Alcohol misuse: tackling the UK epidemic - London

It is important to exercise caution about the relationship between age and sexual experience. There is
evidence to suggest that age at first intercourse may not take into account variations in individual
development and social norms. NATSAL found that more than a third of young women for whom first
intercourse occurred at age 15 years were sexually competent, and more than a third of those aged 18 to
24 were not. 156
Among adolescents there has been a sustained increase in condom use over time; only a small minority of
the 16 to 19 year olds interviewed (7.4% of men and 9.8% of women) reported having had unprotected
first intercourse. 156
A quarter of young women were already using oral contraception at first intercourse. 156
Among 16 to 24 year olds, non-use of contraception increased with declining age at first intercourse;
reported by 18 per cent of men and 22 per cent of women aged 13 to 14 at occurrence. 156
Adolescents and STIs
STIs have increased in the UK in recent years. The Health Protection Agency (formerly the Public Health
Laboratory Service or PHLS) collates comprehensive data on communicable diseases seen in
genitourinary medicine (GUM) clinics – these do not include cases treated in primary care. Data show
that, between 1995 and 2000, diagnoses of gonorrhoea, syphilis and chlamydia all more than doubled in
England, Wales and Northern Ireland. 160
In England, the latest figures indicate an increase of 78 per cent
in cases of gonorrhoea since 1997. Chlamydial infection has increased by 73 per cent and syphilis by 374
per cent. 3
Large and increasing numbers of diagnoses of STIs among adolescents, especially females, are of
particular concern. 160
Chlamydia is most commonly seen in young people; the peak age is between
20 and 24 in men and between 16 and 19 in women. Two pilot studies of chlamydia screening carried out
in the Wirral and Portsmouth reported that 10 per cent of women under 25 years of age attending health
services and being screened were infected with chlamydia. 3
Young women have been found to be at greater
risk of chlamydial reinfection than those over the age of 25. 161
One of the reasons for the currently high prevalence rates of STIs is that most, such as chlamydia and
gonorrhoea, may go undiagnosed because the infection is asymptomatic and screening is not widely
available. This enables STIs to spread rapidly and sometimes reach epidemic proportions. 160
In a single act
of unprotected sex with an infected partner, adolescent girls have a 1 per cent chance of acquiring HIV, a
30 per cent risk of getting genital herpes and a 50 per cent chance of contracting gonorrhoea. 162
Costs of
STIs to the individual, society and the NHS include preventable infertility, ectopic pregnancy, hospital
admissions for pelvic inflammatory disease, and psychological stress. 160
Adolescents and ‘teenage pregnancy’
There is no biological reason to suggest that having a baby before the age of 20 is associated with ill health.
In fact it is older women who face increased risk of chromosomal abnormalities and complications of
pregnancy. 163
The children of adolescent mothers can fare as well in physical and social terms as those born
to older women. Early childbearing can protect women from breast cancer, and their children from
diabetes. 164
Many teenage pregnancies are, however, unplanned. Being an adolescent parent can lead to
an increase in relative poverty, unemployment, poorer educational achievements and poor health of the
child born. 165
Evidence suggests that teenage pregnancy can increase the likelihood of having a low birth
weight baby 166
and the risk of sudden infant death syndrome. 167
Children of teenage mothers are also more
likely to be admitted to hospital as a result of an accident than the children of older mothers. 168
Forty-one
per cent of teenage mothers have an episode of depression within one year of childbirth. 169
Some people argue that the so called public health problem of teenage pregnancy is really a reflection of
what is considered to be socially, culturally and economically acceptable in the UK. 163
However, although
teenage pregnancy is not necessarily a public health problem, the cumulative effect of social and economic
exclusion on the health of mothers and their babies, whatever their age, is. 163
Teenage motherhood often
British Medical Association Adolescent health 35