FOR PROFESSIONAL REFERENCE ONLY
THE
Teen Pregnancy
FACTS…
HIV/ AIDS
What you need to know about: Sexually Transmitted Infections (STI)
TEEN PREGNANCY
TEEN PREGNANCY STATISTICS
Calgary Region◊
From 1995 to 2002, the teen pregnancy *rate for teens aged 15-19 in the Calgary Region steadily declined from 53.3 to 36.8.1 In the year 2002, the teen birth *rate was 13.5 compared to 24.3 in 1995.1 In the year 2002, the teen **abortion rate was 23.3 compared to 30.9 in 1998.1 In the years 2001-2003 (combined), the estimated pregnancy *rate for youth aged 10-17 was 7.2. 2 Pregnancy Rates among 15 to 19 Year Olds in the Calgary Health Region
6 0 .0
5 3 .3 5 0 .0
◊1
5 0 .0
4 8 .6
4 8 .7 4 2 .7 4 2 .3 3 9 .2 3 6 .8
4 0 .0 Rate per 1,000
2 9 .4 3 0 .9 2 5 .1 2 0 .6 1 9 .1 1 7 .7 2 5 .5
3 0 .0
2 8 .7 2 4 .3
2 9 .3
2 5 .7 2 3 .3
2 0 .0
1 7 .4
1 6 .7 1 3 .3 1 3 .5
1 0 .0
0 .0 1995 1996 1997 1998 1999 A b o r ti o n 2000 2001 2002
T o ta l P r e g n a n c y
L i v e B i r th s
Alberta
From 1992 to 2002 the pregnancy *rate for Alberta teens aged 15-19 declined from 62.7 to 41.8.3 In the year 2002, the teen birth *rate was 22.3 compared to 37.7 in 1991. 3 In the year 2002, the teen induced **abortion rate was 18.8 compared to 23.5 in 1998. 3 From 1998 to 2003, the pregnancy *rate for youth 10-17 years of age declined from 11.2 to 7.8. 2 For the years 2001-2003 (combined), the pregnancy *rate was 8.1 for youth 10-17 years of age. 2
Data may differ from previously published data due to differences in definitions. *rate - reflects the number per 1,000 population. **Doesn't consider spontaneous abortion or abortions received in U.S.
◊
Sexual and Reproductive Health Program Phone Number: 944-7115
FOR PROFESSIONAL REFERENCE ONLY
Canada
In Canada, the pregnancy *rate for 15-19 year olds in 2002 was 33.9, the lowest in 14 years.4,5 In 2002 the induced **abortion rate for 15-19 year old teens was 14.9. The abortion rate has gradually declined since 1994.4 In 2002 the birth rate for teens 15-19 years old was 18.4.4
Summary
Adolescent Pregnancy, Birth and Abortion Rate Comparisons 2002: Calgary, Alberta and Canada1, 3, 4 Pregnancy *Rate Birth *Rate **Abortion Rate Calgary 36.8 13.5 23.3 Alberta 41.8 22.3 18.8 Canada 33.9 14.9 18.4
CONSEQUENCES OF TEEN PREGNANCY
Socioeconomic Factors
Teen parenthood is associated with school drop out. With less education, the teen mother and/or father may lack job skills. As a result, teen parents and their children often experience poor economic and social outcomes.6 Teen mothers are at increased risk for single parenthood.7 Single parent teen mothers have an increased risk of low income and depression, both of which threaten a secure and healthy parent child attachment.6 In 2002, 42% of youth aged 15-24 were unemployed. On average, males aged 15-24 made $10.58 per hour, and females aged 15-24 made $ 9.52 per hour.8 In 2002, the average cost of raising an infant the first year of life was $9,915.9
Health Risks
Infants of teen mothers are at risk for premature birth and low birth weight putting them at risk for illness and/ or death.10 Mothers in Alberta under the age of 20 have the highest rate of stillborn births compared to all other age groups.3
ADOLESCENT SEXUALITY AND INFLUENCES ON DECISION MAKING
In 2000, a national survey revealed that nearly half of Canadian youth aged 15-19 are sexually active.11 In 2002, 19% of grade 9 Canadian females had sexual intercourse at least once compared to 21% in 1989.12 In 2002, 23% of grade 9 Canadian males had sexual intercourse at least once compared to 31% in 1989.12 In 2002, 46% of grade 11 Canadian females had sexual intercourse at least once. The percentage was the same in 1989. 12 In 2002, 40% of grade 11 Canadian males had sexual intercourse at least once compared to 49% in 1989.12
*rate - reflects the number per 1,000 population. **Doesn't consider spontaneous abortion or abortions received in U.S.
