Search Results (20)

Background: Adolescent depressive and anxiety symptoms may erode motivation and problem-solving needed for timely contraception, while online information quality is uneven. We synthesized evidence linking mental health, contraceptive knowledge/access, and teen pregnancy risk. Methods: Following PRISMA-2020, we searched PubMed, Embase, and Scopus to 7 July 2025 for primary studies including adolescents that measured validated mental health symptoms or psychiatric settings and reported contraceptive knowledge/access/behavior and/or teen pregnancy outcomes. Two reviewers screened/extracted data; risk of bias was appraised with the Newcastle–Ottawa Scale and ROBINS-I. Given heterogeneity, we conducted narrative synthesis. Results: Six U.S.-based studies met the criteria, spanning community colleges, a national cohort, school surveillance, psychiatric inpatient care, and pediatric emergency departments (samples: n = 143 to weighted N = 29,755). Depressive symptoms were associated with contraception access (adjusted odds ratio [aOR] 1.58, 95% CI 1.27–1.96) and anxiety/stress with similar risk (aOR 1.46, 1.17–1.82). A first depressive episode in the same year as sexual debut increased teenage pregnancy hazard (adjusted hazard ratio 2.70, 1.15–6.34). School surveillance showed mental health indicators correlated with contraception non-use at last sex (odds ratios 1.78–2.71). Among psychiatric inpatients, not knowing where to obtain contraception and access difficulties strongly predicted interest in information (aOR 2.96–3.33) and initiation (aOR 2.85–4.72). In a pediatric emergency department trial, same-day initiation occurred in 26.8% versus 3.1% under usual care. Conclusions: Evidence directly linking adolescent mental health symptoms to teen pregnancy is limited (one study), whereas multiple studies show associations with contraception knowledge/access and delayed or non-use, suggesting plausible indirect pathways to pregnancy risk. These findings support hypothesis-generating, integrated approaches and highlight the need for studies with teen pregnancy endpoints. Full article

Background: Teen dating violence (TDV) is a serious public health concern, with sexual and gender minority youth (SGMY) at elevated risk due to minority stress and systemic inequalities. This systematic review examines individual, relational, and contextual risk factors for TDV among SGMY. Methods: A systematic search was conducted in Scopus, Web of Science, and APA PsycInfo on 10 December 2024. Studies published between 2014 and 2024 focusing on teen dating violence (TDV) as an outcome among sexual and gender minority youth (SGMY) aged 13–19 were included. Study selection was independently performed by multiple reviewers using Rayyan. Risk of bias was assessed using the JBI Critical Appraisal Tools. Due to heterogeneity in the study design and measurement tools, a narrative synthesis was conducted. Results: Six risk domains emerged: (1) Demographic/Identity (e.g., gender, orientation, or race); (2) Psychological/Behavioral (e.g., distress or substance use); (3) Violence/Bullying (e.g., cyberbullying or exclusion); (4) Family/Sexual Abuse (e.g., family rejection); (5) Relational/Social (e.g., partner outing); and (6) School/Community (e.g., non-inclusive environments). Bisexual, pansexual, transgender, and racialized youth showed heightened vulnerability. Most studies were conducted in the USA and relied on non-validated TDV measures and cross-sectional designs, limiting comparability and causal inference. Conclusions: SGMY face unique, often overlooked TDV risks. There is a need for intersectional, longitudinal research and inclusive, developmentally appropriate prevention efforts that address both relational and structural factors. This review received no external funding and was not registered. Full article

The Teens Linked to Care (TLC) pilot program utilized a youth-led integrated strategy to prevent substance use and risky sexual behavior among school-attending youth at disproportionate risk, including sexual and gender minority youth (SGMY). The program developed a framework to address human immunodeficiency virus (HIV), sexually transmitted diseases (STDs), teen pregnancy, and high-risk substance use within schools. Strategies included education, primary prevention, and early detection screening. High schools in two rural counties served as pilot sites and successfully implemented strategies to encourage youth to engage in healthier sexual practices and avoid harmful substance use. An evaluation of TLC demonstrated its effectiveness in developing youth-friendly resources, promoting connectedness, and building resiliency among students and staff. This program used the results of two iterations of the Youth Risk Behavior Survey (YRBS) to understand the situations of youth, including SGMY. YRBS results helped tailor program activities for SGMY populations. By focusing on education, access to care, and supportive environments, schools can utilize the TLC model to combat youth substance abuse and risky sexual practices. Full article

