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Adolescent Protective Behaviors: Abstinence and Contraceptive Use Print

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A recent study found that 86% of the decline in U.S. teen pregnancy could be attributed to increased contraception use, while 14% was due to teens’ increased abstinence.[1] Although U.S. teens are increasingly adopting protective sexual behaviors, they face barriers to consistency in these behaviors.

U.S. Teens Remain Abstinent Longer Than in the Past

  • In 2003 and 2005, 53 percent of U.S. high school students reported never having had sexual intercourse, up from 46 percent in 1991.[2,3]
  • Between 1991 and 2005, the percentage of U.S. youth that said they never had sex increased in all high school grades. For example, 33 percent of high school seniors in 1991 said they never had sex, compared to 53 percent in 2003 and 66% in 2005.[2,3]
  • Abstinence rates also increased between 1991 and 2005 by gender and by race/ethnicity. In 1991, 49 percent of high school teenage women said they had never had sex, compared to 54 percent in 2005; among males, the numbers were 43 and 52 percent, respectively.[2,3]
  • Fifty percent of white students said they never had sex in 1991, compared to 57 percent in 2005; among Latino students, the numbers were 47 and 49 percent, respectively; among African American students, 19 and 32 percent, respectively.[2,3]
  • In one study, only 14 percent of gay, lesbian, and bisexual high school students had never had sex, compared to 52 percent of their heterosexual peers.[4]

In Many Industrialized Nations, the Typical Age of Sexual Initiative is Around 17.5

  • In the United States, the typical age at first sexual intercourse is 17.[5]
  • In Canada, the typical age at first sex is 17.3; in Great Britain, it is 17.5.[5]
  • In the Netherlands, the typical age at first sex is 17.7; in France, it is 18.0.[5,6]

Sexually Active Adolescents' Use of Condoms is Up But Leveling Off

  • In U.S. studies, 70 percent of women and 69 percent of men ages 15 to 19 reported condom use at first sex.[7]
  • Among sexually active U.S. high school youth in 2005, 63 percent reported using a condom during most recent sex—a significant increase over 1991's 46 percent.[2,3]
  • In 1995, fewer gay, lesbian, and bisexual high school students reported condom use at most recent sex, compared to their heterosexual peers (51 and 58 percent, respectively).[4]
  • In 2005, sexually active African American high school students were more likely than their white or Latino peers to report condom use (69, 63, and 58 percent, respectively).[2]
  • Among sexually active youth, only about eight percent of female teens and 17 percent of male teens reported using both condoms and hormonal contraception at most recent sex.[7]

Some Sexually Active Adolescents Use Other Contraceptive Methods

  • Overall, 18 percent of sexually active high school youth in the United States report use of birth control pills before most recent sex. Rates vary significantly among sexually active students by race/ethnicity: 22 percent of whites; 10 percent of Latinos; and 10 percent of African Americans.[2]
  • In one study, bisexual and lesbian teenage women, although about equally likely to have had sex as their heterosexual peers, reported more than twice as great the rate of pregnancy (12 percent versus five percent, respectively).[8]
  • Among sexually experienced U.S. teens, more women reported use of birth control pills before most recent sex than reported using no method (33 and 20 percent, respectively) compared to 59 percent and 12 percent of French adolescents, respectively.[5] In a German study, 73 percent of 14- to 17-year-old women used birth control pills before most recent intercourse while one percent used no protection.[9]

