Bridging the gap between sex education and clinical services

Improving access to sexual health information and services is critical to reduce unwanted pregnancies and STIs among adolescents and improve their overall sexual and reproductive health. One strategy to address barriers to care that they face is to include information about local sexual and reproductive health services during sex education programs.

California is the only known state to formally incorporate clinical information into adolescent sexual health programs. Bixby researchers talked to young people around the state to hear their thoughts on this information about services and their suggestions for improvement.

Young people said they received relevant information about clinical services during sex education and had positive impressions of local services. Most were satisfied with the information and said that it increased the likelihood that they would access services if they needed to.

They still identified barriers to seeking care. Embarrassment, stigma and parental disapproval were the most common concerns. They also brought up structural barriers like transportation, clinic location and clinic hours.

This research also highlighted the importance of privacy and confidentiality for youth. Providing information about how to access confidential services and details explaining how clinics protect their confidentiality could address some concerns about seeking services.

The young people in the focus groups also discussed the role that parents and guardians can play, serving as either helpers or barriers to care. Some said that they rely on their parents for support, including transportation and emotional support. They wanted their parents’ approval to access services.

The groups mentioned things to help people get care, including peer and family support, confidentiality, awareness and education, and accessibility. Their recommendations to improve connections to clinical services included providing more sex ed classes, widely sharing information about health services, and including clinic tours in health classes.

California’s innovative programs and policies of including information about local clinical services can serve as a model to increase awareness of youth-friendly sexual and reproductive health. Sexual health programs that include information about local clinics and services may help increase adolescent awareness and address common concerns like confidentiality and embarrassment. Clinical information should be a required component of sexual health education, and educators should also consider developing formal referral mechanisms to local services. Explaining what is included in sex education classes to parents and guardians, and providing information about how to talk to kids, could also help improve adolescents’ ability to access services.

While some barriers can be addressed directly in sexual health education classes, creating a supportive environment for young people seeking services may also require changes in societal norms, laws and policies. Ensuring that local clinics are accessible, confidential and respectful to youth is also crucial.

"I feel comfortable coming here and knowing it's confidential because, like, I feel uncomfortable if my mom knows I'm coming to get condoms or birth control, because my parents, they assume that I'm doing something bad … which is why knowing that it's confidential is something very important." (Los Angeles County).

"When [the health educators] were here, they said that if you go to Planned Parenthood, it's like secret. It's like nobody would know. Like they will not tell your parents or anything like that, so I think if they know that, they will feel comfortable going." (Sacramento County)