Sexual and Reproductive Health Program Phone Number: 944-7115
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Adolescent Participation in Sexual Activity At Least Once (2002) 12
100 90 80 70 P e r c e n ta g e 60 50 40 30 20 10 0
D e e p K is s in g T o u c h in g A b o v e W a is t T o u c h in g B e lo w W a is t O ra l S e x Sexual In t e r c o u r s e
28 32 19 23 67 65 82 81 64 67 54 57 52 53 81 81 74 75
46 40
F e m a le G ra d e 9
M a le G ra d e 9
F e m a le G ra d e 1 1
M a le G ra d e 1 1
Alcohol and Drug Influences
The use of alcohol and drugs reduces decision-making abilities required to say no to sexual intercourse or to practice safer sex. An Albertan student survey conducted in 2002 indicated 35.8% of students in grades 7-9 and 75.4% of students in grades 10-12, used alcohol in the last year.13 A survey of Albertan students (2002) indicated 11.8% of students in grades 7-9 and 41.9% of students in grades 10-12, used marijuana in the last year.13 A 2002 Albertan survey revealed 2.7% of youth in grades 7-9 and 7.6% of youth in grades 10-12, used club drugs (ecstasy and crystal meth) in the last year.13 A Canadian study (2003) indicated 39% of grade 9 males and 28% of grade 9 females used alcohol or drugs prior to their last sexual intercourse compared to 38% of grade 11 males and 21% of grade 11 females.12 Adolescents who drink alcohol or use drugs before engaging in sexual intercourse are less likely to use protection such as condoms and therefore increase their risk of pregnancy or developing STI/HIV.12
Reducing the Risk of Pregnancy and STI with Condoms
It is recommended that when the birth control pill is used to prevent pregnancy, a male or female condom should also be used to protect against STI/HIV. Studies have shown that females who use the birth control pill do not necessarily consider using a condom for STI/HIV prevention.14 Latex condoms, used consistently and correctly, are the best protection available for reducing the risk of STI/HIV for people who choose to engage in sexual intercourse.15 The most common causes of condom failure are that they are not used consistently (e.g. with every act of intercourse) or correctly. Misuse of condoms account for condom breakage or slippage.15 In a 2000 survey of Albertans, 18.5% believed young people are protecting themselves against HIV, and 78.6% believed that more access to condoms is needed.16
Sexual and Reproductive Health Program Phone Number: 944-7115
FOR PROFESSIONAL REFERENCE ONLY
The Benefits of Sexuality Education
Effective sexual health education provides opportunities for individuals to explore the attitudes, feelings, values and moral perspectives that may influence their choices regarding sexual health.17 In one study (2001), Canadian youth stated that friends, siblings, and media sources are the most common sources of sexual health information.18 In the Netherlands (one of the countries with the lowest teen pregnancy rates), strategies that have helped reduce teen pregnancy include sexuality education, open discussion of human sexuality in the mass media, easier access to contraceptives, education programs and active participation of teens and parents in such programs.19 Evaluations of comprehensive sexual health education programs (full information at appropriate ages) revealed that they result in: postponement of first sexual intercourse; decreases in the number of partners; and significant increases in condom use.14 Evaluations of abstinence only programs indicated they are ineffective at delaying intercourse, preventing pregnancy, and preventing STI.20 In a series of surveys of Canadians, 85% of parents and 89% of adolescents agreed that sexual health education should be provided in the schools.20 A Calgary Health Region Parents Survey (2001) indicated that, 76% of parents with children aged 29, and 87% of parents with children aged 10-17, occasionally or often talk with their children about relationships and sexuality.21 For teens, there is a hierarchy of preferred sexual behavior. Abstinence from sexual activity for teenagers is preferred because of health consequences that may affect the individual. Postponement of initial sexual activity, adherence to one sexual partner, and protected sexual intercourse are sequentially offered as the next best alternatives.22
