By Cindy Hanford, Staff Writer

A study released this week concludes that teenagers in the United States have higher rates of pregnancy and sexually transmitted diseases (STDs) compared to teenagers in other developed countries, despite similar levels of sexual activity.

According to the study by the Alan Guttmacher Institute, the United States could learn from the experiences of other countries and decrease the rates of teenage pregnancy and abortion. Unlike teens in Canada, Great Britain, France and Sweden, teens in the U.S. don't have adequate access to sexual and reproductive health services. Social attitudes about teen sexuality also play an important role in preventing teen pregnancy and STDs.

"In countries where youth receive social support, full information and positive messages about sexuality and sexual relationships, and have easy access to sexual and reproductive health services, they achieve healthier outcomes and lower rates of pregnancy, childbearing, abortion and STDs," noted Dr. Jacqueline Darroch, who led the study.

The study, "Teenage Sexual and Reproductive Behavior in Developed Countries: Can More Progress Be Made?," compared the United States to Canada, Great Britain, France and Sweden. Key findings include:

• U.S. teenage birthrates are higher, and have decreased more slowly, than those of other developed countries. While the U.S. teenage birthrate of 49 births per 1,000 women aged 15-19 in 2000 is down about 20% from 1990, it remains about twice as high as rates in Great Britain and Canada, and five times as high as in Sweden and France.

• Access to contraceptive and reproductive health services makes the difference. In many countries, free or extremely low-cost contraceptive and reproductive health services are provided under a national health system. In the U.S., where there is no universal health insurance, those lucky enough to have health insurance may find their policy does not cover contraceptives.

• U.S. teenagers are less likely than teens in other countries to use contraceptives, especially the more effective hormonal methods. Only four in 10 sexually active teenagers in the U.S. rely on oral contraceptives or other long-acting hormonal methods, compared with as many as seven in 10 sexually active teenagers in the other countries studied.

• Among teens in the five countries studied, teenagers in the U.S. are the most likely to have a child by age 20. Teens in the U.S. are more likely to grow up in disadvantaged circumstances, lacking access to health care, but U.S. teenagers in the highest economic group are still 14% more likely than similar teens in Great Britain to have a child. In the lowest economic group, U.S. teenagers are 58% more likely to have children than those in Great Britain, which has a universal healthcare system.

• In the United States, where the predominant social message is that teenage sex is not acceptable, official efforts emphasize preventing youth from engaging in sexual activity. The study found that "being accepting of teenage sexual relationships and having clear expectations about responsible behavior are linked to low levels of teenage pregnancy and STDs." While the other study countries are more accepting of teenage sexual relationships, they also have "strong and clear social expectations that sexual relationships should be committed and monogamous, and that teenage partners should use contraceptives to avoid pregnancy and to prevent STDs."

• Paid parental leave and family support policies in other countries encourage younger women to delay childbearing in order to wait for guaranteed benefits that are determined by salary levels at the time of pregnancy.

November 30, 2001