Despite every effort over many years, the level of teenagers having sex and getting pregnant is as high as ever. And nobody really knows why...
By Sean Coughlan
BBC News Online
This week there have been fresh worries about the levels of teenage pregnancy and sexually transmitted diseases. But are the people who should most care - the teenagers themselves - paying any attention to the risks they take?
According to National Statistics figures, the answer is "not much". Since the mid-1970s, the rate of teenage pregnancies has not substantially changed. By international standards, Britain's rate remains worryingly high.
Those who wish to play devil's advocate might argue that nothing has changed because teenagers haven't been paying the slightest bit of notice to advice from well-meaning adults.
The government has set its own target to reduce teenage pregnancies, saying that the rate will be halved by the end of the decade, with a policy that offers access to information, education and family planning services.
But with this year's rate higher than in 2002, this too looks like a tough goal.
Professor David Paton, of the University of Nottingham, a researcher in this field, makes no bones about dismissing these targets as being entirely unlikely to be achieved. "They're pie in the sky."
Some may feel motherhood is their only option
He points to the efforts of the previous Conservative administration, which set its own failed target of cutting teenage pregnancies by half by the end of the 1990s.
"Those targets were quietly forgotten. And now the present government is trying to sell the idea that its strategy will work."
Professor Paton says that his research suggests that the current National Teenage Pregnancy Strategy is no more likely to work than anything before. "There is a lot of evidence that these policies have had very little impact."
Hot in the inner-city
Even positive signs, such as a fall of more than 9% since 1998, are shadowed by the fact that in a number of inner-city areas there has been a sharp rise in teenage pregnancies over that same period.
And a breakdown by local authority shows that there are huge differences between areas that are only a few miles apart.
Lambeth, in south London, has the highest rate of pregnancies among 15 to 17-year-olds in the country, with more than 100 pregnancies for every 1,000 females in this age group. This is twice the national average - and four times the rate of some other parts of the country.
Melissa Dear, of the FPA (formerly the Family Planning Association), says there are clear links between high pregnancy rates and other forms of social deprivation.
If youngsters do not expect to stay in education and have low hopes of a good job, there is less deterrence from getting pregnant. Put simply, they feel they have less to lose.
Ms Dear rejects the suggestion that family planning initiatives have failed to make much difference, but she points to wider and less easily quantifiable factors in high pregnancy rates.
Sex is everywhere
Youngsters who develop unsafe sex lives at an early age might be responding to a sense of "emotional deprivation". And society sends youngsters a deeply confusing message about sex, she says.
"We surround young people with sexual images - and then when they show an interest in sex, they're roundly condemned."
Images of sex are everywhere
Professor Paton says research suggests that rather than the current response of advice and family planning services, there are two key routes to lowering teenage pregnancy rates.
And the first of these is to tackle poverty. A young woman who is poor and has little prospect of getting richer has less incentive to delay motherhood. If they feel they have good educational and employment prospects ahead, they won't want to put it at risk by getting pregnant.
"The biggest reason that youngsters do not get pregnant, is because they don't want to," he says.
Another key factor is how healthy relationships are within the family unit, such as whether parents are able to talk openly with their children. In countries with low teenage pregnancy rates, such as the Netherlands, there is a culture of openness and communications within families.
True love waits?
While the UK rate of teenage pregnancies shows little sign of dropping, in the United States there has been a steady, decade-long reduction. It still remains unclear why this is happening. Professor Paton says the evidence has so far been contradictory, but it could reflect a shift towards a more socially conservative culture.
Unlike in the UK, the US has seen a movement towards sexual abstinence, with organisations such as True Love Waits and the Silver Ring Thing urging young people to keep their virginity until marriage.
Not all pay heed to safe sex advice
There is so far no consensus on whether this attempt to make chastity fashionable - a moved backed by President Bush - has changed behaviour.
A survey presented at the National STD Conference in Philadelphia this week shows that youngsters who promise to keep their virginity until marriage have levels of STDs as high as everyone else.
And the FPA points that even with the reductions, the teenage pregnancy rate in the US remains far higher than in the UK.