Teen pregnancy and birth rates might have reached historic lows in Minnesota in 2016, but sexual abuse and relationship violence could undermine further progress.

Nearly one in five 11th-graders reported some form of relationship violence in 2016, and nearly one in 10 specifically reported sexual violence, according to the annual adolescent sexual health report released Thursday by the University of Minnesota.

The results suggest a need to get beyond “the nuts and the bolts and the birds and the bees” and to start talking with teens more about healthy relationships, said Jill Farris, director of adolescent sexual health training and education at the U’s medical school.

“We probably need to broaden our definition of success [with teens] to be more than just not getting pregnant,” she said.

Advocates attribute the historic decline in Minnesota’s pregnancy rate — from 59 pregnancies per 1,000 teens ages 15-19 in 1990, to 17.2 pregnancies in 2016 — to delayed initiation of sex and broader use of contraception. Many sex education classes in Minnesota have focused more on goal-setting and helping teens see how unplanned pregnancies could disrupt those goals.

Success on that front allowed university researchers for the first time this year to expand their adolescent sexual health report to focus on partner violence. What they found is that one can influence the other, and further progress in pregnancy prevention might require more focus on healthy relationships.

Drawing data from the 2016 Minnesota Student Survey, the researchers found that sexually harassed high school students were more likely to skip school and feel unsafe, and sexually abused students were much more likely to abuse drugs and have suicidal thoughts.

Related to pregnancy risks, the data also showed that sexually abused students were less likely to use contraception and more likely to have multiple sexual partners.

Farris said teens aren’t getting enough information and positive role models when it comes to healthy romance: “Most young people do not report that they have had any conversations with an adult in their life about relationships or love or intimacy or things like that. I think that is a problem,” she said.

The #MeToo movement and other factors have piqued interest in how to teach young people about healthy relationships and sex lives, said Lindsey Hoskins, health education director for the St. Paul-based Family Tree Clinic.

But she agreed that time-pressured school health classes aren’t getting far beyond the basic message of pregnancy prevention.

“Even when a sex-ed unit does talk about something like consent, sometimes it’s reduced to this ‘yes means yes, no means no’ kind of message,” she said. “The conversations need to be more nuanced than that. We need to talk about things like body language and communication. We also need to talk about things like power and systems of oppression and all of the things that go into a sexual violence situation before it happens.”

The university’s annual report combines data from multiple sources to provide a comprehensive look at teens and their sexual health.

Reductions in teen births in Minnesota were largely driven by reductions among minorities, the report stated. However, teen birthrates remain elevated among minorities. Minnesota’s rate of American Indian teen births is higher than the national rate.

One positive finding in the report was a slight decline from 2015 to 2016 in the rate of teens with chlamydia, a sexually transmitted infection that can lead to infertility or other health problems over time. That decline was only the second in the past decade.