Providing sexual and reproductive health services to adolescents in school settings can provide more equitable access

By providing SRH services in a school setting, SBHCs enable young people to connect with a healthcare provider, learn how to ask questions, and develop feelings of safety in medical settings. Interacting with caregivers in a confidential setting is particularly important because many young people may not have parents who can take them to routine health appointments. Even young people who do have a primary care provider may not feel comfortable talking to their healthcare provider or may not be able to do so in private when their parent is in the room. SBHCs always encourage young people to involve their parents in health decisions, but some students do not feel safe or supported by their parents and need confidential care. Creating time and space for confidential conversations with young people is in line with guidance in youth medicine. In addition, SBHCs can be an essential element in adolescents’ transition to adult care by teaching them to talk to and advocate for themselves with caregivers. Parents can support their teens by encouraging conversations with providers without being in the room themselves; SBHCs are uniquely positioned to support this type of growth.

By providing SRH services in an accessible and confidential location, more young people get access to the services they need. Ultimately, increasing the reception of SRH services among young people may reduce the number of unintended pregnancies and STIs and increase young people’s reproductive autonomy.

Differences in reception of SRH services among sexually active adolescents

Among female high school students who had received SRH services in the past 12 months, we found striking differences in the types of services received by race/Hispanic ethnicity. Notably, Hispanic women were less likely than Black women to have had a birth control-related visit in the past 12 months; Black women were less likely than Hispanic women to have had an emergency contraception-related visit; and non-Hispanic white women were less likely than black women to take a pregnancy test. While the data does not account for these interesting nuances in receiving certain types of SRH services by race/ethnicity, the existing literature may offer possible explanations.

While two-thirds of all sexually active high school students reported a birth control-related visit, nearly half of Hispanic women did not. Hispanic women may have fewer birth control-related visits because of lower levels of trust in health care due to historical and current discriminatory practices, lower contraceptive knowledge, fear of side effects, and higher perceived infertility. Some studies have also shown that early pregnancy is accepted and even desirable in many Hispanic cultures, which may also result in lower contraceptive use among young women, although other research has found that most Hispanic teens do not want to experience pregnancy. However, this cultural norm may mean that young Hispanic women who want to use birth control may not know where to go or how to arrange transportation or finances to obtain birth control. This lack of knowledge is compounded by the lack of comprehensive sex education in the United States.

Nearly a quarter of sexually active high school students purchased emergency contraception (EC) or received EC services from a health care provider, indicating potentially inconsistent contraceptive use or potential pregnancy anxieties. Lower levels of taking or receiving a prescription for EC among black women can be attributed to barriers to access to EC, such as a lack of knowledge and misinformation about EC, lack of accessible pharmacies, lack of financial resources or transportation to buying EC, or fear of confidentiality or embarrassment when buying EC in a community pharmacy. In addition, research has shown that black women are more concerned about hormonal methods than other women, suggesting that some black women may be concerned about EC (a hormonal method) and fear its side effects.

Nearly one-third of high school students have taken a pregnancy test in the past year, which may be due to pregnancy anxiety or health care provider’s demands for pregnancy testing as part of birth control counseling. We found that pregnancy testing rates were highest for black female high school students, which may be attributed to higher rates of contraceptive-related visits among black women in our sample. It has also been documented that black women are more likely to rely on less effective birth control methods, which can lead to more anxiety surrounding a potential pregnancy and more frequent pregnancy tests. Future research should assess whether there are differences in clinicians’ performance of pregnancy testing by race or ethnicity.

Although we found no differences in STI testing by race/Hispanic ethnicity, only one-third of the sexually active high school students in the sample had been tested for STIs in the past 12 months. This is concerning given the high rates of STIs among the young adult population. The Centers for Disease Control and Prevention (CDC) recommends annual testing for STIs in sexually active individuals younger than age 25.

Providing sexual and reproductive health services to adolescents in school settings can provide more equitable access

Leave a Reply

Your email address will not be published.

Scroll to top