by Emily Bridges, Director, Public Information Services

Yesterday the CDC released the results of its Youth Risk Behavior Surveillance , a survey of 15,000 high school students around the nation that asks questions about a variety of health and safety behaviors.

The headline for sexual health was: no headline.

There were no statistically significant changes in the percent of young people who have ever had sex (47%), who are currently sexually active (34%), or who used condoms (60%) and/or the most effective forms of birth control (24%) at last sex. 

The only statistically significant change was in HIV education, and it wasn’t good: the percentage of students taught in school about HIV has trended down since 1997 and went down between 2009 to 2011 (from 87% to 84%). 

What lessons can we take from this?

1) No matter how much adults want to live in denial, a significant proportion of teens are having sex. Among seniors, 63 percent of students have already had sex and nearly half are currently sexually active. 

2) Safer sex messages still haven’t taken hold among all young people. While it’s wonderful that so many young people are using condoms and birth control, those numbers need to be much closer to 100 percent, with all young people fully protected.

3) Every year fewer students are learning about HIV – and we already knew that less than a quarter have been tested for HIV. What’s causing this – the abstinence-only programs that have taken root around the nation? No Child Left Behind and the emphasis on standardized testing? Funding cuts in the current economic climate? Whatever the cause, the erosion of HIV education has to stop. Students’ lives depend on it.

Read the full Youth Risk Behavior Surveillance here.   Also check out Martha Kempner's discussion of the results on RH Reality Check.

by Emily Bridges, Director, Public Information Services

It seems like every week brings a new study about young people and sexual health.  Below are some of the "headlines" - important statistics from major sources of data.  And don't forget to explore our series of frequently updated guides to research on adolescent reproductive and sexual health issues at researchguides.advocatesforyouth.org.

Bullying, Violence, and Harassment

48 % of students have been sexually harassed

• AAUW report, 2010

32% of all students have been bullied at school; 11% physically bullied

• Dept of Ed report, 2010

85% of LGBT students have been bullied at school, 28% physically

• GLSEN Climate Report 2009

8% of high school students have been forced to have intercourse; 9% have experienced dating violence. 

• Youth Risk Behavior Surveillance 2011

With questions or comments, contact:

Emily Bridges, Director of Public Information Services, Advocates for Youth
202 419 3420   This e-mail address is being protected from spambots. You need JavaScript enabled to view it  

Sexual Experience and Contraceptive Use Among Female Teens — United States, 1995, 2002, and 2006–2010
Morbidity and Mortality Weekly Report (MMWR)

This CDC report examined trends in sexual activity and contraception use over time, finding that while fewer teens are having sex, those who are sexually active are likelier to be using highly effective contraceptive methods than teens in 1995.   “To describe trends in sexual experience and use of contraceptive methods among females aged 15–19 years, CDC analyzed data from the National Survey of Family Growth collected for 1995, 2002, and 2006–2010 (3). During 2006–2010, 57% of females aged 15–19 years had never had sex (defined as vaginal intercourse), an increase from 49% in 1995. Younger teens (aged 15–17 years) were more likely not to have had sex (73%) than older teens (36%); the proportion of teens who had never had sex did not differ by race/ethnicity. Approximately 60% of sexually experienced teens reported current use of highly effective contraceptive methods (e.g., intrauterine device [IUD] or hormonal methods), an increase from 47% in 1995. However, use of highly effective methods varied by race/ethnicity, with higher rates observed for non-Hispanic whites (66%) than non-Hispanic black (46%) and Hispanic teens (54%). “

Human Papilloma Virus infection in sexually active adolescent girls.
Gynecological Oncology

In a sample of 149 sexually active female teens, 62 tested positive for HPV, and 25 of those tested positive for a high risk type of HPV.  “Girls that tested positive for HPV had similar age at sexual debut with those that tested negative (15.1years in all groups) but had on average more sexual partners. Only 9 girls in this cohort had been vaccinated against HPV. Approximately half of girls reported using inadequate or no contraception.”  Adds to a growing body of work that examines inadequate HPV vaccination.

Intimate partner violence and sexually transmitted infections among young adult women
Sexually Transmitted Diseases

Researchers looked at National Longitudinal Study of Adolescent Health data to determine if being in a violent relationship (as perpetrator, victim, or reciprocally violent) is associated with STIs and STI risk behaviors.  Intimate partner violence was associated with lower condom use , multiple partners, and having an STI.

