Teen Perspectives

1. Teen Perspectives Deena Ellison, Director, WV DHHR Adolescent Pregnancy Prevention Initiative deena.s.ellison@wv.gov Kate Flack, WISE in WV Program Manager, WV FREE kate@wvfree.org What WV youth think about sex Education, Pregnancy, and Relationships

2. Why are teen pregnancy and reproductive health education areas of interest?

3. Teens Are Having Sex FACTS • Before the age of 13 4.9% • By the 9th Grade- 25.3% • By the 10thGrade- 27.5% • By the 11thGrade- 43.6% • By the 12thGrade- 58.1% • Overall- 50.9% WV (YRBS, 2011)

4. WV Teen Birth Rate (age 15-17) Source: Kidscount.org/datacenter

5. Source: US Department of Health and Human Services, Office on Adolescent Health

6. National Campaign to Prevent Teen and Unplanned Pregnancy, The Public Costs of Teen Childbearing in West Virginia

7. Source: West Virginia Pregnancy Risk Assessment Monitoring System, Unintended Pregnancy Rates by Age, 2009.

8. The CDC lists teen pregnancy • as a Winnable Battle!

9. WV 2011 Youth Sexual Risk Behaviors • 50.9% of girls and 47.4% of boys in WV high schools have had sex • 39.8% of WV high school males did not use a condomthe last time they had sex • 74.5% of WV high school females did not use birth control pills before the last time they had sex • 12.0% of females and 16% of males in WV high schools were never taught in school about AIDS or HIV infection Source: WV YRBS Survey Results 2011

10. THE ISSUE: • More Sex, Less Protection • We wanted to know what teens thought.

11. Teen Perspective Focus Groups • Focus group design • Focused in 3 counties: Nicholas, Kanawha, McDowell • Quizzes WHY Nicholas, Kanawha and McDowell?

12. So, What did they have to say?

14. The Talk: Conversations with Parents

15. The Talk: Conversations with Parents • When asked about the types of conversations around sexuality at home and what was said teens replied: • “Use a condom, don’t get a girl pregnant” • “We don’t talk about that stuff at my house!” • “Don’t bring no babies home” • “If you want to have sex, tell me so I can make sure you are safe.” When asked who started the conversation, and was their info correct? Many youth felt they could trust the info their parents gave them simply because they had experienced childbearing. However, not all youth agreed. • “I’m pretty sure they have accurate information because they had me” • We don’t talk about that stuff at my house! 90% of students have had some type conversation with their parents about sex. Parents are often the conversation initiators.

17. Tools to talk Why can’t they just talk to us, why does it have to be complicated? • When asked what could be provided to help parents talk to teens about sex, teens suggested: • “Pictures- I like pictures” • “A book would be nice for parents so they could learn to talk with us and they won’t be jumping to conclusions” • “Parents don’t want teens to have sex PERIOD but if they had more information and could be more comfortable with it, it would be better for everyone.” • “Whether parents want it to happen or not it will. Make parents more comfortable.”

18. FACTS • PARENT FICTION • “My teens don’t want to hear what I have to say about relationships.” • “My teenager knows she can talk to me about anything!” • “It doesn’t matter what I say, my kid is going to do whatever he wants anyway.” • two thirds of teens report that they wish they could talk to their parents more about relationships • 18 percent of teens do not feel like they can discuss serious health issues with either parent • Nearly half of all teens say that parents most influence their decisions about sex

19. It isn’t comfortable to talk about sex with a teenager…but it is necessary! Knowledge is Power! When it comes to sex… • Teens are naturally curious. • Parents are naturally terrified. I want to talk to her but I’m afraid I’ll say the wrong thing. I wish I could ask my mom.

20. Repro Health 411: Where Teens get Their info • ON RELATIONSHIPS • TV • Friends • Family • “When you are surrounded by bad relationships you learn the bad things about relationships.” • “My friends who’ve been out there in the world” Social Media Facebook, Instagram, and Twitter

21. Repro Health 411: Where Teens get Their info • ON BIRTH CONTROL • School – Health Class • Parents/Family • Peers • School Clinic • Wellness Center • TV commercials My dad always said use duct tape. Family Planning Clinics where they give you free birth control.