Despite great strides in the development of contraceptive technologies, the United States has one of the highest teen pregnancy rates in the world. Religion and associated values may shape the sexual health behaviors of college students, as prior studies have aimed to determine how social factors may influence the use of contraception amongst college students. Thus, we sought to examine the differences in current contraceptive methods and the age of first contraceptive usage among sexually active female college students with different religious affiliations and strengths of religiosity. It was hypothesized that there would be no difference in current contraceptive methods among different religious affiliations and strengths of religions and that there would be a difference in the age of first contraceptive usage among different religious affiliations and strengths of religiosity. Two hundred and twenty-four college-aged females completed a 20-question survey about sexual health and religious practices. Chi-squared tests were implemented to determine the frequencies of responses across religious affiliations and strengths of religiosity. Significant differences in the frequency of responses for the age of first contraceptive usage were observed across different strengths of religiosity (p = 0.016) and for the self-perceived impact of religion on sexual health across different religious affiliations (p = 0.033) and strengths of religiosity (p = 0.005). All other differences were found not to be statistically significant. It was determined that increased strengths of religiosity resulted in delayed onset of contraceptive usage and that both different religious affiliations and greater strengths of religiosity lead to different self-perceived impacts of religion on sexual health despite low levels of current practice. Full article

Adolescents in the child welfare system often face multiple maladaptive experiences that predispose them to worse sexual health outcomes. This study aims to (1) describe the sexual health of adolescents in Spanish residential care by exploring their sexual knowledge, attitudes toward sexuality, and sexual behaviors and (2) to find out whether there are certain characteristics that make a subgroup particularly vulnerable to engaging in risky sexual behaviors. A total of 346 adolescents recruited from 47 Spanish residential care facilities (34.1% girls, 65.9% boys) aged between 11 and 19 years old completed some self-report instruments. Descriptive analyses and tests to prove gender and age differences were conducted. Their knowledge of sexuality was lower than observed in the general adolescent population, their attitudes more negative, and their tendency to engage in risky sexual behaviors higher. Girls made very infrequent use of condoms, while boys had more sexist attitudes and made habitual use of withdrawal. Although more than 20% of them had experienced sexual exchange activities before the age of 13 until 17, they did not use condoms systematically. The low level of knowledge, the early initiation of sexual exchange activities, and the scarce use of protection methods, together with sexist attitudes, place this group in a situation of great vulnerability, increasing the risk of unwanted pregnancies, sexually transmitted infections, and even teen dating violence. Full article

In the United States, racial/ethnic and sexual youth and young adults (YYA) of color are disproportionately affected by HIV. Subsequently, YYA experience HIV stigma and engage in increased risk behaviors and reduced HIV testing. HIV communication has been identified as a potential buffer to HIV stigma, resulting in health-seeking behaviors, such as HIV testing. In this study, we respond to a meaningful gap in the literature by examining different types of HIV communication and their impact on HIV stigma and HIV testing in a diverse sample of YYA. We analyzed secondary data from the Kaiser Family Foundation National Survey of Teens and Young Adults on HIV/AIDS. A 40-question, web-based survey was conducted with 1437 youth (ages 15–24). Recruitment included a dual sampling method from households with: (1) listed phone numbers, (2) unlisted phone numbers, (3) telephones, (4) no telephone, and (5) only cell phone access. The purpose of the survey was to establish participants’ HIV knowledge, communication, experiences, and testing behaviors. Findings suggested an association between intimate-partner HIV communication, increased HIV testing, and reduced HIV stigma. We also identified differentials in HIV testing and stigma based on gender, income, age, and sexual minority status, explained by HIV communication. Further research is needed that examines ways to use intimate-partner HIV communication to reduce stigma and increase HIV testing among YYA of different sociodemographic characteristics and sexual orientations. Full article

Teen dating violence is a public health concern that can lead to short- and long-term mental and physical health consequences, including depression, anxiety, risky behaviors, and unhealthy future relationships. Research shows that social and structural determinants of health, such as racism, low socio-economic status, and neighborhood conditions, may predispose certain communities to violence. To better understand methods to reduce TDV among ethnically and economically diverse populations, we used a trauma-informed race equity lens to adapt an efficacious prevention program known as Fourth R. This universal program has been shown to reduce some dating violence, substance use, and risky sexual behaviors, but there remains room for improvement. Specifically, more attention to trauma and the importance of societal risk and protective factors may improve the program’s effectiveness. Thus, focus group discussions were conducted with students and we then adapted Fourth R lessons specific to trauma, racism, and discrimination. Major themes discussed are that Fourth R and other prevention programs should focus attention on social and structural issues, such as racism and discrimination. Full article