References
1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. Calgary Health Region. (March, 2005). Electronic communication with Edwin Enns, Manager, Performance Reporting, Figures based on Vital Statistics data, Alberta Registry population figures, and Physician Claims file. Alberta Health and Wellness. (2005). Alberta child health surveillance report. Alberta Health and Wellness. (2004). Alberta reproductive health: Pregnancies and births. Statistics Canada. (2005). Teen pregnancy, by outcome of pregnancy and age group, count and rate per 1,000 women, Canada, provinces and territories, 1998-2002. Retrieved January 24, 2006, from http://www.statcan.ca/english/freepub/82-221XIE/2005001/tables/html/411_02.htm Statistics Canada. (October 2000). Table A: Outcomes of teenage pregnancy, by age at end of pregnancy, Canada, 1974-1994. Retrieved January 24, 2006, from http://www.statcan.ca/english/kits/preg/preg3g.htm Health Canada. (1999). Toward a healthy future: Second report on the health of Canadians. Retrieved August 01, 2003, from http://www.hc-sc.gc.ca/hppb/phdd/pdf/toward/toward_a_healthy_english.PDF Hotz, V.J., McElroy, S.W., & Sanders, S.G. (1997). The impacts of teenage childbearing on the mothers and the consequences of those impacts for government. In R.A. Maynard (Ed.), Kids having kids (pp. 55-94). Washington: The Urban Institute Press. Statistics Canada. (2003). Perspectives on labor and income, 4 (1). Catalogue #75-001-XIE. Manitoba Agriculture and Food. (2001). The cost of raising a child [On-line]. Available: www.gov.mb.ca/agriculture/homeec/cba28s02.html Health Canada (1999). Teen Pregnancy. Measuring up: A health surveillance update on Canadian children and youth [On-line]. Available: http://www.hc-sc.gc.ca/pphb-dgspsp/publicat/meas-haut/mu_ee_e.html Bibby, R. (2001). Canada’s teens: Today, yesterday, and tomorrow. Toronto: Stoddart Publishing Co. Limited. Boyce, W., Doherty, M., Fortin, C., & MacKinnon, D. (2003). Canadian youth, sexual health and HIV/AIDS study: Factors influencing knowledge, attitudes and behaviors. Toronto: Council of Ministers of Education. AADAC. (2002). Summary report: The Alberta youth experience survey 2002. Retrieved January 23, 2006, from http://corp.aadac.com/content/corporate/research/TAYES-SumReportBook.pdf Health Canada. (1998). STD epi update: Oral contraceptive and condom use. Retrieved January 27, 2006, from http://www.phacaspc.gc.ca/publicat/epiu-aepi/std-mts/std511_e.html th Hatcher, R.A., Trussell, J., Stewart, F., Nelson, A.L., Cates, W., Guest, F., & Kowal, D. (2004). Contraceptive technology (18 ed.). New York: Ardent Media, Inc. AB Health and Wellness. (2000). HIV/Hepatitis C issues in AB: The 2000 survey of adults. pp. 18, 20. Health Canada. (2003). Canadian guidelines for sexual health education. Retrieved January 27, 2006, from http://www.phacaspc.gc.ca/publicat/cgshe-ldnemss/pdf/guidelines_e.pdf DiCenso, A., Busca, C.A., Creatura, C., Holmes, J.A., Kalagian, W.F., & Partington, B.M. (2001). Completing the picture: Adolescents talk about what’s missing in sexual health services. Canadian Journal of Public Health, 92 (1), p. 35-38. Millar, W.J., & Wadhera, S. (1997). Teenage pregnancies, 1974 to 1994. Health Reports, 9 (7). Catalogue # 82-003-XPB. McKay, A. (2000). Common questions about sexual health education. SIECCAN Newsletter, 35 (1), p. 129-137. Calgary Health Region. (2002). Health of the Calgary Region. Retrieved January 20, 2006, from http://www.crhahealth.ab.ca/hocr/influ/index.htm Calgary Health Services. (1996). Teen sexuality education and birth control. Sexual and Reproductive Health Program education services manual.
