A Tremendous Loss for Our Field

Douglas Kirby

It is with a heavy heart that Healthy Teen Network shares the news that our respected colleague, Douglas Kirby, PhD, passed away Saturday, December 22, 2012. He is survived by his wife, Gail, and his daughter, Katherine, and son, Cameron. A memorial service will be held for Doug on Saturday, January 5th, 2013, at 2:00pm PST at the La Selva Beach Community Church in La Selva, California. Donations in Doug’s honor can be made to Zambia Orphans of AIDS.

Doug was a Senior Research Scientist at ETR Associates in Scotts Valley, California, and an internationally renowned expert on adolescent sexuality and reproductive health and evidence-based programs. For more than 30 years, he directed studies of adolescent sexual behavior, sexuality and HIV education programs, school-based clinics, school condom-availability programs, and youth development programs. He co-authored research on the Reducing the RiskSafer Choices, and Draw the Line curricula, all of which significantly reduced unprotected sex, either by delaying sex, reducing the number of partners, increasing condom use, or increasing contraceptive use. He painted a more comprehensive and detailed picture of the risk and protective factors associated with adolescent sexual behavior, contraceptive use, and pregnancy, and identified important common characteristics of effective sexuality education and HIV education programs. He authored Emerging Answers 2007: Research Finding on Programs to Reduce Teen Pregnancy and Sexually Transmitted Diseases, a widely acclaimed resource.  Over the years, he authored or co-authored more than 100 volumes, articles, and chapters on adolescent sexual behavior and programs designed to change that behavior.  These have included reviews of the field for the National Campaign to Prevent Teen and Unplanned Pregnancy, the Centers for Disease Control, the National Institutes of Health, and others.

It would be hard to overstate Doug’s tremendous contributions to our field. In 2004, Healthy Teen Network awarded Doug the Outstanding Contribution in Promoting Evidence-Based Practices Award in recognition for his application of research to program. No one has done more to make research accessible to programs than Doug Kirby. For more than three decades, Doug looked at the state of field and analyzed and discussed his findings in ways we could all use. Doug was dedicated to advancing the research base of our field, staying focused and determined to provide top quality research and evaluation. Doug’s work, his legacy, will continue to stand out in the field and guide how we best serve our youth.

Beyond Doug’s professional contributions, he was an incredible person and a joy to know. We are grateful for having had the opportunity to know him, and we will miss him.  Our hearts and thoughts are with his family and friends as they mourn his loss.

One Third Is Too Much

As most of us in the field know, teen pregnancy rates have hit record lows over the past couple years. The teen birth rate for girls aged 15-19 decreased 9% between 2009 and 2010, from 37.9 births per 1,000 to 34.3 per 1,000. This is the largest decline recorded in a single year since 1946-47, and teen birth rates are now at their lowest levels since National Center for Health Statistics (NCHS) began tracking teenage childbearing .

Guttmacher brief released earlier this year help explains some of the reason for this success in driving down rates: “The majority (86%) of the decline in the teen pregnancy rate between 1995 and 2002 was the result of dramatic improvements in contraceptive use, including an increase in the proportion of teens using a single method of contraception, an increase in the proportion using multiple methods simultaneously and a substantial decline in nonuse.” This finding underscores Healthy Teen Network’s core belief that all youth can make responsible decisions about their sexuality and reproductive health when they have complete, accurate, and culturally relevant information, skills, resources, and support.

Still, with all the strides that have been made in the right direction, one third of American youth currently receive no formal information about contraception. This needs to change: one third is too much.

For more than 33 years, Healthy Teen Network has been building the capacity of professionals and organizations to support and empower adolescents and young adults, including teen parents, to lead healthy sexual, reproductive, and family lives. Accurate education on contraceptive methods is crucial to empower youth to make responsible choices.

For example, as part of our grant with the Centers for Disease Control and Prevention Division of Reproductive Health, Healthy Teen Network provides training and technical assistance to state grantees, supporting the implementation of evidence-based programs to prevent teen pregnancy. Healthy Teen Network member and project grantee Erin Livensparger, of Planned Parenthood of Southern New England, Inc., recently attended a Healthy Teen Network five-day training-of-educators on evidence-based programs, and participated in follow-up technical assistance.

“I really enjoy the high caliber way Healthy Teen Network trains on curricula,” Erin says, adding that it was “really powerful” to attend the training, and that it was “really helpful” to be trained on three curricula, all at once. Erin has found that the Healthy Teen Network trainers have “always been accessible and [are] sort of like our über-trainers whom we aspire to be like.” She continues, “The trainers were really approachable, asking what we were thinking, sharing ideas.”

Healthy Teen Network technical assistance goes beyond a single training, providing both proactive and reactive support to build long-term capacity among youth-serving professionals.

Keeping an Eye on STI in the Age of LARC

Valerie Sedivy

Valerie Sedivy

In case you have been under a rock for the past few years, LARCs (otherwise known as Long Acting Reversible Contraceptives) are all the rage in the teen pregnancy prevention community. While implants and injectable contraception have been promoted for many years in this age group, the resurgence of the IUD (intrauterine device) has refocused our attention on LARCs in a big way. Given what we know about the failure rate of other contraceptive methods among teens, this may well be a good thing.

On the other hand, maybe it’s not as simple as it seems. By promoting LARCs among teens, are we inadvertently discouraging condom use? A recent Journal of Adolescent Health study suggests that this may be the case. Now keep in mind that this study only pointed to an association between the use of LARCs and decreased condom use. We cannot say for sure that the use of LARCs caused the decline in condom use. But it does suggest cause for concern. We all want to help teens avoid pregnancy in the most effective way possible, and clearly LARCs help us achieve that aim—and I would wager that none of us wants to do so at the expense of rising rates of STIs. As we all know, some STIs have consequences far more severe than pregnancy.

So what do we do? Do you have a clear and compelling way to make the case that condoms are still essential, even when a teen has the pregnancy risk covered? Is it realistic that teens will do both? After all, many may choose to use LARCs once they are in an ‘established’ relationship when they perceive the risks of STIs to be low to none. At what point is it OK to say “go ahead and skip the condom”? Is it ever OK?

Do the field a favor and share your thoughts and ideas. We need to address this issue more than ever. While teen pregnancy rates are on the decline, rates of STIs among this age group are still far too high and may climb higher if the use of LARCs increases at the expense of condom use.

Valerie Sedivy is a Senior Program Manager at Healthy Teen Network.

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