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2011 ElElPaso County Paso County Health Indicators Health Report 2011 Report


Section 1: Unsafe Sexual Practices and Teen Pregnancy

Unsafe sexual practice

leads to adverse outcomes including unintentional pregnancy (especially for teens), sexually transmitted infections (STIs), and human immunodeficiency virus (HIV). Teen pregnancy and teen mothering have been associated with repeat pregnancies and with higher incidence of STIs in that age group, potentially causing exposure of a fetus or newborn infant to these pathogens. Teen pregnancy also can lead to poor fetal or infant outcomes related to lack of prenatal care, gestational complications, low maternal weight gain, preterm delivery and low birth

weight. Adverse socioeconomic outcomes related to teen pregnancy have included single parenthood, marital instability, school dropout and lower educational attainment, unemployment and welfare dependency. In addition, in the U.S. the public costs associated with unintended pregnancies is $11 billion per year and $16 billion of annual health care costs is attributed to sexually transmitted diseases.

How is it measured?

(mistimed or unwanted). Teen birth rates, also referred to as teen fertility rates, are measured as live births per 1,000 teens aged 15-17 years. Youth Risk Behavior Surveillance System (YRBS) questionnaires measure the percent of high school students who have ever had sexual intercourse and the percentage of high school students who use birth control to prevent pregnancy. STI rates collected at the county and state level for all age groups are available through the state STI/ HIV surveillance program.

Data is collected by the state Pregnancy Risk Assessment Monitoring System (PRAMS) How are we doing in El to quantify the percent of Paso County? pregnancies that are unintended Figure 1 illustrates the

90 80 70

Percent

60 50 40 30 20 10 0 15-19

20-24

25-34 Age

35+

White

Hispanic White

Black

Race/Ethnicity

Figure 1: Proportion of pregnancies that were unintended, by age and race/ethnicity, El Paso County 2005-2009. Source: PRAMS; Health Statistics Section, CDPHE


proportion of pregnancies that are unintended in El Paso County. Unwanted or mistimed pregnancies generally indicate the efficacy of a person’s safe sexual practices. From 20052009, an estimated 77 percent of pregnancies for young women age 15-19 were unintended. For all women who gave birth in El Paso County in 2009, 38.5 percent of pregnancies were unintended. Approximately 38 percent of women whose pregnancy was unintended were using some form of birth control at the time of conception.

Figure 2 shows that teen

fertility rates in El Paso County and Colorado have been

trending downward in the past decade. Teen fertility rates are lower in El Paso County than for the state of Colorado as a whole, with 14.7 births per 1,000 women age 15-17 in El Paso County in 2010. Of young women age 15-19 that gave birth in El Paso County in 2010, approximately 12 percent of the births resulted in low birth weight babies, which is higher than the rate for women age 2044. Babies born weighing less than 5 pounds, 8 ounces (2,500 grams) are considered low birth weight. Low birth weight babies are at increased risk for serious health problems as newborns, lasting disabilities, and even death.

For teens with a lifetime history of sex, YRBS data indicates that approximately 74 percent used a reliable form of birth control during their last intercourse (Figure 4).

Figure 2: Teen Birth Rate for Females aged 15-17

35 Live births per 1,000 females aged 15-17

Teen sexual behavior data is available at the state level only, but is a reasonable reflection of trends in El Paso County. The 2009 YRBS survey indicates that nearly 44 percent of young men in high school have ever had sex and approximately 36 percent of young women have had sex. Roughly 1 in 10 high school students has already had four or more sexual partners in their lifetime (Figure 3).

30 25

Source: State and County Birth and Death Summary Tables

20

15

El Paso County Colorado

10 5

2010

2009

2008

2007

2006

2005

2004

2003

2002

2001

2000

0

Year

Figure 3: Sexual behavior among Colorado youth grades 9-12, 2009

50 45 40

Percent

35 30

Source: YRBS

25

Male

20

Female

15 10 5 0 Ever had sex

Had sex in past 3 Had sex before Had sex with 4+ months age 13 partners in life


However, only 6 in 10 sexually active teens (i.e., had sex in past three months) chose a birth control method which also protects against STIs, such as gonorrhea, chlamydia and HIV. In El Paso County, this translates to a high rate of infection for chlamydia and gonorrhea in the teen population. In 2010, teens age 15-19 experienced an infection rate for Chlamydia at 1,284.2 per 100,000 population and gonorrhea at 123.4 per 100,000 population. The rates of sexually transmitted infections for all ages in El Paso County are higher than the state average (Figure 5). While the numbers have been trending down in the

past decade for gonorrhea, the trend for chlamydia infections has remained relatively unchanged. In 2010, the rate of chlamydia infection among all ages is 435.4 per 100,000 population and the rate of gonorrhea infection among all ages is 65.2 per 100,000 population. The incidence of HIV and acquired immune deficiency

syndrome (AIDS) is another outcome of unsafe sexual practices. In El Paso County, there were 35 new diagnoses of HIV in 2010 and it is presumed that 428 people live with HIV and an additional 308 live with AIDS. The rate of HIV infection in El Paso County is lower than it is for Denver, Adams and Arapahoe Counties (Figure 6).

The rates of sexually transmitted infections for all ages in El Paso County are higher than the state average.

Other 3%

Not sure 5%

Withdrawal 8% No method 10%

Condoms 51% Birth control pills 19%

i

Depo-provera 4%

Robert Wood Johnson Foundation. 2011 County Health Rankings. http://www.countyhealthrankings.org/health-factors Healthy People 2020. iii PRAMS. Health Statistics Section, CDPHE. iv Colorado Birth Statistics, CDPHE. v March of Dimes. http://www.marchofdimes.com/Professionals/medicalresources_lowbirthweight.html vi YRBS, CDPHE. vii STI/HIV Surveillance Program, CDPHE. ii


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