As they mature and become sexually active, more young people face serious health risks. Most face these risks with too little factual information, too little guidance about sexual responsibility, and too little access to health care. Meeting young adults' diverse needs challenges parents, communities, health care providers, and educators. Despite urgent needs, program efforts have been slight and slowed by controversy.
PIP: The overview of this report, illustrated with tables, discusses the size and proportion of the population ages 10-19; the definition of young adult; the falling age of puberty; sexual activity among young adults (including premarital sexual activity); the rising age at marriage; fertility patterns; contraceptive usage (including factors that inhibit usage, such as a lack of information, of access, of decision-making ability, and/or of power); and unmet contraceptive needs. The report's essay on growth, change, and risk behavior associated with youth deals with the specific topics of sexually transmitted diseases, sexual violence and coercion, the health risks of early pregnancy, unintended pregnancy and the complications of unsafe abortion, the social and economic consequences of early childbearing, and ways to meet needs and, thus, prevent problems. This last subject leads into an overview of programs available for young adults, including large school programs, small health programs, and European youth programs and social norms. A table gives types of reproductive health programs for young adults that defines the audience/activities, extent of the program, special issues addressed, and research findings for 1) family life education programs, 2) clinic-based programs, 3) AIDS prevention programs, 4) condom distribution programs, 5) school clinics, 6) communication through the entertainment media, and 7) peer education. In the next major section of the report, evaluations of the various types of programs for youth are reviewed to determine whether the programs lead to a delay in initiation of sexual intercourse, an increase in sexual intercourse, and/or an increase in contraceptive usage. Consideration is then given to what makes programs work and how to win support for programs from the community and from young adults. These major essays are punctuated with short highlights on such topics as whether adults and youth have differing views about sex behavior, whether young people are different today than they were in the past, reaching boys with services, where young people learn about sex, contraceptive choices for youth, and lessons learned from youth programs.