ADOLESCENT

SEXUAL HEALTH IN THE STATE OF IOWA

WHAT WE KNOW

Sexuality is a natural, human trait.
In adolescence, we experience significant physical, psychological, and social changes related to our sexuality. We also explore behaviors, values, and feelings which in turn shape our identities.

Sexual health isn’t simply avoiding negative outcomes.
Sexual health at any age is “a state of physical, emotional, mental, and social well–being in relation to sexuality; it is not merely the absence of disease, dysfunction, or infirmity.”

Sexual health is determined by life choices, social and structural factors, and access to education and services.
Healthy sexual development is impacted by an adolescent’s level of access to quality sex education, safe and affordable healthcare, and family support. Outcomes are also influenced by poverty and discrimination, gender inequities and gender role expectations, and the assumption that everyone is or should be heterosexual.

MEET THE TEENS

Iowa’s population is over 3.1M. Of that, 214,359 (7%) are teens 15 – 19 years old who identify as:

WHAT WE SEE

Education, family and community support, health care access, and poverty influence adolescent sexual health outcomes. Barriers may increase depression, isolation, and violence.

In Iowa, 89% of students graduate high school, 16% live below the poverty level, and 4% under age 18 lack health insurance.

The Iowa Youth Survey reports that of 6th, 8th, and 11th graders:

• 78% have positive family relationships while 69% experience family involvement and support
• 84% agree adults in their community care about teens
• 75% agree their school peers respect each other’s differences (e.g., gender, race, culture, sexual orientation)
• 54% report having been bullied at least once (including name-calling, being excluded or ignored, having false rumors spread, making sexual jokes, being physically hurt, or electronically bullied)
• 11%  of females have received a hurtful electronic message while 12% had something hurtful shared on social media
• 95% of gay, lesbian, bisexual, and transgender youth felt excluded while 88% deal with rumors/ lies

FIGURING IT ALL OUT

Meaningful responses from parents, schools, healthcare providers, and faith communities help teens understand their sexual values.

Against their values to have sex as a teenager:

• 6th Graders – 85%
• 8th Graders – 81%
• 11th Graders – 45%

Iowa’s High School Youth Risk Behavior Survey from 2011* indicates:

• 56% of high schoolers haven’t had sex
• 44% of high schoolers have had sex: Freshmen (21%), Sophomores (40%), Juniors (56%), and Seniors (58%)
• 4% had sex before age 13
• 21% of seniors have had 4+ sexual partners

In the past 30 days, 11th graders surveyed:

• Drank Alcohol – 23%
• Used Tobacco Products – 14%
• Used E-Cigarettes – 14%
• Smoked Marijuana – 11%

Among sexually active teens*, 61% used condoms, 37% used birth control, and 18% drank or did drugs at last sexual intercourse. Overall, teens report increased use of LARCs and all other forms of contraception, except condoms.

CONSENT FOR MINORS

Teens age 13 and under cannot give consent in Iowa. Consent can be given by teens ages 14 – 15 if their partner is less than four years older. Minors can give unrestricted consent starting at age 16. (Iowa Code § 709.4) Minors may consent to contraceptive services as well as HIV/STD testing and treatment starting at age 12. Parents must be notified if a minor tests positive for HIV. Some testing facilities, e.g. Title X clinics, are exempt from notifying a minor's legal guardian by federal statute, regulation, or Centers for Disease Control and Prevention guidelines. (Iowa Code 139A.35, 141A.7) Minors may consent to an abortion without parental permission, but treatment facilities must notify a parent or grandparent at least 48 hours prior to the abortion. Exceptions are granted in abuse, assault, incest, and/or neglect situations or in medical emergencies. (Iowa Code 135L.3) Sexting may be prosecuted under Iowa’s law prohibiting Dissemination and Exhibition of Obscene Material to Minors(Iowa Code 728.2) or Sexual Exploitation of a Minor. (Iowa Code 728.12)

SEX ED IN PUBLIC SCHOOLS

Iowa law mandates that schools must provide age-appropriate, research-based instruction in human growth and development in grades 1 – 12. This instruction must be free of racial, ethnic, sexual orientation, and gender bias, and be culturally appropriate. However, many schools don’t require courses that include sexual health education. Required topics include self-esteem, stress management, interpersonal relationships, human sexuality, domestic abuse, HPV and its vaccine, and HIV/AIDS. Schools may teach abstinence-based or abstinence-only curricula if it meets the human sexuality component of the human growth and development requirements. School districts must notify parents about curriculum content annually. Parents may review materials and opt their children out if desired. (Iowa Code 279.50)

SEXUALLY TRANSMITTED DISEASES and HIV/AIDS

Gender disparities in STD rates exist due to physiological and social factors, and greater female testing rates.

• Statewide, teens 15 – 19 years account for 22% of chlamydia cases, 18% of gonorrhea cases, and 5% of syphilis cases.

• In Iowa, 2,496 people live with HIV/AIDS, and 119 of them are under age 19 (5%).

TEEN BIRTH RATE ON THE DECLINE

Despite progress, teens still need age–appropriate, accurate information on abstinence and contraception.

• About 55,430 women aged 13 – 19 need publicly-funded contraceptives and services.
• Most teen mothers are 18 – 19 years old (74%); 25% of teen mothers are 15 – 17 years.
• The cost of teen childbearing is estimated to be $85 million (2010 dollars).

THE FACTS: In Iowa, the number of teen births has decreased 39% since 2011.

BIRTHS PER 1000 FEMALES, 15-19 YEARS

THE FACTS: Iowa’s teen birth rate is lower than the U.S. rate, but minority teens have a disproportionately higher teen birth rate compared to the statewide rate: Hispanic (48), Black/African American (47), and American Indian/Alaska Native (34).

Most (66%) teen mothers received prenatal care during their first trimester, but 7% had no or late prenatal care. Nearly 1 in 7 births (14%) to mothers under 20 are subsequent births

To view the county breakdown data of births to teen mothers in Iowa, click here.

VIOLENCE IN DATING AND SEX

Teen dating violence and sexual violence impedes the healthy sexual development of too many Iowa teens.

Among reported forcible* rape victims in 2015, 30% were 13 – 17 years old. Females were the victim 95% of the time.

“Forcible” defined by law as “any sexual act directed against another person, forcibly and/or against that person’s will; or not forcibly or against the person’s will where the victim is incapable of giving consent.”

• 8% of teens in 9th through 12th grade have been hit, slapped, or physically hurt on purpose by their partner, and 10% of females and 4% of males have been forced to have sex.
• In 2015, there were 263 teen domestic abuse victims aged 18 – 19 and 47 were 13 – 17.

In Iowa, minors can obtain Protective Orders (POs), and courts can issue them against minor abusers. Iowa also allows people in dating relationships to seek POs against their abusers (Iowa Code § 236). However, Iowa law does not currently provide for a school response to dating violence.