22. Repro Health 411: Where Teens get Their info • ON PREGNANCY • TV shows • Friends • Family • Facebook • School • Pregnant or parenting teenagers I get my information from my friends who have had babies.

23. Repro Health 411: Where Teens get Their info On Sexually Transmitted Infections • School • Health Class • Clinic • Doctor • Ex-girlfriend/boyfriend • Internet People that have already had it if they talk about it Shoot man, everybody talking about that…

25. Sex Ed in School • When asked if they had received sex education in school many teens indicated they that had had NO sex education, while others sited they received sex education, but with varying consistency: • Only in health class for one semester one time during high school • In middle school, about puberty only • In 9th grade only, for one semester • “From people (guest speakers) that came and spoke to us about sex ed –– very good I learned a lot” • “People came in our school for a week – we went during health class – taught us about diseases, we acted out scenarios – I learned a lot” • For one semester in the gym • During parenting class • One time per week throughout the school year for one year

26. Sex Ed in School • When asked if they thought what they were taught was ENOUGH, an overwhelming number of teens said “no,” other teens responded: • “Yes, but we can always learn more” • “You can never get too much” When asked if the focus of their sex education was on health, ethical issues or fear the response was about even for each of the results. • Health 25% • Fear 25% • Morals 25% • A combination of all the above 25% Kids learn about it, but they don’t learn about it the right way. They think it’s scary.

27. Sex Ed in School • People need to realize it’s a part of life and it happens to everyone. Students were asked, What don’t they teach you that you feel is important? • “They don’t teach you enough” • “They don’t give out condoms” • “They don’t teach how to talk to your parents or how your parents will react” • “People need to realize it’s a part of life and it happens to everyone. There are changes in life and we should talk about them.” When asked what they would make different if they could change sex education in schools. Students suggested: • “Teach us how to put a condom on” • “Give more information at a younger age so we can be better prepared.” • “Teach us about all types of sex” (LGBTQ issues) • “Be honest and teach us what we need to know!” “I’m against sex ed in schools but I understand that some students don’t have adults at home to talk to.” “If you start at a younger age…we’ll be more comfortable when you need to tell us important things.”

29. opinions on Teen Pregnancy • Both, because they both decided to have sex so they should both have to take care of it • When asked who’s responsible if someone chooses to become pregnant, the majority of teens indicated both were, but there were a few thought the responsibility wasn’t equally shared. • “Depends on which one is more mature, but I guess the girl.” • “I believe the mother would take more responsibility than the father.”

30. opinions on Teen Pregnancy What needs to be in place before you have a child? • Money, Income, “Be financially prepared” • “You must have a job!” • Family Support • College Degree • House/Home/Place to live • Work out any relationship issues • Maturity and responsibility • “Be with someone you want to spend the rest of your life with” • Be stable and have a stable living situation

31. opinions on Teen Pregnancy When asked what they knew about becoming a parent as a teen, most all indicated it is very difficult and that their priorities would have to change. • “It is hard, because they can’t go to school and get the education they need.” • “A lot of my friends have had babies and it’s been hard for them; they didn’t get to go to senior beach week or walk across the stage with us.” • “Can’t leave a baby at home while you’re out partying.”

32. opinions on Teen Pregnancy When asked what teens thought about their peers having sex but not being responsible about birth control, most indicated that was an unacceptable choice: • “I think if you know how to protect yourself, you should” • If you’re going to choose to have sex, you need to be responsible and be a grown up - it’s not a kid thing. • I think it’s pretty irresponsible to have sex and not be protected, especially if you’ve already had a kid.

33. opinions on Teen Pregnancy When asked to discuss the possible benefits to teen pregnancy, most youth didn’t understand why a girl would want to get pregnant, but thought it may be to keep the guy around, get free food or housing, or to have someone to love them. • “Have a baby tryin’ to trap the dude and the dude wanna leave.” • “Watching TV, many girls think [having a baby] is so perfect, but in real life most times the guy leaves.” • “They tryin a have a baby to make him stay, to get that money, like money from the gov’t, or from the dude if the baby needs anything.” • “Some people get pregnant not for the money or the dude, but to have someone to love them.”

