They are often embarrassed at being seen in a reproductive health facility. They are likely to be concerned about a lack of privacy and confidentiality, or afraid that their parents might find out about their visit. They are afraid of medical procedures, especially pelvic exams. They might be ashamed of having experienced coercive or abusive sex. They find the clinic staff hostile.
Many adolescents are unaware of the risk of pregnancy.
They are also unfamiliar with STD symptoms and don't know when to seek services. They don't know where reproductive health services are located, or they are unfamiliar with the kinds of services offered. The health facilities they might go to are not open at convenient hours. There is no transportation to an existing clinic site. The cost of services is beyond their means.