Effectiveness of a National Media Campaign to Promote Parent-Child Communication About Sex.
Health Education and Behavior

An assessment of the U.S. Department of Health and Human Services’ Parents Speak Up National Campaign (PSUNC) to encourage parent-child communication about sex.  They found that parents, specifically mothers, who were familiar with the campaign were more likely to have communicated with children about sex and more like to have recommended that their children “wait.”

Sexual Timetables for Oral-Genital, Vaginal, and Anal Intercourse: Sociodemographic Comparisons in a Nationally Representative Sample of Adolescents
American Journal of Public Health

Researchers examined data from the National Longitudinal Study of Adolescent Health  (ADD Health) to determine at what ages young people engage in sexual behavior and demographic correlates of that behavior.

Beyond Age at First Sex: Patterns of Emerging Sexual Behavior in Adolescence and Young Adulthood
Journal of Adolescent Health

This article also examined the ADD Health data to determine the timing of various sexual behaviors before loss of virginity.  “Approximately half of respondents followed a pattern characterized predominately by initiation of vaginal sex first, average age of initiation of approximately 16 years, and spacing of >1 year between initiation of the first and second behaviors; almost one-third initiated sexual activity slightly later but reported first experiences of oral-genital and vaginal sex within the same year.”

Sexual Orientation and Substance Use Among Adolescents and Young Adults
American Journal of Public Health

This study attempted to explore associations between substance abuse and sexual orientation.  Researchers ultimately concluded that “sexual identity was less strongly associated with substance use than sexual experience and attraction were, pointing to the need for more nuanced indicators of sexual orientation in public health studies.”

Here are a few relevant articles about adolescent reproductive and sexual health, retrieved on March 29, 2012. Find more statistics, research, and reports in Advocates for Youth’s research guides.

Knowledge of Medication Abortion Among Adolescent Medicine Providers (Journal of Adolescent Health)

Researchers surveyed adolescent medicine providers in the Society for Adolescent Health and Medicine to determine knowledge about medication abortion.  “Almost 25% of respondents incorrectly believed that medication abortion was not very safe, 40% misidentified that it was < 95% effective, and 32% did not select the correct maximum recommended gestational age (7–9 weeks). Providers had difficulty identifying that serious complications of medication abortion are rare. Those who counseled on medication abortion had more accurate information in all knowledge categories, except for expected outcomes. Only 32% of respondents had very good knowledge, and self-assessed knowledge minimally predicted actual knowledge (r² = .08).”  Better education on medication abortion is recommended.

Patterns and Correlates of Parental and Formal Sexual and Reproductive Health Communication for Adolescent Women in the United States, 2002–2008 (Journal of Adolescent Health)

Researchers examined the National Survey of Family Growth to learn about parental communication, and formal communication (i.e. a sex education or prevention program) on sexual and reproductive health among young women ages 15-19.  “Seventy-five percent of adolescent women had received parental communication on abstinence (60%), contraception (56%), sexually transmitted infections (53%), and condoms (29%); 9% received abstinence-only communication. Formal communication (92%) included abstinence (87%) and contraceptive (71%) information; 66% received both, whereas 21% received abstinence-only.”  Overall, parental communication around sex had increased, while there was no increase in formal communication around sex.

Cost-Utility Analysis of A Female Condom Promotion Program in Washington, DC. (AIDS and Behavior)

Researchers analyzed the cost-effectiveness of DC’s female condom distribution program.  The program distributed 200,000 condoms at a cost of $414k.  An estimated 23 HIV infections were prevented, which because of the high cost of treating HIV, rendered the program highly cost effective. Read a Washington Post article about the study

Recent Trauma is Associated with Antiretroviral Failure and HIV Transmission Risk Behavior Among HIV-Positive Women and Female-Identified Transgenders (AIDS and Behavior)

This study examined data from a “prevention with positives” program “to understand if socio-economic, behavioral, and health-related factors are associated with antiretroviral failure and HIV transmission-risk behaviors among 113 HIV-positive biological and transgender women. Compared to participants without recent trauma, participants reporting recent trauma had over four-times the odds of antiretroviral failure and over three-times the odds of reporting sex with an HIV-negative or unknown serostatus partner and <100% condom use with these partners.   Researchers conclude that women who have experienced sexual and physical abuse, and other forms of trauma,  are likelier to engage in risk behavior and experience anti-retroviral failure (that is, not get HIV drugs for whatever reason). In a Voice of America article he noted that “trauma is the key to the HIV epidemic”,  and that trauma was more common among HIV+ women than non HIV+ women.   He recommended that screening and treatment for trauma be a routine part of HIV care.