Sexual and Reproductive Health Program Phone Number: 944-7115
FOR PROFESSIONAL REFERENCE ONLY
SEXUALLY TRANSMITTED INFECTIONS (STI) AND HIV/AIDS
STI STATISTICS
In Alberta, the following STI are reported to the provincial health officer: syphilis; chlamydia; gonorrhea; nongonococcal urethritis (NGU); and mucopurulent cervicitis (MPC).1 Herpes and Human Papiloma Virus (HPV/ genital warts) are non-reportable STI. Herpes and HPV are viral diseases that spread through skin to skin genital contact. HPV is the main cause of cervical changes detected by Pap tests. If cervical changes are not detected early, they may go on to become cervical cancer. 2,3
Calgary Region
In 2004, approximately 22% of all STI reported in the Calgary Region were reported among teens aged 15-19 and approximately 62% of all STI were reported among youth aged 15-24.4 In 2004, 745 individuals aged 15-19 were diagnosed with an STI, compared with 644 in 2000.4 Chlamydia is the most commonly reported STI in 15-19 year olds with the numbers rising. In 2004, there were 649 chlamydia cases compared to 515 in 2000.4 Gonorrhea is also on the rise. In 2004, there were 51 cases among youth ages 15-19 compared to 15 cases in 2000. The chlamydia rate for all ages increased from 179.4 in 1998 to 229.4 in 2002.1 The gonorrhea rate for all ages increased from 15.3 in 1999 to 25.4 in 2002.1 The infectious syphilis rate for all ages decreased from 1.76 in 2001 to 0.81 in 2002. The noninfectious syphilis rate decreased from 2.28 in 2001 to 2.22 on 2002.1 The NGU/MPC rate for all ages increased from 85.1 in 2001 to 101.1 in 2002.1
Age Distribution of Reported Calgary STI Cases 20044
40%
Breakdown of Reported STI Cases in Calgary (2004)4
S y p h ilis 2 % NG U 12% M PC 2% G o n o rrh e a 9%
22% 19%
12% 7%
0 .0 0 6 % 0 -1 4 1 5 -1 9 20-24 25-29 3 0 -3 9 40+
C h la m y d ia 75%
Alberta The chlamydia rate for all ages escalated from 184.1 in 1998 to 262.3 in 2004. From 2000-2004, approximately 28% of all chlamydia cases were in individuals under the age of 19, and 70% of cases were in individuals under the age of 25.5 The gonorrhea rate for all ages rose from 18 in 1999 to 43 in 2004. From 2000-2004, approximately 21% of all gonorrhea cases were in individuals under the age of 19, and 50% of cases were in individuals under the age of 25.5
rate - reflects the number per 100,000 population
Sexual and Reproductive Health Program Phone Number: 944-7115
FOR PROFESSIONAL REFERENCE ONLY
The infectious syphilis rate for all ages increased from 0.5 in 2002 to 2.3 in 2004. From 2000-2004, approximately 9% of all infectious syphilis cases were in individuals aged 15-19, and 29% of all infectious syphilis cases were in individuals under the age of 25.5
Canada
Chlamydia is the most commonly reported STI for Canadian teens, 15-19 years old. The chlamydia rate for teens steadily escalated from 546.7 in 1997 to 791.5 in 2002.6 The chlamydia rate for all ages increased from 113 in 1997 to 208 in 2004.5 The gonorrhea rate for 15-19 year olds steadily increased from 52.3 in 1997 to 71.4 in 2002.6 The gonorrhea rate for all age groups rose from 15 in 1997 to 28 in 2004.5 The infectious syphilis rate for adolescents ages 15-19 decreased from 0.7 in 2001 to 0.5 in 2002.6 The infectious syphilis rate for all ages increased steadily from 0.4 in 1997 to 4 in 2004.5 Canadian Chlamydia, Gonorrhea, and Syphilis Rates for Youth Ages 15-19 (2002): Male, Female, Total6
1600 1400 1200 1000 R a te 800 600 400 200 0 C h la m y d ia Gonorrhe a S y p h ilis ( In f e c t io u s ) 252 101 43 71 0 .6 0 0 .5 0 0 .5 0 792 1362
fe m a l e
m a le
to ta l
HIV AND AIDS STATISTICS
Although infection with HIV (human immunodeficiency virus) can be transmitted sexually, it is reported separately from other STI.
