also available in [pdf] format.

focus on sexual and reproductive health

across the united states, young people are at risk for unintended pregnancy and sexually transmitted infections (stis) including hiv. due to structural barriers and policies that do not support young people’s rights to honest, medically accurate information and services, florida’s youth are likelier to experience pregnancy, hiv, aids, and other sti diagnoses than most young people in the united states. comprehensive sexuality education, health equity, and access to contraception are more important than ever to the health of young people in the state.

florida’s youth population: an overview

• according to the 2014 american communities survey, florida’s population is 77.8 percent white, 16.8 percent african american, 2.8 percent asian, 24.1 percent hispanic or latino, .5 percent american indian, and .1 percent native hawaiian or pacific islander. [1]
• as of 2014, 12.9 percent of florida’s 19,361,792 were between the ages of 15 and 24. [2]

sexual health outcomes in florida: young people have high rates of pregnancy, hiv, and stis

• according to the florida youth risk behavior survey, in 2013 30.6 percent of high school students reported currently being sexually active, compared with 34 percent nationwide. 44.3 percent of high school students reported ever having sex, with 6.7 percent reporting having sex before age 13 and 13.3 percent reporting having sex with four or more partners during their lifetime – all roughly in line with or below the national rates.3 12.6 percent of high schoolers in florida had used no method to prevent pregnancy during the last time they had sexual intercourse, compared with 13.7 percent nationwide. [4]
• even though florida’s youth have roughly average sexual behaviors, in 2013 there were 10.8 hiv diagnoses for every 100,000 young people aged 13-19 in florida, over 1.5 times the national rate.5 the rate of aids diagnoses among young people 13-19 was 2.9 per 100,000 – almost double the national rate.6 rates of hiv and aids diagnoses above the national average also exist for young people 20-24 – at 54.1 per 100,000 and 14.6 per 100,000 – were both well higher than nationwide. [7]
• in 2013, florida had the fourth highest rate of syphilis among young people age 15-19.8
• in 2010 there were 60 pregnancies per 1,000 florida women age 15-19 – the 19th highest teen pregnancy rate in the united states. there were 19 abortions per 1,000 women age 15-19, the 9th highest rate in the u.s. [9]

social and structural factors put youth of color and lgbtq youth in florida at risk

• racial disparities in health outcomes for young people in florida are stark: although african americans make up 16.8 percent of florida’s population and hispanics make up 24.1 of florida’s population in 2011, 36 percent of births to women under 20 were to black women and 27 percent were to hispanic women.10 in 2014, 67 percent of new hiv diagnoses among young people ages 13-24 were among black/african american young people. [11]
• disparities in barriers to accessing healthcare services, poverty, structural exclusion, and disadvantage all contribute to young people’s ability to prevent unintended pregnancy, hiv, and stis. florida has some of the worst rates of health insurance coverage and affordable housing in the country, and a full 18 percent of young people 18 to 24 were neither in school or working as of 2012. [12]
• lesbian, gay, bisexual, transgender, and queer (lgbtq) youth in florida are marginalized, increasing their risk of hiv, stis, and other negative health outcomes: the national youth risk behavior survey found that 11 percent to 30 percent of gay and lesbian students and 12 percent to 25 percent of bisexual students surveyed did not go to school at least one day during the prior month because of safety concerns. these concerns put lgbtq youth greater risk for depression, substance use, and sexual behaviors that place them at risk for hiv and stis. [13] as a result, in florida the hiv epidemic in the state is disproportionately concentrated among men who have sex with men, with over 50 percent of new diagnoses among young people in 2014 related to male to male sexual contact. [14]

ex education in florida varies by district, but most parents want comprehensive sex ed

• in florida, school districts have the discretion to create health education curricula which “reflect local values and concerns.” thus, school districts – including broward county school district,15 which serves over 260,000 students16 – have chosen to create comprehensive sex education policies that comply with department of education guidelines recommending selecting an evidence-based and medically accurate curriculum. [17]
• where districts have not created a specific policy, they may use florida’s state statutes. these require health instruction that emphasizes abstinence, and whenever instruction on human sexuality is given, it must emphasize that abstinence until heterosexual marriage is the expected standard for school age students. [18]
• recent research on abstinence-only programs found them ineffective, with no impact on reducing teen pregnancy, delaying sexual initiation, or reducing stis. recent research on comprehensive sexuality education has shown that young people who receive complete and accurate information about abstinence, condoms, and contraception were not more likely to acquire an sti, but were significantly less likely to be involved in teen pregnancy and were significantly more likely to use condoms once sexually active. [19]
• although florida youth face higher rates of hiv and aids diagnoses than the national average, 16.9 percent of high school students in 2013 had never learned about hiv or aids in school, compared with 14.7 percent of high school students nationwide. [20]
• in fiscal year 2014 agencies and organizations in florida received a total of $6,840,141 in teen pregnancy prevention program grants, $1,813,398 in department of adolescent & sexual health grants, and $4,548,090 competitive personal responsibility education program grants, to help implement targeted programs that have more comprehensive approaches to sexual health education for certain groups of young people.21 that year, agencies and organizations in florida also received $2,738,485 in title v abstinence-only-until-marriage funding. [22]

conclusion

young people in florida are at serious risk for unintended pregnancy, hiv and stis. youth of color and lgbt youth are at even higher risk for negative sexual health outcomes. to address these risks, research shows that comprehensive sexuality education and access to contraceptive services can help young people protect their health and well-being.23 in addition to helping young people choose healthier behaviors, we must also dismantle barriers to health equity (including poverty, lack of insurance, and disparities in education) and support structural interventions that help allow all young people to build healthy lives.

