Confidential reproductive health care for adolescents.

Purpose Of Review: There have been recent legislative efforts in the USA to implement mandated parental involvement for minor adolescents seeking services for contraception and, in some cases, sexually transmitted diseases.

Recent Findings: Research collecting information from adolescents in family planning clinics shows that the majority report that a parent knows they use the clinic for sexual health services. Similarly, a majority of minor adolescent females expects that they would use family planning clinics for prescription contraception, even if parental involvement were required.

The role of reproductive health providers in preventing HIV.

Reproductive health providers serve millions of women in developing countries now at the center of the global HIV pandemic and are increasingly reaching out to young people and to men. As such, they are poised to play an important role in reducing the incidence of new HIV infections over the coming years. Policymakers, donors, researchers and activists should recognize the benefits of supporting the fuller integration of HIV prevention efforts with reproductive health services.

Adolescents' reports of parental knowledge of adolescents' use of sexual health services and their reactions to mandated parental notification for prescription contraception.

Context: Legislation has been proposed that would mandate parental notification for adolescents younger than 18 years (minors) obtaining prescription contraception from federally funded family planning clinics.

Objective: To determine the extent to which parents are currently aware that their teenage daughters are accessing reproductive health services and how minors would react in the face of mandated parental involvement laws for prescription birth control.

Design, Setting, And Participants: A total of 1526 female adolescents younger than 18 years seeking reproductive health services at a national sample of 79 family planning clinics were surveyed between May 2003 and February 2004.

Trends in sexual behaviours and infections among young people in the United States.

Objectives: To describe trends over time in sexual behaviour, condom use, and sexually transmitted infections among female and male adolescents in the United States.

Methods: A review was carried out of published studies using data from six surveys since the 1970s on sexual behaviour and surveillance data on sexually transmitted infections.

Results: The proportion of adolescents who have ever had sexual intercourse increased for females and males through the 1980s and then declined for males through the 1990s.

The availability and use of publicly funded family planning clinics: U.S. trends, 1994-2001.

Context: It is important to monitor trends among publicly funded family planning clinics to determine where clinics are successfully meeting the contraceptive service needs of low-income women and where more effort is needed.

Methods: Service data for all U.S.

Confidential reproductive health services for minors: the potential impact of mandated parental involvement for contraception.

Context: Recent legislative efforts to implement mandated parental involvement for minor adolescents seeking family planning services threaten the rights of adolescents younger than 18 to access reproductive health care.

Methods: State and federal laws and policies pertaining to minor adolescents' rights to access services for contraception and sexually transmitted diseases are reviewed, and research examining issues of parental involvement among adolescents using clinic-based reproductive health services is synthesized.

Results: Attempts to mandate parental involvement for reproductive health care often focus on contraceptive services and are typically linked to federal or state funding.

U.S. insurance coverage of contraceptives and the impact of contraceptive coverage mandates, 2002.

Context: In 1993, coverage of reversible contraception by U.S. health insurance plans was extremely low.

Factors associated with the content of sex education in U.S. public secondary schools.

Context: While sex education is almost universal in U.S. schools, its content varies considerably.

Services for men at publicly funded family planning agencies, 1998-1999.

Context: Men's reproductive health needs are receiving increased attention, but most family planning clinic clients are female, and clinics have reported barriers to serving men.

Methods: A 1999 survey of publicly funded agencies that administer family planning clinics asked several questions about current policies and services and the number of men served in 1998. Data on 17 services were collected, as well as the proportion of clients who were male and agencies' barriers to serving men.

The incidence of abortion worldwide.

Context: Accurate measurement of induced abortion levels has proven difficult in many parts of the world. Health care workers and policymakers need information on the incidence of both legal and illegal induced abortion to provide the needed services and to reduce the negative impact of unsafe abortion on women's health.

Methods: Numbers and rates of induced abortions were estimated from four sources: official statistics or other national data on legal abortions in 57 countries; estimates based on population surveys for two countries without official statistics; special studies for 10 countries where abortion is highly restricted; and worldwide and regional estimates of unsafe abortion from the World Health Organization.