Family talks about sex can protect against teens’ risky sexual behavior, but most research has focused on the role of mothers. The current study included cross-sectional survey data from 728 adolescents in the 11th and 12th grades (M_age = 17.00, SD = 0.90) in the United States. Structural equation modeling (SEM) was used to assess associations between teens’ direct and indirect talk, defined as less straightforward ways to communicate one’s sexual values, with fathers about sex, and teens’ sexual behaviors. There were no significant direct associations between father-teen talk about sex and teens’ sexual behavior. However, teen gender moderated associations between indirect father-teen communication and teens’ sexual behavior. The results suggest the need to assess indirect talk about sex in studies of family sexuality communication and to further investigate the role of teens’ identities in determining the influence of father-teen talk about sex on teens’ sexual behavior. Full article

Background and Objectives: Without mandatory school-based education, Romania is a leading European country in teen pregnancy. This survey aimed at assessing the level of knowledge and the opinions about sexual education and sexual-related issues among mothers of female teenagers aged 13–18 years old. Material and Methods: The survey was conducted between 2015 and 2017 and had four parts, collecting data about sociodemographic variables, the level of knowledge about sexuality, sexually transmitted diseases, and contraception. The respondents were mothers of female teenagers hospitalized in a tertiary pediatric clinic. Data were analyzed using IBM Statistical Package for Social Sciences (SPSS) Statistics for Windows, version 25 (Inc., Chicago, IL, USA). Results: One hundred and thirty-five mothers (42.46 ± 6.81 years old) were included in the research. Most of them were from rural areas, had graduated secondary school, were Christian-orthodox, married, and with a stable job. More than half of the mothers (61.42%) declared that they personally knew adolescents that were already mothers. In great proportion, mothers proved good knowledge about sexual education, contraception, and STDs. They considered that the minimum age for becoming married, in general, is about M = 18.62 ± 2.09 years old but in the case of their daughters, mothers appreciated that the best age would be 23.56 ± 9.37. Mothers considered that they had good communication with their daughters (M = 4.28 ± 0.99) and two-thirds sustained that they had discussed with them about sexual activity, pregnancy, sexually transmitted diseases, and contraception. In case of unwanted pregnancy of their daughters, one-third of the mothers (38.50%) would advise their girls to continue the pregnancy and 7.40% mentioned the termination of pregnancy. Two-thirds of them (74.10%) agreed to school-based sexual education. In the order of preferred sources for sexual education, mothers mentioned parents (85.90%), teachers (33.30%), and family doctors (24.40%). Comparative results regarding their own sex life and that of their daughters are presented. Conclusions: School-based programs should meet parental beliefs about sexuality and sexual education. School, as a creator of values and models, should find the golden ratio to better shape the personal, familial, and social needs for the healthy sexual behavior of the new generation. Full article

Nowadays, technology has become part of the daily activities of a large part of the population. Many of the activities and development and socialization processes of minors and young people have been transferred to the online world, generating attention and concern from the educational, scientific, and forensic communities. One of the most worrying issues derived from this new online world is the consumption of pornography by teens. The objective of this literature review is to draw attention to the consequences and emotional disturbances derived from the consumption of pornography in young people, as well as the forensic implications of this phenomenon, among which are paraphilias, perpetration, and victimization of sexual assaults, and the development of new forms of online sexual victimization. The main findings suggest that the first contact with pornography starts at the age of 8 years old, with important behavioral and psychological consequences, such as hypersexualization, emotional disturbances, and the perpetuation of gender inequality. Furthermore, pornography consumption by youth has been linked to the exacerbation of paraphilias, an increase in sexual aggression perpetration and victimization, and, finally, it has been linked to an increase in online sexual victimization. Implications and future lines of research are discussed. Full article

School violence towards peers and teen dating violence are two of the most relevant behaviour problems in adolescents. Although the relationship between the two types of violence is well established in the literature, few studies have focused on mediators that could explain this empirical relationship. We departed from the evidence that relates anger, emotional distress and impaired empathy to teen dating violence and juvenile sexual offending, to explore the role of personal distress, i.e., a self-focused, aversive affective reaction to another’s emotion associated with the desire to alleviate one’s own, but not the other’s distress; as a possible mechanism linking school violence towards peers and teen dating violence in a sample of Spanish adolescents. We also explored the prevalence of emotional and physical teen dating violence, both occasional and frequent, and the differences between boys and girls. A total of 1055 adolescents (49.2% boys and 50.8% girls) aged between 11 and 17 years (M = 14.06, SD = 1.34) who had had at least one romantic relationship within the last year, completed measures of school violence towards peers, teen dating violence, and personal distress. Statistical analyses revealed that occasional and frequent teen dating violence (both physical and emotional) was more frequent in girls than in boys, and that personal distress functioned as a partial mediator, with an overall model fit higher for boys than girls: in boys, partial mediation occurred for both physical and emotional teen dating violence; in girls, partial mediation occurred only for physical violence. The interpretation of the results is tentative given the novel nature of the study, and points to the evidence of the emotional costs of school violence and the importance of emotion and behavior regulation to undermine the social costs of personal distress. Full article

