Background: Addressing the sexual and reproductive health of young people can complement and enhance HIV/STD prevention efforts by taking a holistic view of health, considering underlying social issues, emphasizing wellness, focusing on relationships, and coordinating prevention efforts. With this broader approach, assessment, planning, and communication are especially important to ensure strategic activities that address youth HIV/STD prevention and sexual health.
Methods: Drawing on theory, research, and programmatic experience, members of the Centers for Disease Control and Prevention’s Workgroup on Adolescent Sexual and Reproductive Health developed a conceptual framework for youth HIV/STD prevention and sexual health. The framework is based on the social-ecological model and stages (i.e., early, middle, late) and domains (e.g., physical, cognitive, emotional) of adolescent development.
Results: The framework provides a broad overview of possible ways to address youth sexual and reproductive health. It lists 15 relevant environments (e.g., school, health service settings, home) and within each environment, examples of factors that influence sexual and reproductive health. For example, school connectedness, parent engagement, peer norms, extracurricular activities, and health and mental health services are important factors to consider within schools. Public health functions can be applied across the environments and factors to address sexual and reproductive health, and the framework defines four overarching functional domains: surveillance, research, program, and policy.
Conclusions:This framework provides a way to assess public health efforts to improve youth sexual and reproductive health by considering what functions are used in which environments to address which outcome(s). Moreover, the framework can help strengthen planning efforts and define prevention services. Gaps and priority actions can be identified by comparing current activities with the range of possible approaches to youth HIV/STD/pregnancy prevention outlined in the framework. Finally, the framework can help communicate current activities and future directions to internal and external partners, which will enhance coordination.