1. SEXUALLY ACTIVE STUDENTS Presentation by: Rebecca Gowen

2. TOPIC OVERVIEW  Literary Review  Considerations for School Counselors  Multicultural Considerations  Sexual Activity  Contraception  Pregnancy  Sexually Transmitted Diseases  Risk Factors to Consider  Protective Factors  Prevention and/or Intervention

3. LITERARY REVIEW  School Counselors have to determine the a great deal when it comes to counseling sexually active students:  Disclosure of information  Parental involvement  Ethical and/or legal concerns  School Board Policies  Community Resources  School Counselor’s personal values and/or biases  Counseling sexually active students can be incredibly difficult in regards to confidentiality  School Counselors should seek supervision and/or consult.

4. LITERARY REVIEW CONTINUED  Mixed beliefs on whether school based sex education programs promote sexual activity.  Availability of condoms?  School Health services are associated with fewer pregnancies among students  However, research does indicate depending on the amount of services provided correlates both positively and negatively.  Comprehensive sex education is often denied to American teens even though it has been shown to be effective in reducing sexual risk-taking behaviors.  Successful prevention efforts involve collaborative efforts with teens, parents, school faculty members, health professionals, and policy makers.  A study including ethnically diverse students indicated teens are more concerned about getting pregnant than about contracting an STD.

5. LITERARY REVIEW CONTINUED  Teens do expect fewer negative consequences as a result of oral sex:  Physical  Health  Social  Emotional  LGBTQ have a higher risk for risky sexual behaviors and HIV infection.  Teen moms are more likely to rely on public assistance, experience family strains, and come from disadvantaged backgrounds.  Virginia explicitly allows all minors to consent to contraceptive services.  Virginia requires parental consent and/or notification for a minor’s decision to receive an abortion.

6. CONSIDERATIONS FOR SCHOOL COUNSELORS  The following are recommendations for School Counselors when counseling sexually active students:  Know school board policy  Regulations and ethical/legal obligations  Know the state’s age-of-consent laws  Consider developmental concerns  Consider the impact of the school setting and parental rights  Multicultural variables  Consult  Understand personal values and biases  Avoid involvement in a student’s medical care

7. MULTICULTURAL CONSIDERATIONS  School Counselors need to improve their multicultural education, competencies, training when working with LGBTQ:  LGBTQ have a higher risk for:  Risky sexual behaviors and HIV infection  Sexual harassment  Mental disorders  Substance abuse and abuse  Pregnancy and poverty rates double for African American and Latina teens.  Religious and/or moral beliefs.

8. SEXUAL ACTIVITY  On average, students are sexually active by age 17. The average age for marriage is mid- 20’s.  This increases the risk for unwanted pregnancies and STD’s.  Among sexually active students, those who are reporting, indicate their first sexual experience is with a steady partner (70% female, 56% male).  Since 2010, the amount of teens having sex has decreased. Reasons for decrease include:  Teens stating it is against their religion and/or morals  Females stated they do not want to get pregnant  Teens have not found the right person

9. CONTRACEPTION  The majority of sexually experienced teens use contraceptives their first time having sex.  The younger age teen, the less likely they are to use a contraceptive method.  The condom is the most common contraceptive method.  Dual method offers protection against both pregnancy and STDs/STIs.  Nearly 1 in 4 female teens is at risk for unintended pregnancy if not using any contraceptive method.

10. PREGNANCY  Each approximately 600,000 teens aged 15- 19 become pregnant.  Two-thirds occur in 18-19 year olds  82% of teen pregnancies are unplanned; with one-fifth accounting for the unplanned pregnancies annually.  Teen pregnancy is on a decline.  Due to improvement of contraceptive use  Despite decline, pregnancy rate still remains one of the highest concerns for the U.S.  Pregnancy and poverty rates is double for African Americans and Latina women, ages 15- 19, than for White women.

11. PREGNANCY OUTCOMES Pregnancy Outcomes:  60% in Birth  26% in Abortion  15% in a Miscarriage  Most births are the first for teens  18% result in second or third births  Nearly all are nonmartial (89%) Fatherhood:  Most males report they would be very upset if they got someone pregnant.  Teen fatherhood varies considerably by multicultural factors  Highest among black males Abortion:  Reasons reported for having an abortion include:  Concerns about how a baby would change their lives  Cannot afford a baby  Do not feel mature enough to raise a child  38 states require parental involvement in minors decision in seeking an abortion

12. SEXUALLY TRANSMITTED DISEASES  Teens between the ages of 15-24 account for half (9.1 million) of the new cases of STD’s each year.  Human papillomavirus (HPV) accounts for half of the STD diagnosis for teens.  Trichomoniasis and chlamydia are the next most common diagnosis for teens aged 15-24..  In 2011, HIV accounted for 21% of STD diagnosis for teens aged 13-24.  In 2013, 43% of females aged 15-19 received counseling and testing for STD’s and/or HIV.  All 50 states allow minors to consent to STD/STI services without parental involvement.  11 states require that a minor be of a certain ages (12 to 14) to do so  31 states include HIV testing and treatment for minors to consent to

