Apter Dan
The Sexual Health Clinic, Family Federation of Finland, Helsinki, Finland.
Endocr Dev. 2012;22:287-301. doi: 10.1159/000326704. Epub 2012 Jul 25.
Sexual health for adolescents is based on three components: recognizing sexual rights, sexuality education and counseling, and confidential high-quality services. Contraception needs to include prevention of both STIs and pregnancy. The main options for adolescents are condoms backed-up by emergency contraception; and hormonal contraceptives in a longer, mutually monogamous relationship. Condoms and hormonal contraception together can be well recommended for adolescents. Condom use should not be stopped before it is reasonably certain that the partner is STI-negative. Other alternatives can be considered in special cases. Improved contraceptive methods do not automatically lead to reduced numbers of adolescent abortions. The prevention of unintended adolescent pregnancies requires four elements: a desire to use protection, a good contraceptive method, ability to obtain the contraceptive method, and ability to use it. All these components are important, and if one is missing contraception will fail. In the developed countries, we have good contraceptive methods, but improvements are still needed in the other components. When adolescent sexuality is not condemned but sexuality education and sexual health services instead are provided, it is possible to profoundly improve adolescent sexual health with comparatively small costs. Each year new groups of young people mature, requiring new efforts.
认识性权利、性教育与咨询以及保密的高质量服务。避孕需要兼顾性传播感染的预防和妊娠预防。青少年的主要选择是使用避孕套并辅以紧急避孕措施;对于处于长期相互一夫一妻关系中的青少年,则可选择激素避孕法。避孕套和激素避孕法可同时推荐给青少年使用。在没有合理确定性伴侣没有性传播感染之前,不应停止使用避孕套。在特殊情况下可考虑其他选择。改进避孕方法并不会自动导致青少年堕胎数量减少。预防意外妊娠需要四个要素:使用避孕措施的意愿、良好的避孕方法、获取避孕方法的能力以及使用避孕方法的能力。所有这些要素都很重要,缺少任何一个,避孕都会失败。在发达国家,我们有良好的避孕方法,但在其他要素方面仍需改进。当不谴责青少年性行为,而是提供性教育和性健康服务时,就有可能以相对较小的成本大幅改善青少年性健康。每年都有新的年轻人群体成年,需要做出新的努力。