Issues affecting the adolescent population - Research Paper Example

?Issues affecting the adolescent population Introduction Adolescence is a period which marks a transition from childhood to adulthood. It is also a period which marks major physical and sexual developments which then readies the person for specific future roles and functions as a male or female. Secondary sexual characteristics also impact on the growing adolescence and with these developments, issues often manifest in the life of the adolescent. These issues include abortion, unprotected sex, body image issues, conduct behavior, drug abuse, sexual promiscuity, early pregnancies, and HIV/AIDS. These issues often revolve around the development of sexual characteristics and the hormonal changes which often cause the adolescents to act impulsively and recklessly. These issues often cause other problems to manifest in the adolescents life, with sexual promiscuity leading to pregnancy and HIV infection, and possibly, abortions. A clear and comprehensive evaluation of these issues needs to be carried out in order to establish clear solutions to some of these issues. This paper shall discuss two adolescent issues: abortion and HIV infection. First, a physical and psychological description of adolescents shall be made, and secondly abortion statistics and background data will also be presented. Thirdly, a background of HIV will also be established. Fourthly, the sociocultural, political, economic, legal, and ethical elements of these issues shall also be discussed. Fifth, the personal, professional and ethical implications of these issues will also be covered, as well as two of the most significant challenges being faced in resolving these social issues. Finally, a statistics research project proposal is also part of this research. Body Physical and psychological description of adolescents The adolescent population is the population in their puberty stage and undergoing sexual maturation and growth spurts (American Psychological Association, 2002). The process of maturation and development for adolescents takes years to unfold. The growth spurt is usually seen in age 10 to 12 among girls and 12 to 14 among boys; this process completes at around 17 years for girls and 20 years for boys (Hofman and Greydanus, 1997). Sexual maturation is earlier for girls and the physical changes include menstruation; for boys, their maturation starts with the enlargement of their testes at around 11 or 12. Secondary sexual characteristics also develop with boys growing body hair and with their voice changes (American Psychological Association, 2002). Girls also develop hair in their pubic, armpit, and leg area. They also develop their breasts; and more fat deposits on their hips, leading to more curvaceous physical features. For the boys, more muscular development is seen at the shoulders and their upper arms. Their behavior also changes with self-consciousness and a tendency to compare themselves with others being a predominant trait (Mannheim, 2011). Their sexual maturation also causes some of them to explore and experience their sexuality. Some actually develop sexually active and promiscuous behavior. For which reason, they may be involved in issues like abortion and HIV/AIDS. Abortion Statistics and background data on abortion Teenagers on the verge of sexual maturity are likely to explore such sexuality through unprotected sex. Their limited education and understanding of sexual activities can place them in danger of unwanted pregnancies. In order to resolve their situation, they may seek abortion. While abortion can safely be carried out without causing any physical dangers to the adolescents, abortions may also be carried out under unsafe circumstances which often endanger the life of the adolescent (de Bruyn and Packer, 2005). Among the poorest adolescents, the risks of unsafe abortion are especially ominous. Since younger women are more likely to be fertile than older women, the likelihood for pregnancy among adolescents is high. These adolescents are also less likely to have data about abortion or access to safe and legal abortion services. Their knowledge of abortion techniques may include the insertion of objects into the vagina to induce abortion, as well as the use of drugs and toxic substances to abort the fetus (de Bruyn and Packer, 2005). These adolescents may also resort to self-harm in order to induce a miscarriage. Unqualified abortionists may also be consulted and these illegal abortion clinics usually do not have hygienic, sterile, or safe places where they can carry out abortions (de Bruyn and Packer, 2005). Lack of knowledge in post-abortion care is also seen among these adolescents. As a result of these unsafe practices, incidents like cervical or vaginal lacerations, hemorrhage, bowel or uterine perforation, tetanus, pelvic infections and