Health Services for Teens
Preventive health services can have a significant impact on an adolescent’s immediate and life-long health by reducing risk behaviors and preventing negative health outcomes.
Teens in the United States are less likely than younger children and adults to receive recommended preventive health services. Schools can play a critical role in facilitating the delivery of needed health services to teens, including sexual health services (SHS).
Teen Sexual Risk Behaviors
Although teens are generally healthy, sometimes they engage in sexual behaviors that put them at risk for HIV, STDs, and pregnancy. For instance, young people (13–24) accounted for an estimated 21% of all new HIV infections in the United States,1 and nearly half of the 20 million new STDs reported each year.2
- Among U.S. high school students surveyed in 2019, 38% had ever had sex and 46% of sexually active students did not use a condom the last time they had sex.3 Additionally, although teen pregnancy rates have declined consistently during the past 25 years, the rates of unintended pregnancy still remain high.
- One way to prevent HIV, STDs and unintended pregnancy among teens is to increase their access to and use of SHS, including HIV testing, contraceptive counseling, gonorrhea and chlamydia testing and treatment, and Human Papillomavirus (HPV) vaccination.4,5
What schools can do
Schools can help increase student access to health services. Schools have direct daily contact with more than 15.4 million students attending grades 9-12 in 2020, making schools vital partners in connecting teens to health services. School districts can help teens access health services either through provision of on-site school services or by referrals to youth-friendly health care providers in the community.
Many U.S. schools already have healthcare service infrastructure in place, including school-based health centers (SBHCs) or school nurses, and can play an important role in providing adolescents access to information to help reduce their risk and to services if they are needed.
There has been less attention on how schools can improve youth health services despite evidence for promising approaches.
Teens need preventive health services
Several national guidelines for preventive care specifically include recommendations for SHS for teens. Despite these official guidelines and recommendations, teens may not seek or have access to recommended SHS.
For instance, in 2019, less than 10% of all students reported having ever been tested for HIV,3 and results from an online survey found that only 7% of 15-19 year olds had been tested for STDs in the previous year.6
What CDC is Doing
CDC recommends actions that school districts and schools can take to ensure students have access to key SHS through on-site services at schools, or off-site referrals to youth-friendly, community-based health service providers. SHS can be provided by or linked to SBHCs, school nurses, and community healthcare providers.
One of CDC’s key programmatic strategies is to improve schools’ capacity to increase adolescents’ access to key preventive SHS either by providing on-site services or making referrals to adolescent-friendly community-based health service providers.
CDC provides program guidancepdf icon on how to increase student access to SHS by encouraging schools to
- Help ensure student confidentiality;
- Increase awareness of adolescent sexual health needs by providing medically accurate information to district and school staff, community partners, and parents;
- Raise student awareness of the need for and availability of SHS (e.g., school-wide social marketing campaigns);
- Establish solid community partners that can help deliver SHS on-site or serve as a source of referral; community partners can assist with sexual health education or professional development trainings;
- Establish a referral system that helps link students to youth-friendly providers; and
- Provide SHS on-site by expanding or making current services more appealing to students or adding new services.
Research shows poor mental health is associated with health risks during adolescence and into adulthood. Youth who feel sad and hopeless are more likely to engage in behaviors that put them at risk for HIV, STDs, unintended pregnancy, violence, substance use, poor grades, and potentially life-long health problems.3
Schools can provide social, physical, behavioral, and mental health services and build an environment that provides a sense of safety and connection for all students.
What Works In Schools
CDC’s fact sheet on sexual health services assists schools with following a recommended approach to school-based HIV, STD, and unintended pregnancy prevention.
Condom Availability Programs (CAPs)
Condom availability programs (CAPs) began in the early 1990s and are one way schools can help prevent HIV, STD, and pregnancy among teens. Research has shown that CAPs in high schools do not increase sexual activity among teens and can increase condom use among sexually active students and students at high risk.
- How Schools Can Support HIV Testing Among AdolescentsThis fact sheet explains why schools are important partners in supporting HIV testing among students and linking them to confidential health services.
- Sexual Health Services (SHS) Fact Sheetpdf iconThis fact sheet is for school districts and education agencies and explains the importance of health care resources and increasing student access to preventive health services.
- Teen Health Services and One-On-One Time with A Healthcare Provider: An Infobrief for ParentsThis infobrief explains how parents can help create a trusting relationship by allowing their teen one-on-one time with their healthcare provider.
- Healthy Students, Promising Futurespdf iconexternal iconThis toolkit provides state and local action steps and practices to improve school-based health.
- Developing a Referral System for Sexual Health Servicesexternal iconThis tool provides information and strategies implement referral systems and improve access to youth-friendly sexual health services.
- Get Yourself Tested for High Schools campaign home pageThis campaign provides information and materials to assist high schools with encouraging students to get tested for HIV and STDs.
- CDC. Diagnoses of HIV infection in the United States and dependent areas, 2018 (Updated). HIV Surveillance Report 2020;31.
- CDC. Sexually Transmitted Disease Surveillance 2018. Atlanta: U.S. Department of Health and Human Services; 2019.
- CDC. Youth Risk Behavior Surveillance—United States, 2019. MMWR Suppl 2020;69(1):1-83.
- U.S. Preventive Services Task Force. Guide to Clinical Preventive Services, 2014external icon. Content last reviewed June 2014. Agency for Healthcare Research and Quality, Rockville, MD. Accessed 31 March 2021.
- CDC. Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Health-Care Settings MMWR 2006;55:1-17.
- Cuffe KM, Newton-Levinson A, Gift TL, McFarlane M, Leichliter JS. 2016. Sexually Transmitted Infection Testing Among Adolescents and Young Adults in the United States.J Adolesc Health; 58(5):512-9