February 9, 1990

Adolescent Pregnancy Prevention: Primary, Secondary, and Tertiary

Author Affiliations

Ann Arbor, Mich

Ann Arbor, Mich

JAMA. 1990;263(6):813. doi:10.1001/jama.1990.03440060053024

To the Editor.—  It was with pleasure that I read the recent article about prevention of adolescent pregnancy. It was with dismay that I noted the misuse of the terms primary prevention, secondary prevention, and tertiary prevention."Primary prevention" refers to prevention of the occurrence of a disease or injury; "secondary prevention" refers to early detection and intervention to reverse, halt, or at least retard the progress of the condition; and "tertiary prevention" refers to minimization of the effects of a condition. Although pregnancy is not a disease or injury, it is not terribly unreasonable to apply to it the terms referring to types of prevention.As primary prevention, Drs McAnarney and Hendee rely mostly on education regarding sexuality—education of the primary care provider, of parents, and of the adolescent. The link between education regarding sexuality and behavior change (avoidance of pregnancy) is never made clear and may not exist.