If birth control is easy to get, such as from a school clinic, more sexually active teens may use contraception.
That's the conclusion of a new study appearing in the November issue of the American Journal of Public Health, which compared direct distribution of contraceptives in a school clinic to a voucher system where the teens had to visit a community clinic to pick up birth control.
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At the same time, the researchers from the Minneapolis Department of Health and Family Support found easier access to birth control didn't encourage sexual activity among teens who were not sexually active.
Direct distribution works well
Direct distribution is a much more effective way to get sexually active kids on contraception, that, hopefully, in the long run will have an impact on teen pregnancy rates, says study author Abbey Sidebottom, an epidemiologist with the Minneapolis Department of Health and Family Support in the US.
Until 1998, Minneapolis high school students could receive birth control vouchers from school clinics they could later redeem at a community clinic for free contraception. But under this system, only 41 percent of the students redeemed all of the vouchers they requested.
Minneapolis teens studied
In 1997, the rate of teen pregnancy in Minneapolis was significantly higher than it was in the rest of Minnesota and in the United States. During that year, nearly eight percent of Minneapolis adolescents were pregnant compared to just over three percent in Minnesota and slightly less than six percent nationwide, according to the study.
In response to this growing public health crisis, the Minneapolis Department of Health and Family Support looked for more effective ways to distribute contraception. The agency already had five school-based clinics operating where teens could receive comprehensive health services, including contraception counselling and birth control prescriptions.
Parents who don't want their children to receive such services can request that their children not be seen at these clinics, or that they can be seen, but not for contraception services.
Direct distribution vs. voucher system
In May 1998, the agency switched from the voucher system to directly distributing birth control at the school-based clinics. Sidebottom points out teens couldn't just come in and get birth control. They had to schedule a comprehensive social and general health examination. She says teens are also encouraged to talk to their parents about sex.
Under the direct distribution system, 99 percent of the students received all of the contraceptives requested. Sidebottom says she believes more teens got their contraceptives simply because access was no longer a problem. Getting to the community clinics may have been difficult for some teens, she says.
Won't it encourage teens?
While some people might be concerned that offering birth control at school encourages teens to become sexually active, Sidebottom says this wasn't the case. Under both the voucher system and the direct access system, about 11 percent of teens requested contraception.
Health-care behaviours are not altered by the availability of reproductive health-care services for adolescents, says Dr Michael Lotke, a paediatrician who heads the adolescent wellness programme at Mount Sinai Hospital in Chicago.
These types of clinics aren't going to get these kids in trouble; they're only helping to protect them, Lotke says.
Findings surprise expert
One thing that did surprise Lotke was the number of teens (11 percent) who used the contraceptive services. He says he would have expected the number to be higher. But, he says it may be because parents didn't allow the clinics to offer the services to their teens, or because the teens were concerned about confidentiality. While school-based clinics offer the same confidentiality as other health-care providers, Lotke says teens may be concerned that people will see them entering or leaving the clinic, or they may have concerns - even if unfounded - that the information isn't as confidential as promised. - (HealthDayNews)
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