Counseling About Abstinence and
Contraception
Counseling about abstinence and
postponement of sexual intercourse
is an important aspect of adolescent
sexual health care. Abstinence is 100%
effective in preventing pregnancy and
STIs and is an important part of contraceptive
counseling. Adolescents should
be encouraged to delay sexual onset until
they are ready. However, existing data
suggest that, over time, perfect adherence
to abstinence is low (ie, many
adolescents planning on abstinence do
not remain abstinent).29,30 Therefore,
pediatricians should not rely on abstinence
counseling alone but should
additionally provide access to comprehensive
sexual health information
to all adolescents. For sexually active
adolescents, including gay and lesbian
adolescents,31 and those considering
initiation of sexual activity, counseling
additionally includes initiating contraception,
supporting adherence to the
contraceptive method, managing adverse
effects, and providing periodic
screening for STIs.24