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July 24, 1996

Adolescent Pregnancy-Reply

Author Affiliations

Stanford University School of Medicine Palo Alto, Calif

JAMA. 1996;276(4):283. doi:10.1001/jama.1996.03540040027025

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In Reply.  —I thank Dr Donohoe for expanding on many of the points in my Editorial, especially the role of poverty and limited access to effective birth control. To these, he appropriately adds the role of older men in the experience of adolescent pregnancy. Whether the partner or perpetrator is a peer or an adult, however, the factors responsible for increased vulnerability of adolescent girls to unwanted sexual involvement are the same.Drs Fitch and McIlhaney are critical of the 3 potential levels of intervention I describe, which they mistakenly characterize as interventions that have been tried and have failed. A careful rereading of the Editorial will underscore my belief that the research findings with regard to pregnancy prevention among adolescents are inconclusive and inconsistent. The problem with most of the extant research is that it has tended to focus on 1 factor or a few factors, rather than on the multiplicity