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• Concerns about confidentiality limit access to sexual and reproductive health care, especially when young people rely on their parents’ health insurance.

In 2013–2015, 18% of all adolescents aged 15–17 and 12% of young adults aged 18–19 covered by their parents’ insurance reported that they would not seek sexual or reproductive health care because of concerns that their parents might find out.

• There has been a shift toward evidence-based interventions in the United States over the last few decades.

The first dedicated federal funding stream for evaluation of adolescent sexual health programs was established in 2010 and has contributed to improvement in the quality and quantity of evaluation research.

For example, the share of rural adolescents who had received instruction about birth control declined from 71% to 48% among females, and from 59% to 45% among males.

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• Leading public health and medical professional organizations—including the American Medical Association; the American Academy of Pediatrics; the American College of Obstetricians and Gynecologists; the American Public Health Association; the Health and Medicine Division of the National Academies of Science, Engineering, and Medicine (formerly the Institute of Medicine); the American School Health Association and the Society for Adolescent Health and Medicine—support comprehensive sex education.

• The share of adolescents aged 15–19 who had received formal instruction about how to say no to sex but had received no instruction about birth control methods increased between 2006–20–2013, from 22% to 28% among females and from 29% to 35% among males.

• Declines in formal sex education were concentrated among young people residing in rural areas.

• In 2011–2013, more than 80% of adolescents aged 15–19 had received formal instruction about STDs, HIV and AIDS or how to say no to sex.

In contrast, only 55% of young men and 60% of young women had received formal instruction about methods of birth control.

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