This is a well-written, easy-to-read and up-to-date book on a crucial topic. It stems from the authors' extensive involvement with a teenage pregnancy prevention initiative in Staffordshire. Steph Chambers was 14 at the time she wrote her contributions and one of the major distinguishing marks of the book is its determination to reflect what young people are really thinking. The introductory chapter 'A Teenager's Viewpoint' by Anna Brown, aged 16, sets the tone and provides much for Triple Helix readers to reflect upon.

The approach is primary care-focused, practical and very comprehensive with chapters covering clinical governance, reaching young people, confidentiality, contraception, unplanned pregnancy, STIs, disability, sexual abuse and influence of peers, media and the press.

Culture, religion and beliefs also merit a chapter, which concludes with the warning to 'Make sure that you understand your own belief systems so that you do not unwittingly try to impose them on others inappropriately'. This sounds reasonable but of course implies there is little or no place for such belief systems (except presumably pragmatic humanism) having any influence wittingly or appropriately.

The text reflects the universal belief-system of books on teenage pregnancy in the UK that since teenagers will have sex whatever you tell them, provision of accurate sex information and easing access to contraceptives are the keys to preventing both unplanned pregnancy and STIs. Yet these authors do at least show awareness that these are not the only factors involved in sexual health. For example they conclude the section on Regretted sexual intercourse with the admission that 'Spreading the word that many teenagers regret exerting pressure and not planning their first intercourse might help other young people to postpone instant gratification in favour of later satisfaction'.

A paragraph from the section on Gender and sexuality movingly describes where most young people are at: 'Young women often know about safe sex, and intend to use condoms, but find themselves unable to be assertive enough to do this within the context of a sexual relationship. They feel they should be passive and undemanding and that the man should take the lead. Young men are confused too. How can they take the lead with these apparently more confident and knowledgeable young women?

Whatever they do will be wrong... They are encouraged to despise the "easy" sexual conquest (as "cheap" and having no value), but equally they brand women who resist their sexual advances as "frigid". How can they ever get it right?' This wistful questioning surely tacitly acknowledges that there is more to teenage sexual health than correct use of contraceptives. Religious values and especially Christian ones have a more important place in sexual relationships than these authors are consciously aware of. Spirituality and sexuality are inextricably linked and we separate them at our peril.

Reviewed by:
Trevor Stammers
General Practitioner in West London who writes and broadcasts on sexuality