately not all.