Background Information
Note: Agencies can also use this information in basic youth facilitation skills trainings designed to prepare youth facilitators to lead discussions in topics related to sexuality and STI prevention.
Adolescent Development
Adolescence is a time of change and transitions. Many things are happening at the same time, which may be confusing to both adolescents and the adults around them.
Biological Development
Adolescents go through many important transitions as their hormones begin to signal changes in their development. Hormonal changes trigger the development of secondary sex characteristics (changes in voice, hair growth, etc.). Hormones also are related to emotional changes, characterized by rapid mood swings or what may appear to be overly emotional reactions. These reactions may be confusing to teens themselves, as well as to those around them.
Physical Development
Individual adolescents experience growth spurts at different times. While one 12-year-old boy may suddenly grow tall and muscular, his friend of the same age may still be short and slight in build. One girl may have begun her menstrual cycle and have developed a mature-looking body while her friend of the same age may still look more like a little girl. These changes become important to a young person’s self-image, and to their status among peers. Adults need to be sensitive to these issues, since adolescents are sensitive to them and may react to them quite strongly.
Psychological Development
Cognitive skills. As young people go from preadolescence into adolescence, their ability to think about situations and concepts develops considerably. Preadolescents are more likely to think about things concretely, and need many examples before they can grasp the meaning of a concept. As adolescents mature, they gain the ability to think more abstractly. They begin to enjoy thinking and talking more about abstract concepts, and to consider possibilities and hypothetical situations. This becomes an exciting time for them as they become more aware of their own mental abilities. If you can capture their imaginations, it will make the sessions much more interesting to them.
Identity. During the course of development, adolescents may fall on different points along the continuum from dependence to autonomy, as they try to negotiate their way toward becoming young adults. However, this is not a smooth process, and the same adolescent may be at either extreme of dependence or autonomy within a matter of moments. Adults’ task is to assist adolescents in negotiating this transition, while recognizing that they may sometimes need to take a few steps back before taking a full stride forward.
Interpersonal Development
Relationship with parents. Issues of power and control can be difficult for adolescents and may be a source of conflict with parents. Adolescents seem to develop best in situations where there are moderate levels of control (neither total freedom nor excessive control), with adults who communicate an atmosphere of emotional support and caring.
Relationships with peers. Relationships with peers are extremely important during adolescence as part of identity formation. Adolescents often look to friends for feedback, for example, about their looks, behaviors, and choices. Saving face is extremely important, especially since adolescents are easily embarrassed. It is important to recognize that one reason for misbehavior may be the need to save face or to maintain a favorable perception in friends’ eyes.
STIs and HIV
Reported cases of several common STIs increased for both sexes from 2012 to 2016, including chlamydia up by 4.7%, gonorrhea up by 18.5%, and syphilis up by 17.6%. Young people ages 15 to 24, several racial/ethnic minority groups, gay and bisexual men, and pregnant women are at particular risk. Incidence and prevalence estimates show that young people ages 15 to 24 acquire half of all new STIs, and 25% of sexually active adolescent females have an STI. Adolescents and young adults are at higher risk of acquiring an STI due to behavioral, biological, and cultural reasons, as well as barriers to accessing quality STI prevention and treatment services (e.g., the inability to pay, few youth-friendly clinics, etc).
Higher rates of STIs among racial/ethnic minority groups is partially explained by higher rates of poverty and unemployment, and lower educational attainment, which affects health status and the ability to access and afford quality health services. Socioeconomic disparities among urban AI/AN are associated with high fertility rates, unintended pregnancy, higher likelihood of having three or more pregnancies, and use of specific contraceptive methods, including female sterilization.
Urban AI/AN also use contraception at a lower rate, have more unprotected first sex, more first sex with older partners, and more forced sex than their non-Hispanic White counterparts. AI/AN in Indian Health Service areas have higher rates of STIs than the overall national rates. HIV rates increased among AI/AN by 19%, but by 63% for gay and bisexual, or two-spirited, AI/AN men.
Teen Pregnancy
Over 400,000 teen girls (4%) ages 15 to 19 give birth each year, equating to 1,100 teen births every day. Teen births represent 10% of the 4 million babies born each year. Teen parenthood has huge economic, social, and health consequences to the parents and child, and to their families and communities.
While teen birth rates have dropped by 40% over the last 20 years to the lowest levels since the United States began tracking teen births, these rates are up to 9 times higher than most other developed countries. Hispanic, Black, and American Indian teen girls are less likely to use birth control and 2 to 3 times more likely to give birth than White teen girls. Teen mothers are much less likely to complete high school: 50% of teen moms get a high school diploma compared to 90% of teen girls who do not become mothers.