13. RISK FACTORS TO CONSIDER In becoming Pregnant  Emotional Bonding  Developmental level  Correlational factors between race, poverty, and health After Pregnancy  Poverty  School dropout  Abuse  Child  Partner

14. PROTECTIVE FACTORS  Secure attachment/bonding with family  Reduction in risky sexual behaviors  Support  Communication  Positive self-efficacy, worth, and esteem

15. PREVENTION AND/OR INTERVENTION  Create positive teen development programs that teach and promote the following:  Social competence  Emotional competence  Cognitive competence  Behavioral competence  Self-determination  Self-efficacy  Positive identity  Pro-social norms/moral competence  Spirituality  Prevention efforts need a collaborative effort  Focus on the needs of the individual student, family, community, and society.  Parental Involvement Programs should encourage consistent messages about:  Sexual risk-taking behaviors  Abstinence vs. contraceptive use  Long term goals  i.e. Career goals  Healthy decision making skills

16. QUESTIONS?

17. REFERENCES Bidell, M. P. (2012). Examining School Counseling Students’ Multicultural and Sexual Orientation Competencies Through a Cross-Specialization Comparison. Journal of Counseling & Development, 90(2). doi: 10.1111/j.1556-6676.2012.00025.x Center of Disease Control and Prevention. (2014). Sexual Risk Behavior. Retrieved from http://www.cdc.gov/healthyyouth/sexualbehaviors/index.htm Center of Disease Control and Prevention. (2014). Sexual Risk Behavior Data & Statistics. Retrieved from http://www.cdc.gov/healthyyouth/sexualbehaviors/data.htm Center of Disease Control and Prevention. (2014). Sexual Risk Behavior Guidelines & Strategies. Retrieved from http://www.cdc.gov/healthyyouth/sexualbehaviors/strategies.htm Daley, A. M. (2012). Rethinking school-based health centers as complex adaptive systems: Maximizing opportunities for the prevention of teen pregnancy and sexually transmitted infections. Advances in Nursing Science, 35(2), E37-E46. Denny, S., Robinson, E., Lawler, C., Bagshaw, S., Farrant, B., Bell, F., Dawson, D., Nicholson, D., Hart, M., Fleming, T., Ameratunga, S., Clark, T., Kekus, M., & Utter, J. (2012). Association between availability and quality of health services in schools and reproductive health outcomes among students: A multilevel observational study. American Journal of Public Health, 102(10), e14-e20. doi: 10.2105/AJPH.2012.300775 Gavin, L. E., Catalano, R. F., & Markham, C. M. (2010). Positive Youth Development as a Strategy to Promote Adolescent Sexual and Reproductive Health. Journal of Adolescent Health, 46(3), S1-S6. doi: 10.1016/j.jadohealth.2009.12.017

18. REFERENCES Ovadia, S., & Moore, L. M. (2010). Decomposing the Moral Community: Religious Contexts and Teen Childbearing. City & Community, 9(3), 320-334. doi: 10.1111/j.1540- 6040.2010.01331.x Robin, L., Brener, N. D., Donahue, S. F., Hack, T., Hale, K., & Goodenow, C. (2002). Associations between risk behaviors and opposite, same, and both-sex sexual partners in representative samples of Vermont and Massachusetts high school students. Pediatric Adolescent Medicine, 156(4), 349-355. Romig, C. A., & Bakken, L. (1990). Teens at risk of pregnancy: The role of ego development and family processes. Journal of Adolescence, 13(2), 195-199. doi: 10.1016/0140- 1971(90)90009-V10.1016/0140- 1971(90)90009-V Silk, J., & Romero, D. (2014). The Role of Parents and Families in Teen Pregnancy Prevention: An Analysis of Programs and Policies. Journal of Family Issues, 35(10), 1339-1362. doi: 10.1177/0192513X13481330

19. REFERENCES Stone, C. (2013). School counseling principals: Ethics and law (3rd ed.). Alexandria, VA: American School Counselor Association Virginia Department of Health & Guttmacher Institute. (2014). American Teens’ Sexual and Reproductive Health. Retrieved from http://www.guttmacher.org/pubs/FB-ATSRH.html Wolk, L. I., & Rosenbaum, R. (1995). The benefits of school-based condom availability: Cross-sectional analysis of a comprehensive health school-based program. Journal of Adolescent Health Care, 17(3), 184-188. doi: 10.1016/1054- 139X(95)00031-M10.1016/1054- 139X(95)00031-M