The accessibility of abortion services in the United States, 2001.

Context: A woman's ability to obtain an abortion is affected both by the availability of a provider and by access-related factors such as cost, convenience, gestational limits and the provision of early medical abortion services.

Methods: In 2001-2002, The Alan Guttmacher Institute surveyed all known abortion providers in the United States, collecting information on their delivery of abortion services and on the number of abortions performed.

Results: A minority of abortion providers offer services before five weeks from the last menstrual period (37%) or after 20 weeks (24% or fewer), but the proportions have increased since 1993.

Abortion incidence and services in the United States in 2000.

Context: Nearly half of unintended pregnancies and more than one-fifth of all pregnancies in the United States end in abortion. No nationally representative statistics on abortion incidence or on the universe of abortion providers have been available since 1996.

Methods: In 2001-2002, The Alan Guttmacher Institute (AGI) conducted its 13th survey of all known U.

U.S. agencies providing publicly funded contraceptive services in 1999.

Context: Nearly one-quarter of women who obtain medical contraceptive services receive care from clinics operated by publicly funded agencies. In light of changes in government policy and funding and in the structure of health care financing, an assessment of agency policies and programs is essential for monitoring women's access to contraceptive care and services.

Methods: In 1999, 637 of a nationally representative sample of 1,016 U.

Overhauling welfare: implications for reproductive health policy in the United States.

The overhaul of the welfare system in 1996 broke the historic link between eligibility for welfare benefits and eligibility for Medicaid, ended a longstanding requirement that welfare recipients be given access to family planning services, and, at the same time, included a number of controversial features directed at reducing out-of-wedlock childbearing and promoting abstinence-only education. Five years later, the number of women enrolled in Medicaid is down, the number not covered by insurance is up, and abstinence-only education has become a prominent feature of the government's effort to decrease the incidence of out-of-wedlock pregnancies. Very little is known about how well these interventions are working and what impact, positive or negative, they have had.

Socioeconomic disadvantage and adolescent women's sexual and reproductive behavior: the case of five developed countries.

Context: Differences among developed countries in teenagers' patterns of sexual and reproductive behavior may partly reflect differences in the extent of disadvantage. However, to date, this potential contribution has received little attention.

Methods: Researchers in Canada, France, Great Britain, Sweden and the United States used the most current survey and other data to study adolescent sexual and reproductive behavior.

Differences in teenage pregnancy rates among five developed countries: the roles of sexual activity and contraceptive use.

Context: Adolescent pregnancy, birth, abortion and sexually transmitted disease (STD) rates are much higher in the United States than in most other developed countries.

Methods: Government statistics or nationally representative survey data were supplemented with data collected by private organizations or for regional or local populations to conduct studies of adolescent births, abortions, sexual activity and contraceptive use in Canada, the United States, Sweden, France and Great Britain.

Results: Adolescent childbearing is more common in the United States (22% of women reported having had a child before age 20) than in Great Britain (15%), Canada (11%), France (6%) and Sweden (4%); differences are even greater for births to younger teenagers.

Family planning clinic services in the United States: patterns and trends in the late 1990s.

Context: Publicly funded family planning clinics are a vital source of contraceptive and reproductive health care for millions of U.S. women.

Reproductive health services for adolescents under the State Children's Health Insurance Program.

Context: The federal government enacted the State Children's Health Insurance Program (CHIP) in 1997 to provide insurance coverage to uninsured, low-income children up to age 19. Individual states' decisions when designing their CHIP efforts will in large part determine the extent to which the program will help the nation's nearly three million low-income uninsured adolescents get needed reproductive health services.

Methods: CHIP administrators in all states and the District of Columbia were sent a survey concerning reproductive health services for adolescents aged 13-18 provided under their state's CHIP effort.

Public or private providers? U.S. women's use of reproductive health services.

Context: U.S. women receive contraceptive and reproductive health services from a wide range of publicly funded and private providers.