abscesses, and secondary infertility may occur (de Bruyn and Packer, 2005). More than a third of adolescent pregnancies in the US are terminated by abortion. Majority of these pregnancies are not intended and about half of these end in abortion (Child Trends Data Bank, n.d). Adolescents often choose abortion because they believe that having a child would significantly change and negatively impact on their lives. They also worry of the financial, educational, and social impact that the pregnancy would have on their lives. Government authorities estimate that adolescent abortions rose during the 1970s, leveled off in the 1980s, and then decreased steadily in the 90s until the year 2000. The younger teens usually manifest with lower abortion rates as compared to older teens, and in 2000, adolescents aged 15 manifested with abortion rates of 0.9 per 1000 as compared with 14.5 per 1000 among adolescents aged 15 to 17 and 37.7 per 1000 among adolescents aged 18 and 19 years (Child Trends Data Bank, n.d). More recent data from the CDC also indicates that the abortion rate among adolescents registered at 16.0 abortions per 1000. These figures represent alarming rates for abortion which also indicate negative implications on the health of the adolescents, especially those in the developing regions. Many teenage pregnancies are the result of sexual assault and for which reason, many of these pregnancies are terminated by the adolescent (Ipas, 2005). The adolescent may however not be physically mature enough to be pregnant; her pelvic bones and birth canal may not have fully developed as yet with the pelvis being too narrow to accommodate the child during the delivery. These teenagers are also susceptible to abortions with about 19% of abortions carried out among pregnant teens and with each years, about 13,000 of adolescent pregnancies are caused by rape or incest (Ipas, 2005). The most common causes for adolescent abortions include pregnancies caused by rape or incest, failure to use and of contraception, fears of upsetting parents, fears of expulsion from schools or work, lack of stable relationships, lack of financial means to support a child, dislike for the man who caused pregnancy (Ipas, 2009). Women who are either too young or too old to get pregnant often have a higher risk of injury or death during abortions and in instances where abortion is prohibited by law, these adolescents often have higher risks in complications and unsafe abortions. The risk for unsafe abortions and mortalities and morbidities associated with it may be seen with the following practices which are commonly used among self-induced abortions: insertion of objects into the vagina, use of drugs or toxic substances, attempts at inducing abortions through bodily harm, seeking assistance from unskilled providers, non-recognition of pregnancy at its early stages, and delays in seeking treatment (Ipas, 2009). Second issue AIDS/HIV Statistics and background data on AIDS/HIV Another issue which is very much related to unprotected sex is the issue of HIV/AIDS. Reports indicate that about 47% of high school students have had sexual intercourse and about 7% of them have had their first sexual contact before the age of 13 (CDC, 2008). The rate of prevalence for HIV/AIDS infection among adolescents have increased in the past two decades and young women seem to have the higher risk of HIV due to their biologic vulnerability, not knowing their partners’ risk factors, not using protection, and having sex with older men (CDC, 2008). Drug use among adolescents is also a risk factor because the sharing of needles may cause the acquisition or the transmission of HIV/AIDS. The adolescents’ lack of awareness on safe sex and AIDS prevention practices are also issues which make this population vulnerable. In 2004, about 4800 adolescents received a diagnosis of HIV or AIDS, and this represents about 13% of the population diagnosed with AIDS for that year (CDC, 2008). HIV progressed to AIDS at a slower pace, and within a year, the progression to full blown AIDS was seen at a proportion of 81% of adolescents aged 15-24; 70% aged 13-14, and 61% of all other individuals (CDC, 2008). These rates signify startling figures for adolescents, but they also present circumstances which can be managed through health education and prevention activities. Adolescents in the US have a persistent risk for being infected by HIV. This risk is particularly significant among minorities (CDC, 2008). In 2004, about 4800 people were diagnosed with HIV/AIDS, and it usually progresses slower among the younger population. Among African Americans and homosexuals, the rate of infection is higher. In the 2001 to 2004 time period, 33 states with confidential HIV reporting reported that about 17,000 individuals aged 13-24 were diagnosed with AIDS, 62% were males and 38% were females (CDC, 2008). Of about 2000 