Boys need to be included in discussions about preventing teen pregnancy
- Copyright © 2013 by the American Academy of Pediatrics
Teen pregnancy is all too common. Images of young girls with growing bellies are splattered everywhere from MTV to inner-city billboards. But what if the pregnant teens in the images were boys?
The Chicago Department of Public Health and other cities are using this premise in a new teen pregnancy prevention campaign. Ads featuring adolescent boys with pregnant stomachs are displayed around the city. The tagline reads, “Unexpected? Most teen pregnancies are.” The ads’ shock value is meant to spark conversation about the fact that a teen pregnancy includes boys, too.
But a boy’s role in pregnancy prevention shouldn’t just be discussed around him — it needs to be addressed with him, according to adolescent medicine specialists.
“In order to most effectively prevent pregnancy, having both partners informed about contraceptive choices and supporting each other is important,” said Paula K. Braverman, M.D., FAAP, chair of the AAP Committee on Adolescence.
By the numbers
The United States consistently has one of the highest teen pregnancy rates among industrialized countries, despite the fact that the pregnancy rate has declined dramatically over the past 40 years. About 7% of teenagers ages 15-19 get pregnant each year, according to the Centers for Disease Control and Prevention (CDC).
According to the 2011 AAP clinical report, Male Adolescent Sexual and Reproductive Health Care, 71% of male adolescents reported using a condom the first and most recent time they had sex, but only 48% report consistent use. Consequently, 13% of sexually experienced adolescent males reported that they have impregnated a partner.
Still, this discrepancy in condom use likely doesn’t stem from a lack of education. According to the National Survey on Family Growth, 97% of male teenagers report having had formal sex education before they turned 18.
Beyond education, however, resources for male adolescents are lacking. For example, teen males are vastly underrepresented in Title X Family Planning, a federal program that supports services to assist in pregnancy prevention and planning. While 9% of those served by Title X clinics are males, only about a third are adolescents.
Later this year, the CDC’s Office of Family Planning will revise the Title X clinical guidelines to include pregnancy prevention procedures for males and females.
Arik V. Marcell, M.D., FAAP, who is involved in developing the guidelines for males, said it is hard to know exactly how to approach adolescent boys about pregnancy prevention because no comprehensive research has been done on the topic. Regardless, he says pregnancy prevention counseling for boys is necessary.
“Female use of birth control is increased if her partner is involved in those methods, too,” said Dr. Marcell, a member of the AAP Committee on Adolescence.
What boys aren’t hearing
Despite this advantage, many boys lack basic knowledge about female birth control methods.
Dr. Braverman said this one-sided education is due in part to pediatricians’ limited time during office visits. She said discussing the importance of using dual methods of contraception with boys is critical to providing more comprehensive counseling. Boys need to know that condoms protect against HIV and sexually transmitted diseases (STDs) but work best to prevent pregnancy when coupled with another form of birth control.
Data from the National Survey on Family Growth show that boys are learning much more about protection from STDs than pregnancy prevention. Boys and girls were equally likely to talk with their parents about HIV/STDs, but only 62% of males reported receiving instruction on different methods of birth control.
Adolescent medicine specialists suggest pediatricians:
Educate adolescent boys on female and male methods of contraception and serve as a resource for questions.
Be aware of clinics where boys and their partners can access contraception services confidentially.
Link with schools and educators to make sure all adolescents receive education on contraception and know where to access clinical services.
While community-based pregnancy prevention programs specifically for males are few and far between, Dr. Marcell said they are on the cutting edge of the types of comprehensive discussions he hopes will become the norm in the clinical setting.
One such program is Man2Man where adult men discuss the responsibilities of manhood, STDs and methods of contraception with adolescent boys. Dr. Braverman helped develop and implement the program, which is a part of Philadelphia’s Family Planning Council.
Roberta Herceg-Baron, director of strategic initiatives at the Family Planning Council, said Man2Man is meant to prepare young boys for life. “They need to be able to make responsible decisions when they are in situations that adults don’t have any control over,” she said. “We can’t keep treating boys like they shouldn’t have any information.”
Dr. Braverman said the boys who participate in Man2Man appreciate the opportunity to discuss these topics in an open, nonjudgmental setting. She noticed one student in particular who took Man2Man’s message to heart. “He called his girlfriend and told her that they needed to sit down and talk about ‘being safe’,” she said. “Not only did he have the information he needed, but he also felt moved to actually initiate this conversation.”
Young Men’s Health: http://www.youngmenshealthsite.org/contra.html
Centers for Disease Control and Prevention, www.cdc.gov/TeenPregnancy/TeenFriendlyHealthVisit.html
The National Campaign to Prevent Teen and Unplanned Pregnancies: http://www.thenationalcampaign.org/