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• Both the American Medical Association and the American Academy of Pediatrics recommend that adolescents’ primary care visits include time alone with health care providers to discuss sexuality and receive counseling about sexual behavior.

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• There has been a shift toward evidence-based interventions in the United States over the last few decades.The first dedicated federal funding stream for evaluation of adolescent sexual health programs was established in 2010 and has contributed to improvement in the quality and quantity of evaluation research.• The share of adolescents aged 15–19 who had received formal instruction about how to say no to sex but had received no instruction about birth control methods increased between 2006–20–2013, from 22% to 26% among females and from 29% to 35% among males.• Declines in formal sex education were concentrated among young people residing in rural areas.• As of 2015, fewer than six percent of lesbian, gay, bisexual and transgender (LGBT) students aged 13–21 reported that their health classes had included positive representations of LGBT-related topics.

• Leading public health and medical professional organizations—including the American Medical Association; the American Academy of Pediatrics; the American College of Obstetricians and Gynecologists; the American Public Health Association; the Health and Medicine Division of the National Academies of Science, Engineering, and Medicine (formerly the Institute of Medicine); the American School Health Association and the Society for Adolescent Health and Medicine—support comprehensive sex education.

• Within each state, relatively few high schools offered instruction on HIV, STDs or pregnancy prevention specifically relevant to lesbian, gay, bisexual, transgender, queer or questioning (LGBTQ) youth in 2014; the proportion ranged from 11% in South Dakota to 56% in Vermont.

Adolescents may receive information about sexual health topics from a range of sources beyond formal instruction.

• Concerns about confidentiality limit access to sexual and reproductive health care, especially when young people rely on their parents’ health insurance.

In 2013–2015, 18% of all adolescents aged 15–17 and 12% of young adults aged 18–19 covered by their parents’ insurance reported that they would not seek sexual or reproductive health care because of concerns that their parents might find out.

• Among females aged 15–17 who had ever had sex, those who reported concerns about confidentiality were one-third as likely to have received a contraceptive service in the previous year than those who did not have these concerns.