While pregnancy and birth rates continue to decline to historic lows for 15 to 19-year-olds, Minnesota youth are contracting sexually transmitted infections (STI) at alarmingly high rates. The 2020 Minnesota Adolescent Sexual Health Report from the University of Minnesota Medical School's Healthy Youth Development - Prevention Research Center (HYD-PRC) attributes the rise in STI rates to a combination of factors, including barriers to prevention, screening and treatment services, education, transportation, cost, concerns about confidentiality and peer and media influences.
Teen pregnancy and birth rates are at historic lows, and Minnesota youth should be commended for making safe and healthy choices about pregnancy prevention. However, we must continue to highlight the importance of condoms and other barrier methods, utilize new and innovative public health educational campaigns to reach youth and expand access to STI services and treatment."
Jill Farris, Director of Adolescent Sexual Health Training and Education for the HYD-PRC
The HYD-PRC's report notes that Minnesota youth are disproportionately impacted by sexually transmitted infections. While adolescents aged 15 to 19 are only 7% of the Minnesota population, they accounted for 24% of all chlamydia cases and 15% of gonorrhea cases in Minnesota in 2019. "It's encouraging that young people are using highly effective contraceptive methods and increasing their use of condoms (up 3% since 2016), but discussions around the importance of barrier methods for STI prevention must continue. Confidential screening and treatment services must be easily accessible for youth, and families need to be supported to have open and nonjudgmental conversation with their children," Farris said.
Disparities in sexual health outcomes - by geography, race and ethnicity - continue to persist, as well. Rural areas in Minnesota continue to experience the highest teen birth rates in the state. Youth from communities of color have disproportionately high STI and birth rates. Birth rates for American Indian, Black and Hispanic youth are higher than for white and Asian/Pacific Islander youth. Adolescents from communities of color experience disproportionately higher rates of STIs, with the highest chlamydia and gonorrhea rates among Black and Hispanic youth.
Minnesota youth are also increasingly identifying their sexual orientation and gender identities on a broad spectrum. In 2019, 14% of male and 26% of female high school students identified their sexual orientation as something other than heterosexual (straight). "This is a dramatic increase from the 2016 figures," Farris said. Youth were also asked about their gender identity; 1.4% of Minnesota high schoolers identified as transgender, genderqueer or genderfluid.
"Students are increasingly fluid in their gender identities and sexual orientations. Health care providers, teachers, youth workers and parents need to respond by providing accurate, non-judgmental information and support to all youth," Farris said. Importantly, diverse sexual orientations and gender identities were reported throughout Minnesota. Young people from rural, suburban and urban areas are represented in these numbers.
This annual report helps Minnesotans understand the current landscape of our young people's sexual and reproductive health and how it is tied more broadly to healthy youth development.
"While focusing on changing individual behaviors that lead to decreases in STIs and teen pregnancy is needed, our youth deserve a holistic approach. We must fully support young people's health by addressing their physical, social, emotional and cognitive development and provide them with skills and support to make healthy decisions," Farris said. "Reducing systematic barriers to resources, power and opportunity will empower Minnesota youth to make healthy choices. Improving adolescent sexual health outcomes starts where we live, learn, work and play."
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