34. LGBTQ Youth in Schools • While many teens felt LGBTQ teens were treated equally, some disagreed • “Depends on who it is.” • “Honestly I think they’re treated like $#!+!” • “I think it’s like a social thing. I think the really reallyjocky & redneck guys are anti-gay. I don’t think it would be that hard for people to be gay in this school.” • When asked how sexual orientation & gender identity could be discussed in school, teens said: • “I think that when they talk about how ‘straight’ people have sex they need to talk about how ‘gay, lesbian, or whatever’ people have sex so they can be protected from disease.” • “I think they should teach about it, cause not everybody’s straight.” • “Gay and lesbian people have sex – they need to know protection”

36. “Bebopping”: Teen Relationships • Bebopping common in certain groups – “I was with this girl last week, with another this week” • When guys brag about multiple sex partners their relationships aren’t very open • I feel like, relationships just start. They do the typical dating thing, then they have sex. They avoid talking about the pregnancy thing. I don’t know if they just don’t feel comfortable about it. • “No communication – don’t know number of partners and their STI status” • “I think that as a whole, the couples that abstain from sex are overall longer lasting than the couples that don’t.“

37. One Teen’s Perspective On Birth Control “Contraceptive literally translates to “against life.” It gets rid of a fertilized egg. I don’t really see difference between taking birth control and having an abortion. I’m completely against contraceptives. If you love someone enough, you should wait. If you love them even more, marry them.”

38. Family Planning Access & Perceptions • When asked who’s responsibility is birth control, the majority of teens said both partners. • When asked to define family planning, many teens did not understand the question but could relate to the concept. “Family Planning is knowing when the right time is to have a family.” “It means planning when you are going to get married and have children.” “Knowing the time when you are ready.” “Understanding supporting your kids, waiting to have them when you can.” “Family planning is planning when you’re going to get married and have kids. My mom had me really young, so I don’t think she planned me, but she swears up and down that she did.” A large percentage of teens knew where the local family planning clinic was located. They did know birth control was available there, but did not know that services to teens were free and confidential.

39. Focus group Conclusions • Overall Themes • Sex education needs to happen earlier (at least by middle school) and more often • Rationalized responsibility through comments like “if you’re old/mature enough to do X, you should be old/mature enough to do Y” • Pregnancy is feared more than STDs but prevention of both is important • Teens felt they weren’t taught enough about consequences and relationship dynamics • Sex and reproductive health issues need to be discussed in a more casual way – not by shaming teens or being judgmental

40. What is currently being implemented

41. What is currently being implemented • The Adolescent Pregnancy Prevention Initiative (APPI) operates under the Office of Maternal Child and Family Health and is a focus area of their Family Planning Program. APPI is a statewide initiative that influences and supports teens as they explore and determine responsible sexual and reproductive options. APPI covers all 55 counties. Additionally, APPI administers the Federal Personal Responsibility Education Program (PREP) grant. Mission WV is a PREP grantee (Cabell County). Other grantees are: Children’s Home Society (Wood and McDowell), KISRA (Kanawha) and MountainHeart (Wetzel). • The THINK (Teaching Health Instead of Nagging Kids) program under Mission WV operates in 20 counties at 61 sites. Mission WV’s THINK program is funded by these grants: • Teen Pregnancy Prevention (US DHHS Adolescent Health) • Personal Responsibilities Education Program (WV DHHR) • Competitive Abstinence Education (US DHHS – ACF) Staff are fidelity-trained and use programs identified as evidence-based curricula (EBC)recommended by the Center for Disease Control and Prevention (CDC) for use in teen pregnancy prevention efforts.

42. Building Partnerships is our Goal! • WV Department of Education • WV Bureau for Public Health • Department of Health and Human Resources • Family Planning Program • Adolescent Pregnancy Prevention Initiative • Adolescent Health Initiative • Regional School Wellness Specialists • School Based Health Centers • Community Partners – PREP Grantees • Mission WV • Children’s Home Society • KISRA • Mountain Heart • WV Free • Planned Parenthood • Family Resource Networks and Centers • Family Planning Providers

44. Kanawha, Nicholas and McDowell County Schools West Virginia Department of Health and Human Resources Bureau For Public Health Office of Maternal, Child and Family Health Family Planning Program Adolescent Pregnancy Prevention Initiative Focus Groups made possible with THANKS to these organizations!