young people diagnosed with AIDS in 2004, 234 died of the disease and complications of the disease. Since this disease was first diagnosed in the US, about 40,000 young people were diagnosed with the disease and 10,000 of them died of the disease (CDC, 2008). There are various risk factors related to this disease, one of these being early age at sexual initiations (CDC, 2008). This means that the earlier the age for first sexual experience, the more likely that the adolescent would be exposed to the disease. Surveys indicate that about 47% of high school students have had sexual intercourse and about 7.5% of them have had their first sexual experience at the average age of 13 (CDC, 2008). Without sexual education, these individuals expose themselves to unprotected sex as well as unwanted pregnancies. Young men who have sex with men (MSM), and then later engage in heterosexual sex are also at a higher risk for being afflicted with AIDS. Most of these individuals do not let their sexual partners know that they are also sexually attracted to men (CDC, 2008). They are also less likely to submit to HIV testing and when they get infected would not likely know about it. Moreover, they are also more likely to spread the virus to the females they may have sex with (CDC, 2008). The highest rates of sexually transmitted diseases are also highest among young people, and this fact makes them even more vulnerable to HIV infection. Adolescents also have high rates of alcohol, tobacco, and drug use. These are risky behaviors which increase the risk engagement in unprotected sex and multiple sexual partners. Runaways and homeless adolescents also have a high risk for HIV infection, especially if some of them exchange sex for money (CDC, 2008). Limited awareness of AIDS is also one of the major risk factors among adolescents because most of them have wrong notions of the disease and often believe that they would not be afflicted by AIDS. Moreover, many of them have limited knowledge about using contraceptive methods to protect themselves against AIDS and pregnancies (CDC, 2008). As a result, these adolescents have a higher risk of being in the streets and being exposed to drugs and unprotected sex. Sharing of needs and unprotected sex are two of the main methods of AIDS transmission, as adolescents are not adequately acquainted with these risk factors. Sociocultural elements impacting on the above issues The stigma attached to adolescent pregnancies is often significant as these adolescents are often labeled as promiscuous and are not afforded the same respect granted to other adolescent girls. As a result of this stigma, adolescents are often prompted to have abortions instead of pushing through with their abortions (Mishra, 2011). They attach the feeling of shame to their actions and their pregnancy and would rather abort their babies rather than live through such shame and stigma. Society is very much divided on the issue of abortion with some people favoring it due to one’s freedom of choice, and other people not favoring it because of pro-life choices. Whether or not a person is pro-life or pro-choice, there is an unfavorable outlook given by society to these abortions. Some of the outlooks are based on moral and ethical grounds and some are based on legal grounds (Mishra, 2011). Political, economic, legal, and ethical elements of the issues The debate on abortion is an ongoing moral and legal fight. Although the Roe v. Wade case settled the pro-choice stance on abortion, various interest groups, including moralists have raised discussions on abortion throughout the years (Warren, 2008). For the most part therefore, abortion in the US is legal – a person’s personal choice. With this legal support, the practice of abortion among adolescents is legitimated. Adolescents have little hesitation in carrying it out based on legal considerations. In some instances, they need not inform their parents as well, they just need to go to an abortion clinic and book an appointment (Warren, 2008). Among some adolescents who do not have the financial means to raise a child, abortion is also seen as an easier option. They worry that they would not be able to raise the child because of their limited economic circumstance and opt to eliminate such burden instead. Despite the legality attached to abortion, there are still ethical and moral implications to this act. Moralists consider abortion as an immoral act, one which must bear punishment in the moral, if not the legal sense (Carroll, 2009). Premarital sex is also considered an immoral and unethical act by many moralists. As such, adolescents who belong to moralist families or who live within a strongly moralist society feel that they would be labeled as immoral for their actions once their pregnancy is revealed. As a result, many of them prefer to have the abortion before they are discovered