Introduction
The article discusses issues related to sexuality, sexual health, and sexually transmitted infections (STIs) among adolescents and young adults in the United States. It provides an overview of current statistics and trends regarding sexual behaviours, HIV/STI rates, and access to sexual healthcare in this population. The article highlights health disparities and increased risks faced by sexual and gender minority youth.
Summary of the Article
The article reports that rates of STIs like chlamydia, gonorrhoea, and syphilis are rising sharply among adolescents and young adults of both genders. About 1 in 5 new HIV diagnoses occur in the 13-24 age group. Sexual and gender minority youth are disproportionately affected. For example, young transgender women have very high rates of HIV/STIs.
Several factors contribute to the vulnerability of adolescents and young adults. Biologically, hormonal changes in puberty increase STI susceptibility. Cognitively, adolescent brains are still developing risk assessment skills. Experimentation and newfound autonomy typically lead to more sexual risk-taking. Marginalization and barriers to healthcare access also increase risks for sexual and gender minority youth (Agwu, 2020)
. The article emphasizes the need for comprehensive, culturally competent sexual health services for adolescents and young adults. It recommends routine STI testing, HIV testing, HPV vaccination, and open provider-patient discussions about topics like healthy relationships, safe sexual practices, family planning and contraception.
Barriers to Accessing Sexual Health Services
While awareness of adolescent sexual health issues has grown, significant barriers remain in accessing sexual health services. Parental consent requirements, lack of transportation, cost of services, clinic hours, and confidentiality concerns can prevent adolescents from getting STI testing, HIV testing, contraception, or other needed care. State policies and age of consent laws also create obstacles (Agwu, 2020)
- Providers may impose individual biases or be unwilling to serve sexual minority youth. The stigma surrounding adolescent sexuality deters open conversations and care-seeking behaviours. Concerted efforts are needed to increase youth-friendly sexual health services and reduce barriers.
Improving Provider-Patient Communication
The article notes shortcomings in provider communication skills and cultural competency regarding adolescent sexual health. Discomfort discussing sexuality limits critical conversations about sexual risk behaviours, identity issues, healthy relationships and family planning. Young people’s needs and perspectives are often not elicited or incorporated into care plans (Agwu, 2020). Enhanced youth participation in designing sexual health services could augment relevance and acceptability. Improving healthcare provider education on approaching adolescent sexual health through a patient-centred, trauma-informed, sex-positive lens is vital for delivering optimal sexual healthcare.
Social Theories
The social theory of medicalization provides insight into how adolescent sexual health has been problematized and treated as abnormal. Historically, medicine has sought to control youth sexuality through containment and medical interventions (Conrad, 1992). Same-gender attraction and transgender identity have also been medicalized as illnesses requiring treatment. Framing adolescent sexuality as an illness can lead to stigma, discrimination and inadequate health services.
The theory of intersectionality sheds light on how interlocking systems of oppression related to gender, race, class, and sexual/gender identity disproportionately impact minority youth health outcomes (Crenshaw, 1989). Young transgender women of colour, for example, face overlapping marginalization that increases their HIV/STI risk. An intersectional lens underscores the need for culturally tailored interventions.
Finally, the concept of social capital provides a perspective on how exclusion from social networks and resources inhibits health-promoting behaviours in marginalized groups like LGBTQ adolescents (Bourdieu, 1986). Building social capital and community belonging can empower these youth to access needed sexual healthcare services and information.
In summary, applying sociological theories highlights the sociocultural dimensions of adolescent sexual health. This moves beyond individual explanations to address systemic factors affecting youth sexual health outcomes. A multifaceted public health approach is required to promote sexual health equity for all young people.
References
Agwu, A. (2020). Sexuality, sexual health, and sexually transmitted infections in adolescents and young adults. Topics in Antiviral Medicine, 28(2), 459.