Youth's Attitudes & Behaviors Reflect Society's Confusion Around Sexuality

  • Pressure from partners and friends—In one study, eight percent of sexually experienced young women cited pressure from their partner as a factor in having sex for the first time; seven percent cited pressure from their friends; among young men, the percentages were one and 13 percent, respectively.[10]
  • Confusion in defining abstinence—In a study of youth ages 12 to 17 who had abstinence education, young people's definitions of abstinence included many sexual behaviors while consistently avoiding only (vaginal) intercourse. In a study of college freshmen and sophomores, 37 percent described oral sex and 24 percent described anal sex as abstinent behaviors.[11]
  • Virginity pledges—In a recent study on the effect of virginity pledges, researchers found that, in early and middle adolescence, pledging delayed the transition to first sex by as much as 18 months. Pledging only worked where some, but not more than about one-third, of students pledged. However, when they broke the pledge, these teens were one-third less likely to use contraception at first sex than were their non-pledging peers.[12] According to the lead researcher, "If we consider the enhanced risk of failure to contracept against the benefit of delay, it turns out that with respect to pregnancy, pledgers are at the same risk as non-pledgers. There is no long-term benefit to pledging in terms of pregnancy reduction, unless pledgers use contraception at first intercourse."[13]
  • Lack of knowledge about effective contraception—In a recent poll, 32 percent of U.S. teens did not believe condoms were effective in preventing HIV and 22 percent did not believe that birth control pills were effective in preventing pregnancy.[14]
  • Negative attitudes about using protection—In the same poll, 66 percent of teens said they would feel suspicious or worried about their partner's past, if the partner suggested using a condom; 49 percent would worry that the partner was suspicious of them; 20 percent would feel insulted.[14]
  • Lack of confidentiality—In a recent study among sexually active women under age 18, 47 percent indicated that mandatory parental notification would cause them to stop using family planning services.[15]
  • Homophobia and violence—Significant barriers to protective behaviors among lesbian, gay, bisexual, and transgender youth, as well as among young men who have sex with men, include homophobia and violence that damage their self-esteem, lack of access to health care, homelessness, and substance use.[16]

References

  1. Santelli JS et al. Exploring recent declines in adolescent pregnancy in the United States: the contribution of abstinence and increased contraceptive use. American Journal of Public Health 2007; 97: 150-156.
  2. Eaton DK et al. Youth risk behavior surveillance, United States, 2005. Morbidity & Mortality Weekly Report 2006;55(SS-5):1–108.
  3. Kann L et al. Results from the national school-based 1991 youth risk behavior survey and progress toward achieving related health objectives for the nation. Public Health Reports 1993; 108 (Supp. 1):47-55.
  4. Blake SM et al. Preventing sexual risk behaviors among gay, lesbian, and bisexual adolescents: the benefits of gay-sensitive HIV instruction in schools. Am J Public Health 2001; 91:940-46.
  5. Darroch JE et al. Differences in teenage pregnancy rates among five developed countries: the roles of sexual activity and contraceptive use. Fam Plann Perspect 2001; 33:244-50+.
  6. Rademakers J. Sex Education Research in the Netherlands. Paper presented to the European Study Tour. Utrecht, Netherlands: NISSO, 2001.
  7. Abma JC, Sonenstein FL. Sexual Activity and Contraceptive Practices among Teenagers in the United States, 1988 and 1995. [Vital & Health Statistics, series 23, no. 21] Hyattsville, MD: NCHS, 2001.
  8. Saewyc EM et al. Sexual intercourse, abuse and pregnancy among adolescent women: does sexual orientation make a difference? Fam Plann Perspect 1999; 31:127-31.
  9. Federal Centre for Health Education. Youth Sexuality 1998: Results of the Current Representative Survey. Cologne: The Centre, 1998.
  10. Kaiser Family Foundation & YM Magazine. National Survey of Teens: Teens Talk about Dating, Intimacy, and Their Sexual Experiences. Menlo Park, CA: The Foundation, 1998.
  11. Remez L. Oral sex among adolescents: is it sex or is it abstinence? Fam Plann Perspect 2000; 32:298-304.
  12. Bearman PS, Brückner H. Promising the Future: Virginity Pledges as They Affect Transition to First Intercourse. New York: Columbia University, 2000.
  13. Bearman P. [Letter]. New York: Columbia University, 2002.
  14. Henry J. Kaiser Family Foundation. Safer Sex, Condoms, and "The Pill": A Series of National Surveys of Teens about Sex. Menlo Park, CA: The Foundation, 2000.
  15. Reddy DM et al. Effect of mandatory parental notification on adolescent girls' use of sexual health care services. JAMA 2002; 288:710-14.
  16. Savin-Williams RC. Verbal and physical abuse as stressors in the lives of lesbian, gay male, and bisexual youths: associations with school problems, running away, prostitution, and suicide. J Consult Clin Psychol 1994; 62:261-69.

Written by Sue Alford
Revised, June 2007 © Advocates for Youth

This publication is part of The Facts series.

 
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