Actually, it seems to be in their hands. Handheld devices give teenagers access to sexual images—including unsolicited images of their peers—as well as anything they could possibly want to know about sex, both positive and negative. The unsolicited photos are an obvious negative, but some of the positives are that they can find a clinic, text a health agency for information, even let a partner know anonymously that they have an STI and need to get tested. With the increase in information from all sources, there have been some real advances in sexual health for adolescents and young adults; but there are still serious problems. So what are they really up to? Media messages mislead adults about adolescent sexual activity, giving the impression that they are having sex at increasingly younger ages. Federal and provincial health surveys seem to tell a different story. In 1996, 32 per cent of 15- to 17-year-olds reported that they had had (vaginal) intercourse; in 2003 and 2009, it was 30 per cent. Moreover, for 18- to 19-year-olds, fewer are reporting having had intercourse than previously. In 1996, it was 70 per cent; in 2009, it dropped to 68 per cent. Condom use is also increasing. Sixty-eight per cent of sexually active Canadians aged 15 to 24 reported using condoms in 2009-2010, compared to 62 per cent in 2003. However, older teenagers are less consistent in their condom use: for 18- to 19-year-olds (with one partner), 72.7 per cent used condoms the last time they had sex as compared to 81.2 per cent of 15- to 17-year-olds. The likely reason for the heterosexual teenagers is that the young women are on the Pill. Like deciding to postpone sex, condom use requires negotiation. In certain social groups, condoms are de rigueur. When I worked in a sexual health clinic, I noticed that there were some young people who were more sophisticated than many adults I know in terms of their ability to make sexual decisions. For example, young men were coming in with their female partners for testing, a great new twist on a date. The rates for adolescent pregnancy have plunged dramatically since the 1970s, with the increase in comprehensive sexual health education and access to birth control and safe abortion as back-up. The remaining pockets of adolescent pregnancy are still to be addressed by increased access to the basics: adequate food, shelter and safety, including sexual safety. Another positive: adolescents are coming out to themselves at younger and younger ages about their sexual orientation and/or gender issues. So we’re getting some things right by changing the discourse at home and school to ensure that they hear lesbian/gay/bisexual/trans (LGBT) positive messages. But we still need to up our game. The older adolescents who are no longer using condoms may not be getting pregnant, but they are getting STIs in record numbers. The number of cases of Chlamydia for 15- to 24-year-olds, for example, continues to rise. This is in part due to more, and better, testing. (Urine tests for males as opposed to swabs make it a lot easier to convince them to go.) As mentioned, heterosexual teenage girls and young women in longer term relationships (three weeks or more!) are starting to use hormonal contraception, such as the Pill, as their method of birth control. But they tend to start the Pill before they get tested for STIs. As soon as they go on the Pill, they stop using condoms. They may be unaware that they were already infected with an STI from a previous partner, or they may get infected by their steady, loving partner, who was himself unaware that he was infected. To my mind, the most dramatic barrier to adolescent sexual health, as I reported in an earlier blog is the persistence of acquaintance rape and the apparent lack of empathy for its victims. Right alongside this phenomenon is intimate partner violence—emotional, physical and sexual abuse—that often starts in adolescence and persists into young adulthood, with the overwhelming majority of victims of intimate partner violence being female. While I fully acknowledge that each one of these problems has many factors, including high-risk behaviors linked to economic and social disadvantages, education remains a key factor. With increased education and access to services, we will be able to keep pushing down the stats on STIs and teenage pregnancy; but it will take some phone smarts to turn those handheld devices to our advantage. Agents for change will have to learn to blast positive messages to each and every one of them. I propose a new Twitter tag: #goodteensex.