Many young people in the United Kingdom are at increased risk of unintended pregnancy and sexually transmitted disease because they wait until after they have become sexually active to seek out sexual health services, according to "When and Why Do Young People in the United Kingdom First Use Sexual Health Services?" by Nicole Stone and Roger Ingham. The article, published in the May/June 2003 issue of Perspectives on Sexual and Reproductive Health, found that 61% of youth surveyed had used sexual health services only after having had intercourse for the first time. While many young people reported obtaining condoms from other sources (pharmacies or vending machines) before having sex, these sources do not provide the education, counseling and broader reproductive health services available from a health care provider.

In the United Kingdom, government health initiatives have developed a range of sexual health services targeted toward young people. However, despite the wide availability of free and confidential contraceptive services, not all teens use the services or use contraceptives consistently. The most commonly reported barriers to seeking out services before first sex included unplanned or unexpected sex, embarrassment or fear, and concerns about confidentiality. Subsequently, however, having had unprotected sex and experiencing contraceptive failure were both triggers for sexually active women to visit a provider.

Previous research has shown that greater acceptance of young people's emerging sexuality is not associated with increased levels of sexual activity, but is associated with improved sexual health. The authors suggest that removing the barriers to effective service use and improving sexual health among youth will involve educating youth, helping parents to be realistic about young people's emerging sexuality and removing the social stigma surrounding young people's sexuality.

To learn more about teenage sexual and reproductive behavior in the United Kingdom, as well as in the United States, Canada, France and Sweden, click here.

Also in this issue of Perspectives on Sexual and Reproductive Health:

• "Heterosexually Active Men's Beliefs About Methods for Preventing Sexually Transmitted Diseases," by Mary Rogers Gillmore et al.;

• "Effects of Psychosocial Risk Factors and Prenatal Interventions on Birth Weight: Evidence from New Jersey's HealthStart Program," by Nancy E. Reichman and Julien O. Teitler;

• "Child Disability and Mothers' Tubal Sterilization," by Jennifer M. Park et al.; and

• Viewpoint: "Access to Adolescent Reproductive Health Services: Financial and Structural Barriers to Care," by Linda Hock-Long et al.