"They're just improvising," said Grubb, the author of new American Academy of Pediatrics guidelines on adolescent barrier protection during sex published Monday in the journal Pediatrics.
"Which I do not recommend because we do not know about safety or effectiveness. But I admire their creativity and devotion to using a barrier!" she added with emphasis.
Grubb hears such stories from teens in her practice at Tufts Medical Center in Boston, she says, because adolescents "aren't really thinking too far ahead" about the consequences of their actions.
"Adolescents are spontaneous and impulsive, and they take risks," Grubb said. "I've heard so many teens tell me that they don't need contraception or they don't need condoms because they don't plan on being sexually active. And then a couple weeks later they're back in the office and we're running a pregnancy test or we're testing for sexually transmitted infections."
High rate of teen STI and HIV cases
Recent rates of sexually transmitted infections, or STIs, have been skyrocketing among teens and young adults, at the same time that the number of teen pregnancies and births has declined.
"Adolescents and young adults account for more than 50% of new STI diagnoses, despite being only about 25% of the sexually active population," Grubb said.
Just as shocking, they account for 1 in 5 of all new HIV (human immunodeficiency virus) diagnoses in the United States, according to the US Centers for Disease Control and Prevention.
Barrier protection is key to solving both problems. That includes external condoms (commonly known as male), internal condoms (commonly known as female) and dental dams, the new guidelines say. (However, the CDC says that "natural" or "lambskin" condoms, while protecting against pregnancy, may not provide protection against HIV or a sexually transmitted infection or STI.)
The AAP supports the "provision of free or low-cost barrier methods within communities, including providing barrier methods within clinics," the policy stated.
"It does not have to be a controversial position," Grubb said. "There is no evidence that providing contraception to adolescents makes them more sexually active or promotes risky behavior.
"In fact, comprehensive evidence-based sexuality education results in adolescents delaying sexual behavior, using contraception at first intercourse, and having less sexual partners at a young age," she added.
It's also important to provide teens with clear, easy to follow instructions on the use of condoms and other barrier protection. The CDC provides illustrations on the right way to use a male condom, a female condom, and a dental dam for oral sex on its website.
The AAP also recommends pediatricians tell teens that "abstaining from sexual intercourse as the most effective way to prevent genital STIs, as well as HIV infection, and unintended pregnancy."
Long acting reversible contraception
In a separate paper also published Monday in Pediatrics,