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references

1. u.s. census bureau, state and county quick facts. florida. available at: http://quickfacts.census.gov/qfd/states/12000.html. accessed on january 27, 2016.

2. u.s. census bureau, 2010-2014 american community survey 5-year estimates. florida. available at: http://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?pid=acs_14_5yr_s0101&prodtype=table. accessed on january 28, 2016.

3. centers for disease control & prevention, adolescent and school health: yrbss results. available at: http://www.cdc.gov/healthyyouth/data/yrbs/results.htm. accessed on january 21, 2016.

4. ibid.

5. slide 9: “rates of diagnosis of hiv infection among adolescents aged 13–19 years, 2013—united states and 6 dependent areas,” hiv surveillance in adolescents and young adults (atlanta, ga: centers for disease control and prevention), www.cdc.gov/hiv/pdf/statistics_surveillance_adolescents.pdf. accessed on january 28, 2016.

6. slide 18: “rates of stage 3 (aids) classifications among adolescents aged 13–19 years with hiv infection, 2013—united states and 6 dependent areas,” hiv surveillance in adolescents and young adults (atlanta, ga: centers for disease control and prevention), www.cdc.gov/hiv/pdf/statistics_surveillance_adolescents.pdf. accessed on january 28, 2016.

7. slide 10: “rates of diagnoses of hiv infection among young adults aged 20–24 years, 2013—united states and 6 dependent areas,” hiv surveillance in adolescents and young adults (atlanta, ga: centers for disease control and prevention), www.cdc.gov/hiv/pdf/statistics_surveillance_adolescents.pdf. accessed on january 28, 2016.; slide 19: “rates of stage 3 (aids) classifications among adolescents aged 20–24 years with hiv infection, 2013—united states and 6 dependent areas,” hiv surveillance in adolescents and young adults (atlanta, ga: centers for disease control and prevention), www.cdc.gov/hiv/pdf/statistics_surveillance_adolescents.pdf. accessed on january 28, 2016.

8. nchhstp atlas, “std surveillance data” (atlanta, ga: centers for disease control and prevention), available at: http://gis.cdc.gov/grasp/nchhstpatlas/main.html. accessed on january 28, 2016.

9. kost, k., and s. henshaw, u.s. teenage pregnancies, births, and abortions, 2010: state trends by age, race, and ethnicity (new york: guttmacher institute, 2014), available at: www.guttmacher.org/pubs/ustptrends10.pdf, table 3.1.

10. office of adolescent health, florida. reproductive health facts. available at http://www.hhs.gov/ash/oah/adolescent-health-topics/reproductive-health/states/fl.html. accessed on january 28, 2016.

11. florida department of health, hiv disease among adolescents (ages 13-19) and young adults (ages 20-24). available at: http://www.floridahealth.gov/diseases-and-conditions/aids/surveillance/_documents/fact-sheet/2014/2014-adolescents-young-adults.pdf. accessed on january 28, 2016.

12. talk poverty, florida (2014). available at: http://talkpoverty.org/state-year-report/florida-2014-report/. accessed on january 28, 2016.

13. centers for disease control & prevention, lgbt youth. available at http://www.cdc.gov/lgbthealth/youth.htm. accessed on january 21, 2016.

14. florida department of health, hiv disease among adolescents (ages 13-19) and young adults (ages 20-24). available at: http://www.floridahealth.gov/diseases-and-conditions/aids/surveillance/_documents/fact-sheet/2014/2014-adolescents-young-adults.pdf. accessed on january 28, 2016.

15. broward county public schools, policy 4315: family life and human sexuality, may 2014. available at: http://www.broward.k12.fl.us/sbbcpolicies/docs/policy percent205315.pdf accessed on january 29, 2016.

16. national center for education statistics, common core of data, district directory information: broward. available at: http://nces.ed.gov/ccd/districtsearch/district_detail.asp?details=1&id2=1200180. accessed on january 29, 2016.

17. florida department of education. florida’s sexual health education community outreach toolkit, 2010.

18. ibid.

19. kohler et al. “abstinence-only and comprehensive sex education and the initiation of sexual activity and teen pregnancy.” journal of adolescent health, 42(4): 344-351.

20. centers for disease control & prevention, adolescent and school health: yrbss results. available at: http://www.cdc.gov/healthyyouth/data/yrbs/results.htm. accessed on january 21, 2016.

21. sexuality education information council of the united states. state profile: florida. 2014. available at: http://siecus.org/document/docwindow.cfm?fuseaction=document.viewdocument&documentid=558&documentformatid=639. accessed on january 28, 2016.

22. ibid.

23. alford s. science and success: sex education and other programs that work to prevent teen pregnancy, hiv & sexually transmitted infections. washington, dc: 喀麦隆vs巴西波胆分析 , 2003.

24. millet, ga. explaining disparities in hiv infection among black and white men who have sex with men: a meta-analysis of hiv risk behaviors. aids 21 (15) 2083-2091. and hallfors dd. sexual and drug behavior patterns and hiv and std racial disparities: the need for new directions. american journal of public health 2007; 97(1): 125-132.

25. alford s. science and success: sex education and other programs that work to prevent teen pregnancy, hiv & sexually transmitted infections. washington, dc: 喀麦隆vs巴西波胆分析 , 2003. 26. http://www.siecus.org/index.cfm?fuseaction=page.viewpage&pageid=1197