Many Male Teens Fatalistic About Unplanned Pregnancy

TUESDAY Sept. 6 (HealthDay News) -- Most sexually active male American teens say they have no intention of getting a girl pregnant, but more than half also believe it is likely that they will do so within the next six months, a new study finds.

This fatalistic attitude "highlights the need to have a larger conversation about pregnancy, condom use, and what the barriers to condom use might be among male adolescents," said lead researcher Cynthia Rosengard, an assistant professor of medicine at Brown University School of Medicine in Providence, R.I. "We need to help them, so that their actions fall more in line with their plans."

According to the Alan Guttmacher Institute, a nonprofit group focusing on reproductive health issues, by the time American teens reach age 17 most have already experienced intercourse. Institute data suggest that most young people start engaging in sexual relations at some point in their mid-to-late teens.

The institute also notes that although teen pregnancy rates dropped significantly in the 1990s, they remain much higher than those in other developed countries -- twice as high as in either Canada or England, and nine times higher than either the Netherlands or Japan. Nearly 80 percent of all teen pregnancies are unplanned -- accounting for an estimated 25 percent of all accidental pregnancies in the United States, according to the institute.

Reporting in the September issue of the journal Pediatrics, the study authors reviewed data from interviews with 101 sexually active teen males attending a sexually transmitted disease clinic in northern California between 1996 and 1998. The boys, aged 14 to 19, were questioned regarding their sexual attitudes and behaviors.

Forty-three percent of those interviewed were black, with white teens and Hispanics comprising another 15 percent each. About 11 percent of the teens were Asian.

While more than 75 percent of the male teens said they had no plans to get anyone pregnant over the next six months, more than 56 percent said there was nonetheless some likelihood they would do so whether or not this was their intention, the researchers report.

Almost 25 percent said they were both planning and likely to get someone pregnant, while 33 percent said the likelihood existed despite their lack of intention. Almost 43 percent said they neither planned nor thought it likely they would get someone pregnant.

Teens who thought they might get a partner pregnant in the near future also admitted to being less able to use condoms in "challenging situations." They also expressed less intention to use condoms in the future, compared with boys who believed they would not impregnate a girl.

Teens who actively planned on impregnating -- or thought they might do so accidentally -- tended to be less negative about pregnancy in general, and came from families with relatively less-educated mothers, the researchers added. Teen boys actively planning pregnancy also tended to subscribe to the notion that condom use undermined trust in a relationship.

The findings highlight the need to take young male viewpoints into account when tackling the issue of unplanned pregnancy, Rosengard said.

"Males inform how often intercourse takes place and whether or not condoms are used," said Rosengard. "Males can influence how the female feels about pregnancy, whether or not she'll have an abortion, and how the baby will be raised once it's born. And yet our work is one of the first of its kind because we focus on males, while most adolescent pregnancy work has focused only on females and their attitudes on pregnancy."

"The problem is that most male adolescents don't have discussions about reproductive health-care issues when they go to access health services," said Rosengard, who is also a researcher in internal medicine at Rhode Island Hospital. "So medical health-care professionals should be aware that that's something they should be talking about with their male patients -- not just their female patients."

David Landry, a senior research associate at the Alan Guttmacher Institute, agreed. He believes health-care professionals need to devote more time to frank discussions of reproductive issues with young males, instead of just handling crises as they arise.

"It's important that teens -- both male and female -- are empowered to feel that they have the right to discuss these issues with their doctor," he said. "And also -- in the U.S. as compared with many countries in Western Europe -- we struggle as a society with how to deal with issues of sexuality. So there's the issue of adults largely putting up barriers to discussions about sex."

But Landry said male teens face additional gender-specific obstacles.

"It's very apparent that health providers do not discuss the use of contraception with male adolescents too often," he noted. "In part I think this is due to the advances in contraception decades back, which gave females so much control over their own reproduction that the medical field and public health officials overstated the role of females and understated the role of males in pregnancy and STD prevention."

Nadine Kaslow, a professor and chief psychologist at the Emory University School of Medicine in Atlanta, believes "it's really important that health-care providers discuss reproductive issues equally with male and female patients. It takes two to tango, and doctors definitely have a responsibility to bring up the issue -- to discuss condom use."

But Kaslow stressed that communication with male teens about reproductive health needs to be broadly based, including parents and teachers as well.

"Teachers and other community leaders can help with all this," she said. "And it's also important that parents do this. It's a family responsibility. Of course, a lot of families don't believe in pre-marital sex, and so even though they may know or fear their son is having sex, they think if they don't talk to him about it, it will go away. So parents need to think about their own value systems and what the reality is."