to be pregnant (Carroll, 2009). Personal/professional/ethical implications of issues On a professional note, abortion among adolescents must be a decision which should not be taken lightly on the part of the adolescent opting for the procedure and on the part of those assisting in the procedure. The adolescent must be enlightened clearly about her option and she must be informed about the implications of the procedure, as well as the risks involved. As a professional who may be involved in these procedures, I must be able to professionally carry out my functions and to keep the procedure safe as much as possible for the patient. Infection control procedures must also be safeguarded by the health professionals. On a personal note, participation in abortion procedures is a personal choice for any health professional. These personal choices must not however be used to influence the decision of the adolescent to decide in one way or another. Two most significant challenges in solving social issues Two of the most significant challenges in solving social issues include limited resources and lack of sufficient information disseminated to the general population. Limited resources hamper the implementation and planning of solutions (Ginsberg, 1999). With limited resources, the government and other government agencies cannot implement solutions to these problems because they do not have the means to set forth policies and avail of tools which they can use to either change the status quo or implement new policies and solutions. Another problem is that the general population often has limited knowledge about these social issues (Ginsberg, 1999). As such they often do not know that their actions are causing them to be part of the problem, not part of the solutions. As exemplified above, many adolescents do not know that having unprotected sex can lead to AIDS and pregnancies. They also do not know that using unsafe methods of abortion can lead to sepsis and possible death. In effect, sufficient knowledge can actually prevent the occurrence of these social issues. Statistical research project proposal: Impact of socio-cultural factors on the rate and incidence of abortion among adolescents What will be measured and why: Level of impact of socio-cultural elements on the rate and incidence of abortion Plan to conduct research study: Interview adolescents aged 13-18 asking them how society and cultural traditions impact on their decision to have abortions. Who would be involved: Adolescents aged 13 to 18 years. Timeline: People needed to carry out the research: Principal researcher, co-researchers, statistician, and research assistants Statistical method of analysis: Percentage, mean Subjects required: Adolescent data demographics – age, gender, socio-economic status, educational status, engagement in premarital sex, engagement in unprotected sex, number of sexual partners. Importance of research study – how data can be used, who would use it: Data can be used in this case in order to establish how socio-cultural factors and pressures impact on adolescent choices. Teachers, school counselors, parents, and health workers involved with adolescents can use these data to establish possible solutions to these issues. Conclusion The discussion sets forth important details among adolescents, their biological and psychological development and circumstances which impact on their behavior and their general welfare. Their sexual maturity and development makes them more likely to engage in sexually promiscuous and risky behavior which then makes them likely candidates for unwanted pregnancies, abortions, and HIV/AIDS. They are not armed with the necessary knowledge and maturity to know that they need to use protection during sexual intercourse and that if they would abort their child they need to seek professional care. These risky behaviors endanger their health and ultimately, the lives of these adolescents. Reference American Psychological Association (2002). Developing Adolescents: A Reference for Professionals. Retrieved from http://www.apa.org/pi/families/resources/develop.pdf Carroll, J. (2009). Sexuality now: embracing diversity. California: Cengage Learning Centers for Disease Control and Prevention. (2011). Reproductive Health. Retrieved 22 October 2011 from http://www.cdc.gov/reproductivehealth/data_stats/index.htm Centers for Disease Control and Prevention. (2008). HIV/AIDS among Youth. Retrieved from http://www.cdc.gov/hiv/resources/factsheets/PDF/youth.pdf Centers for Disease Control and Prevention. (2009). HIV/AIDS among Youth. Retrieved 22 October 2011 from http://www.cdc.gov/hiv/resources/factsheets/PDF/youth.pdf Child Trends Data Bank. (n.d). Teen Abortions. Retrieved 22 October 2011 from http://www.childtrendsdatabank.org/pdf/27_PDF.pdf de Bruyn, M. & Packer, S. (2004). 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