Digital media offer opportunities for youth to confidentially search for information on sensitive topics, and thus are a likely source of sexual health information for young people.• In 2010, 19% of heterosexual youth, 40% of questioning youth, 65% of bisexual youth and 78% of lesbian/gay/queer youth aged 13–18 reported that they had used the Internet to look up sexual health information in the past year.• There has been a shift toward evidence-based interventions in the United States over the last few decades.

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• Concerns about confidentiality limit access to sexual and reproductive health care, especially when young people rely on their parents’ health insurance.

In 2013–2015, 18% of all adolescents aged 15–17 and 12% of young adults aged 18–19 covered by their parents’ insurance reported that they would not seek sexual or reproductive health care because of concerns that their parents might find out.

For example, the share of rural adolescents who had received instruction about birth control declined from 71% to 48% among females, and from 59% to 45% among males.

• Only about half of adolescents (57% of females and 43% of males) received formal instruction about contraception before they first had sex; about four in ten (46% of females and 31% of males) received instruction about where to get birth control.

• Between 2006–20–2013, there were significant declines in adolescent females’ reports of having received formal instruction about birth control, STDs, HIV and AIDs, and saying no to sex.

There was also a significant decline in adolescent males’ reports of having received formal instruction about birth control.• “Abstinence education” programs that promote abstinence-only-until-marriage—now termed “sexual risk avoidance” by proponents—have been described as “scientifically and ethically problematic.” They systematically ignore or stigmatize many young people and do not meet their health needs.• Proponents of “sexual risk avoidance” programs have appropriated the terms “medically accurate” and “evidence-based,” though experts in the field agree that such programs are neither complete in their medical accuracy nor based on the widely accepted body of scientific evidence.Among adolescents aged 15–19 who had ever had sex and who did not get birth control instruction from either formal sources or a parent, only 7% of females and 13% of males talked with a health care provider about birth control in 2006–2010.• Access to the Internet is nearly universal among adolescents in the United States.• Among females aged 15–17 who had ever had sex, those who reported concerns about confidentiality were one-third as likely to have received a contraceptive service in the previous year than those who did not have these concerns.