New policy statement on barrier protection for adolescents: AAP
USA: The American Academy of Pediatrics (AAP) has released a new policy statement on barrier protection use by adolescents during sexual activity. This policy statement, published in the AAP journal Pediatrics is an update to the 2013 AAP statement on condom use.
There is a continuous decline in rates of births, pregnancies, and rates of sexual activity among adolescents during the past decade to historic lows. Despite this, many teenagers are at risk for sexually transmitted infections (STIs) and unintended pregnancy. The consistent and correct use of synthetic and latex barrier methods may reduce the risk of many STIs including HIV, and unintended pregnancy. This updated statement is intended to assist pediatricians in supporting and understanding the use of barrier methods by the patients in order to prevent STIs and unintended pregnancies and address obstacles to their use.
Key recommendations include:
- Discuss abstaining from sexual intercourse as the most effective way to prevent genital STIs, as well as HIV infection, and unintended pregnancy.
- Support and encourage the consistent and correct use of barrier methods as well as other reliable contraception as part of anticipatory guidance during visits with adolescents who are sexually active or contemplating sexual activity, including emphasis on the responsibility of all genders in preventing unintended pregnancies and STIs.
- Use the recommendations in Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Fourth Edition promoting communication between parents and adolescents about healthy sexual development and sexuality and supporting education programs that help parents develop communications skills with their adolescents regarding the prevention of STIs and proper use of barrier methods.
- Remove restrictions and obstacles to barrier method availability to encourage and promote barrier method use among adolescents. Beyond retail distribution of barrier methods, the provision of free or low-cost barrier methods is a priority for adolescent-friendly health services. Pediatricians and other clinicians are encouraged to provide barrier methods within their offices and support availability within their communities.
- Advocate for barrier method availability programs through a collaborative community process and the provision of comprehensive sequential sexuality education. This is ideally part of a kindergarten-to-12th-grade health education program with parental involvement, counseling, coaching, and positive peer support.
- Support school barrier method educational programs, especially because these programs reach large adolescent populations and may potentially provide a comprehensive array of related educational and health care resources.
- Actively communicate to parents and communities that making barrier methods available to adolescents does not increase the onset or frequency of adolescent sexual activity and that use of barrier methods can help decrease rates of unintended pregnancy and acquisition of STIs.
- Monitor adolescents who use preexposure prophylaxis or non barrier contraception, are bisexual or lesbian, and/or are in established relationships closely for risk compensation (the adjustment of behavior in response to the perceived level of risk) leading to decreased use of barrier methods. Pediatricians can assess risk during acute or routine visits to determine the need for additional counseling regarding barrier methods or STI testing. Engage and support additional research to identify strategies to increase continued barrier method use for populations that may engage in risk compensation.
- Advocate for engagement and support of additional research regarding barrier use (and safer sex practices) for higher-risk youth and those living in areas with lack of access to barrier methods.
The detailed policy statement, "Barrier Protection Use by Adolescents During Sexual Activity," is published in the AAP journal Pediatrics.