Health Care Provider Attitudes and Practices Related to Intrauterine Devices for Nulliparous Women (Obstetrics and Gynecology)

Researchers surveyed questionnaire data from office-based and Title X clinic  providers (physicians, physician assistants, certified nurse midwives, nurse practitioners, and nurses) to determine knowledge and attitudes around the IUD and prescription to women who have not yet had children.  “Approximately 30% of respondents had misconceptions about the safety of IUDs for nulliparous women. More than 60% of providers infrequently provided IUDs to nulliparous women.”  Reasons providers did not provide IUDs included nonavailability on site, and concerns about safety. Office-based practitioners were likelier to have misconceptions about the IUD than Title X clinic practitioners. Read a Reuters article on the study

Characteristics of African American Adolescent Females Who Perceive Their Current Boyfriends Have Concurrent Sexual Partners (Journal of Adolescent Health)

Researchers surveyed young African American women at STD clinics to determine if they believed their boyfriend had a current sexual partner; 27% answered yes.   Believing a boyfriend had a concurrent partner was associated with less relationship power, less relationship commitment, and previous STD diagnoses.  The study contradicts the idea that a “one size fits all” approach to sex education is appropriate.  Authors suggest that results can inform prevention interventions by highlighting the need for education about relationship dynamics and about “ the increased HIV/STD risks associated with having a boyfriend with concurrent sex partners.”

The Opt-In Revolution? Contraception and the Gender Gap in Wages (National Bureau of Economic Research)

“This paper explores the role of “the Pill” in altering women’s human capital investments and its ultimate implications for life-cycle wages. Using state-by-birth-cohort variation in legal access to contraception, we show that younger access to the Pill conferred an 8-percent hourly wage premium by age fifty. Our estimates imply that the Pill can account for 10 percent of the convergence of the gender gap in the 1980s and 30 percent in the 1990s.”  Read a Huffington Post article on the study

Pharmacy Communication to Adolescents and Their Physicians Regarding Access to Emergency Contraception (Pediatrics)

This study about pharmacist provision of information about emergency contraception, received widespread media attention this week. A consumer must request EC at the pharmacy counter, but a significant number of pharmacists provide incorrect information about it.  “By using standardized scripts, female callers telephoned 943 pharmacies in 5 US cities posing as 17-year-old adolescents or as physicians calling on behalf of their 17-year-old patients. …Seven hundred fifty-nine pharmacies (80%) indicated to adolescent callers, and 766 (81%) to physician callers, that EC was available on the day of the call. However, 145 pharmacies (19%) incorrectly told the adolescent callers that it would be impossible to obtain EC under any circumstances, compared with 23 pharmacies (3%) for physician callers. Pharmacies conveyed the correct age to dispense EC without a prescription in 431 adolescent calls (57%) and 466 physician calls (61%).”   Read a Time article about the study

Patterns of Disclosure Among Youth Who Are HIV-Positive: A Multisite Study (Journal of Adolescent Health)

This study examined HIV status disclosure among HIV positive young people. “Forty percent of participants reported a sexual relationship with a partner to whom they had not disclosed their serostatus. Participants with multiple sexual partners were less likely to disclose their serostatus than those with one partner. Disclosure was more frequent when the serostatus of the sexual partner was known. Disclosure was not associated with unprotected sex.”   Researchers recommend prevention initiatives should focus on both disclosure and condom use in this high-risk population.

Sensation Seeking and Impulsivity: Combined Associations with Risky Sexual Behavior in a Large Sample of Young Adults (Journal of Sex Research)

This article examined 2 processes in brain, sensation seeking and impulsivity, among adolescents, to discover if and how these contribute to sexual risk taking behaviors.  From the abstract:   “Regression modeling indicated that both sensation seeking and impulsive decision-making were consistently associated with sexual risk behaviors across 11 risk-related outcomes. Results further indicated that sensation seeking and impulsive decision-making operated synergistically with respect to the outcome variables of sex acts using drugs, acts with a partner using alcohol, and acts with a partner using drugs. In contrast to this, sensation seeking and impulsive decision-making operated independently with respect to the other sexual risk outcomes.“  The article contributes to the growing body of work around adolescent brain development and its contribution to sexual risk behavior.