With a wider gap between puberty and marriage, sexual activity outside marriage has increased. Nevertheless, many in authority are unwilling even to acknowledge teenage sexuality. Poor or missing information, policy barriers, or discouragement by care providers prevents many young people, even married ones, from using protection against unwanted pregnancy or from seeking help from health services. Sexual activity is frequently condoned for unmarried young men, but not for unmarried young women. This sexual double standard imposes a heavy burden of responsibility and risk on young women, including an enhanced risk of sexual coercion.
Poor girls are particularly vulnerable to economic coercion.
Whether she is married or not, pregnancy during adolescence exposes a young woman to much higher risks of illness or death than those faced by older women. Many such pregnancies result in unsafe abortion. Half of all new HIV infections are to young people aged 15-24. The risks are especially great for those who have multiple partners, those who sell sex to make a living, and women married to men with multiple partners. As reproductive health programmes become well established, adolescents account for a growing share of the unmet need for family planning.