This article presents findings from a systematic literature review that examined various forms of adolescent sexting, and as relevant to educator responsibilities in the support of prosocial behavior and teen dating violence (TDV) prevention within the United States. Proceeding in three parts, part one documents study methodology and offers an overview of adolescent sexting. This section also discusses tensions between sexting as adolescent empowerment and as a form of dating violence. This is followed by a deeper examination of how adolescent sexting is connected to other forms of sexual violence documented to disproportionately affect heterosexual females. Though laws on sexting are minimal, part three discusses U.S. federal and Supreme Court guidance having particular significance for this issue. This section also presents the case of New York State (NYS) to consider the connection between localized policies and schooling practices. Concerned with sexting as a form of consensual adolescent behavior, this article concludes with considerations for educational research, policy, and practice. This article contributes to established research literature weighing the prosocial aspects of sexting against those factors that contribute to and make it difficult to leave a violent relationship. Though empirical research was limited, it also highlights existent research on sexting as relevant to underserved and marginalized adolescent subgroups. Full article

Although early sexual initiation and childbearing are major barriers against the upward social mobility of American adolescents, particularly those who belong to a low socioeconomic status (SES) and racial minorities such as Blacks, less is known on how SES and race correlate with adolescents’ sex hormones. An understanding of the associations between race and SES with adolescents’ sex hormones may help better understand why racial, and SES gaps exist in sexual risk behaviors and teen pregnancies. To extend the existing knowledge on social patterning of adolescents’ sex hormones, in the current study, we studied social patterning of sex hormones in a national sample of male and female American adolescents, with a particular interest in the role of race and SES. For this cross-sectional study, data came from the baseline data (wave 1) of the Adolescent Brain Cognitive Development (ABCD) study, a national longitudinal prospective study of American adolescents. This analysis included 717 male and 576 female non-Hispanic White or Black adolescents ages 9–10. The dependent variables were sex hormones (testosterone for males and estradiol for females). Independent variables were age, race, family marital status, parental education, and financial difficulties. For data analysis, linear regression models were used. Age, race, parental education, and financial difficulties were associated with estradiol in female and testosterone levels in male adolescents. Associations were not identical for males and females, but the patterns were mainly similar. Low SES explained why race is associated with higher estradiol in female adolescents. Marital status of the family did not correlate with any of the sex hormones. Being Black and low SES were associated with a higher level of sex hormones in male and female adolescents. This information may help us understand the social patterning of sexual initiation and childbearing. Addressing racial and economic inequalities in early puberty, sexual initiation, and childbearing is an essential part of closing the racial and economic gaps in the US. Full article

Extended family can be a resource for conversations about sex, but extended family perspectives have been largely left out of existing research. The present study investigates how extended family, such as aunts and uncles, siblings and cousins, perceive communication with teens in their families about sex. A thematic analysis was conducted with data from interviews in the U.S. with 39 extended family members, primarily siblings, who reported talk with teens in their families about sex. The analyses identified one theme focused on perspectives surrounding what is most important for teens to know about sex and relationships and seven themes focused on the content of conversations with teens about sex. The most prevalent content areas were: Healthy and Unhealthy Relationships (87%), Sexual Orientation (82%), Sexual Behavior (82%), and Protection (74%). The findings highlight extended family members’ unique roles in supporting the sexual health of teens in their families, which include providing information and support about issues other family members may not address, such as sexual orientation and the positive aspects of sex. The findings suggest the need to include extended family in sex education interventions to reflect the broader ecology of teens’ family relationships and access an underutilized resource for teens’ sexual health. Full article

Research shows that family communication about sexuality can protect against teens’ risky sexual behavior. However, few studies assess talk with extended family about sex or how this communication relates to teens’ sexual behavior. The current study includes cross-sectional survey data from 952 adolescents. Structural equation modeling (SEM) was used to assess associations between teens’ sexual risk behaviors and communication with extended family about protection methods, risks of sex and relational approaches to sex, defined as talk about sex within a close relationship. For sexually active teens, talk about protection methods was associated with fewer sexual partners and talk about risks of sex was associated with more sexual partners regardless of teen gender and the generation of extended family with whom teens talk. Results suggest that extended-family talk about sex may influence teens’ sexual behavior independent of effects of teen–parent communication. However, the direction of the effect depends on the content of the conversations. These findings suggest the need to explore whether and how extended family could be included in health prevention and intervention programs, because programs which include family largely focus on parents. Full article