Calgary Region In 2004, there were 69 persons (in all age groups) newly diagnosed with HIV.7
Alberta
In the year 2004, there were 170 newly reported HIV cases (in all age groups) in Alberta. The HIV rate for all ages was 5.35 in 2004 compared to 6.37 in 2000.7 In 2004, 69% of all newly diagnosed HIV cases were in males.7 Heterosexual exposure was responsible for 27% of all newly diagnosed cases of HIV in males in the year 2004.7 In the year 2004, 44% of all newly diagnosed HIV cases in females were attributed to endemic country origin.7
rate - reflects the number per 100,000 population
Sexual and Reproductive Health Program Phone Number: 944-7115
FOR PROFESSIONAL REFERENCE ONLY
In the year 2004, of all newly diagnosed HIV cases, 19% were Aboriginal, 21% were Black, and 50% were White. In 2004, there were 29 HIV positive individuals that developed AIDS.7
Canada
HIV testing became available in November 1985. From November 1985-June 2005, a total of 58,929 positive HIV tests were reported. Of these, 802 (1.4%) were among youth aged 15-19 years.8 As of June 2005, a total of 20,146 AIDS cases were reported. Of these, 294 (1.5%) were among individuals less than 20 years old; 3,139 (15.6%) were among individuals between the ages of 20-29; and 16,713 (83.0%) were among individuals over the age of 30.8 In Canada, males are five times more likely than females to be HIV positive.8
CONSEQUENCES OF STI AND HIV/AIDS
The high incidence of chlamydia has become a national public health concern. Studies have shown that having an STI such as chlamydia increases the transmission and acquisition of HIV infection.9 In women, untreated STI such as gonorrhea and chlamydia, can lead to pelvic inflammatory disease (PID), which is an inflammation of the internal female reproductive organs. PID may lead to chronic pelvic pain, ectopic pregnancy, or infertility. About 75-85% of PID cases are a result of untreated STI.2 Untreated STI such as gonorrhea and chlamydia can put young men at risk of urinary tract and testicular infections. 10 STI such as gonorrhea and chlamydia can be passed from mother to child during birth causing neonatal eye infections, neonatal blindness, and neonatal pneumonia.10
RISK FACTORS FOR STI AND HIV/AIDS 11, 12
Several factors place an individual at risk for contracting STI and/or HIV/AIDS including:
Participation in unprotected sex (no condom used). Use of non-barrier contraceptives, such as the birth control pill, without using a male or female condom. Having a new partner in the past two months. Having two or more partners in the past year. Use of injection drugs, alcohol or other substances that can impair decision making ability. Involvement in street culture. Having a history of STI in the past year.
PREVENTION OF STI AND HIV/AIDS
Consider or re-consider abstinence - not having vaginal, anal, or oral intercourse but showing you care in other ways. Use a male or female condom every time you have intercourse in any new relationship. Limit sexual activity to a partner that you are sure has tested negative for STI/HIV. Condoms and/ or dental dams provide a barrier against HIV and hepatitis B, and other STI such as chlamydia and gonorrhea. They provide some protection against herpes and HPV.12
Sexual and Reproductive Health Program Phone Number: 944-7115
FOR PROFESSIONAL REFERENCE ONLY
References:
1 2 3 4 5 6 7 8 9 10 11 12 Alberta Health and Wellness. (2004). Sexually transmitted infections (STI) surveillance report: Alberta 1998-2002. Retrieved January 30, 2006, from, http://www.health.gov.ab.ca/public/dis_sti2002.pdf Steben, M., & Sacks, S.L. (1997). Genital herpes: The epidemiology of a common sexually transmitted disease. The Canadian Journal of Human Sexuality, 6 (2), p. 127-134. Alberta Cancer Board. (2000). Lifestyle series teaching packages: Cervical cancer screening and prevention [On-line]. Available: http://www.cancerboard.ab.ca/pdf/cancer_prevention/eps_teachers_cervical.pdf Calgary Health Region. (March, 2005). Electronic communication with Colleen Roy, Manager, STD Clinic and TB Services. Alberta Health and Wellness (2005). Annual statistical summary for sexually transmitted infections (STI), 2004. Public Health Agency of Canada. (2005).STI data tables: 2002 Canadian sexually transmitted infections surveillance report. Retrieved January 30, 2006, from http://www.phac-aspc.gc.ca/std-mts/stddata_june05/index.html Alberta Health and Wellness. (2005). Summary of HIV/AIDS statistical reports to December 31, 2004. Public Health Agency of Canada. (2005). HIV and AIDS in Canada: Surveillance report to June 30, 2005. Retrieved January 30, 2005, from http://www.phac-aspc.gc.ca/publicat/aids-sida/haic-vsac0605/ Health Canada. (2000). 1998/1999 Canadian sexually transmitted diseases (STD) surveillance report. Retrieved January 30, 2006, from http://www.phac-aspc.gc.ca/publicat/ccdr-rmtc/00vol26/26s6/ Health Canada. (1998). Canadian STD guidelines, 1998 edition. Retrieved January 31, 2006, from http://www.phac-aspc.gc.ca/publicat/stdmts98/ Public Health Agency of Canada. (2004). HIV/AIDS epi update: HIV and AIDS among youth in Canada. Retrieved January 31, 2006, from http://www.phac-aspc.gc.ca/publicat/epiu-aepi/epi_update_may_04/4_e.html th Hatcher, R.A., Trussell, J., Stewart, F., Nelson, A.L., Cates, W., Guest, F., & Kowal, D. (2004). Contraceptive technology (18 ed.). New York: Ardent Media, Inc.
J: Stats/ Teen Fact Sheets/ Teen FACTS 2006 Revised: 2006/02/16
Sexual and Reproductive Health Program Phone Number: 944-7115