While teen pregnancies and births are at historic lows in Minnesota, the rate of sexually transmitted infections (STIs) among the state’s adolescents has reached a record high, according to a new University of Minnesota Medical School report.
The report attributes the “alarmingly high” STI rates to a variety of factors, including a lack of adequate resources for STI prevention, testing and treatment.
“Minnesota youth should be commended for making safe and healthy choices about pregnancy prevention,” said Jill Farris, one of the report’s authors and director of the U of M’s Healthy Youth Development – Prevention Research Center, in a released statement. “However, increased attention must be paid to the importance of condoms and other barrier methods, widespread adoption of innovations in STI screening, and expanded access to STI treatment.”
A continuing downward trend
In what has been a remarkable turnaround, the pregnancy rate of Minnesota’s teens aged 15 to 19 declined by 72 percent, and their birth rate fell by almost 67 percent, between 1990 and 2017, according to the report.
During that same period, the pregnancy and birth rates for young people under the age of 15 dropped by more than 80 percent, although those declines may be magnified because of the small number of teens in that age group who become pregnant or give birth, the report notes.
Minnesota’s decreasing teen pregnancy and birth rates mirror what has been occurring nationally. From 1991 to 2017, the birth rate among U.S. adolescents aged 15 to 19 fell by 70 percent, reaching a record low of 18.8 births per 1,000.
That rate is still one of the highest among developed nations, however — five times higher than Japan, Denmark and the Netherlands, six times higher than Switzerland, and almost 10 times higher than South Korea, the U of M report points out.
The report also found that a troubling high proportion — 16 percent — of Minnesota’s adolescent mothers give birth a second time while still in their teens.
“Pregnancy prevention among teen parents is a complex issue,” Farris and her colleagues write. “Adolescents who experience a subsequent birth are more likely to be younger at first sex and first birth, have lower educational expectations and attainment, have intended their first birth, be living with a partner, and have not been employed or in school after their first birth.”
Although the number of teens having babies is larger in the Twin Cities Metropolitan Area, the rates of teen pregnancies and births are higher in Greater Minnesota. Indeed, the 10 counties with the highest teen birth rates are all located in Greater Minnesota, the report points out.
“In rural areas, access to confidential, affordable, youth-friendly health care may be limited,” write Farris and her colleagues.
“There are large geographic disparities in sexual health clinics’ hours of availability and distance to services,” they add. “For example there are 18 sexual health clinics in Hennepin and Ramsey counties, with services available five days per week. In contrast, 47.5 percent of rural counties in Minnesota have no sexual health clinic.”
There are also racial and ethnic disparities in sexual health outcomes for Minnesota’s youth. The birth rate for Minnesota’s American Indian adolescents is almost six times greater than that of white teens, and the rates for black and Latinx youth are almost three times greater.
The largest number of Minnesota’s teen births, however, occurs among white youth.
Sexually transmitted infections
Although adolescents aged 15 to 19 make up only 7 percent of Minnesota’s population, they accounted for 25 percent of chlamydia and 17 percent of gonorrhea cases in the state in 2018, according to the report.
Youth from Minnesota’s communities of color have disproportionately higher rates of STIs, the study notes. The gonorrhea rate is almost 25 times higher and the chlamydia rate is almost nine times higher among black youth than among white youth.
“Young people are using highly effective contraceptive methods, but clinicians and educators must continue to stress the importance of barrier methods for STI prevention and strive to provide accessible, confidential screening and treatment services,” said Farris.
Young Minnesotans who have a history of homelessness or running away from home, as well as those who are in a juvenile correctional facility, are significantly more likely to be sexually active, to have been involved in a pregnancy, and to have not used a condom during their last sexual encounter, than other youth, the report also found.
“Youth who are homeless, runaway, and/or in juvenile correction facilities represent our most vulnerable young Minnesotans,” said Farris. “The systems that serve these youth have a unique opportunity to intervene to support their health care needs, and everyone has a role to play to ensure these youth have a successful transition to adulthood.”
“While focusing on changing individual behaviors leading to pregnancy is needed, additional attention must be paid to social determinants that are a critical factor in the sexual health outcomes of our youth,” she added. “Reducing systematic barriers to resources, power, and opportunity will empower Minnesota youth to make healthy decisions, improving adolescent sexual health starts with all of us.”
FMI: The report can be read in full at the University of Minnesota Medical School’s website. You’ll also find there individual reports on each Minnesota county. The Healthy Youth Development – Prevention Research Center will be hosting a free Webinar on “The State of Adolescent Sexual Health in Minnesota” on July 2.