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In assessing the sexual health of U.S. teens, it may be useful to compare them to their peers in Canada and the United Kingdom, two nations whose history and culture are, to an extent, similar to that of the United States. The data show that, although U.S. teens typically initiate sex at around the same age compared to their Canadian and U.K. peers, U.S. teens have higher birth rates and HIV prevalence rates than teens in the other two countries.

Pregnancy Rates

In 2005, the United States' teenage birth rate was three times that of Canada and higher than that of England/Wales. [1,2,3,4]

Birth Rates

In 2005, the United States’ teenage birth rate was three times that of Canada and higher than that of England/Wales. ^[1,2,3,4]

Abortion Rates

In 2005, Canada’s abortion rates among teens were lower than those of the United States and England/Wales. The abortion rate among teens in the United States was higher than Canada’s, but lower than the rates in England/Wales. ^[1,2,3,4]

Adolescent and Adult HIV Prevalence Rates

In 2009, the estimated HIV prevalence among adolescents and adults in the United States was twice that of Canada and three times that of the United Kingdom.^[5]

Typical Age at First Sexual Intercourse

In 2004, the self-reported age of first sexual intercourse in all three countries was nearly the same.^[6] When comparing the data from 2004 to newer data published from the Guttmacher Institute in 2011, on average the typical age at first sexual intercourse for American youth is still around the age of 17.^[7]

Proportion of Sexually Experienced Teens Who Used Contraception at Most Recent Sex

Regarding condom use, U.S. males and females had reported a lower percentage of condom usage at most recent sex compared to their Canadian peers. U.S. females were over three times less likely than Canadian teens to use oral contraceptives at most recent sex.^{[8,9,10,11,12]}

Conclusion

The U.K., Canada, and the United States have all struggled both with what kind of sex education adolescents should receive, and with issues of how to reduce teen pregnancy and ensure adolescent health. By self-report, adolescents in the United States initiated sex at around the same age compared to Canadian and U.K. teens. Yet, the U.S. has a higher HIV rate and higher teen birth rates than the other two countries. While no direct research into the difference in rates has yet been conducted, one fact that cannot be overlooked is that in the U.K. and Canada, all people including young people have confidential, low cost or free access to health care, contraception and condoms; while in the United States, confidentiality laws vary from state to state and millions of young people lack health insurance or the means to pay for health care. No matter where they live, all young people should have access to complete information about sexual health, and the medical care and supplies they need to protect themselves from unintended pregnancy, HIV, and sexually transmitted diseases.

Advocates for Youth © October 2011

Written By Megan Rowe, Intern, Education and Outreach Department

References

1. Statistics Canada. Pregnancy Outcomes: 2005. Available at: http://www.statcan.gc.ca/pub/82-224-x/82-224-x2005000-eng.pdf. Accessed 6/25/2011.
   
   
2. Office for National Statistics. Conception Statistics: Conceptions for women resident in England and Wales, 2005. Available at: http://www.statistics.gov.uk/downloads/theme_health/Conceptions2005/Conceptions2005.pdf. Accessed 6/25/2011.
   
   
3. Guttmacher Institute. U.S. Teenage Pregnancies, Births and Abortions: National and State Trends and Trends by Race and Ethnicity. Available at: http://www.guttmacher.org/pubs/USTPtrends.pdf. Accessed 6/25/2011.
   
   
4. McKay A and Barrett M. Trends in teen pregnancy rates from 1996-2006: A comparison of Canada, Sweden, U.S.A., and England/Wales. The Canadian Journal of Human Sexuality. 2010;19(1-2):43-52.
   
   
5. UNAIDS. 2010: A global view of HIV infection. Available at: http://www.unaids.org/documents/20101123_2010_HIV_Prevalence_Map_em.pdf. Accessed 6/27/2011.
   
   
6. Durex. 2004 Global Sex Survey Results. Available at: http://www.durex.com/en-US/SexualWellbeingSurvey/pages/default.aspx. Accessed 8/7/2008.
   
   
7. Guttmacher Institute. Facts on American Teens’ Sexual and Reproductive Health (In Brief): 2011. Available at: http://www.guttmacher.org/pubs/FB-ATSRH.html. Accessed 6/29/2011.
   
   
8. Rotermann M. Trends in sexual behaviour and condom use. Health Reports. 2008;19(3):55-60.
   
   
9.  Black A, Yang Q, Wen S, Lalonde AB, Guilbert E, and Fisher W. Contraceptive use among Canadian women of reproductive age: results of a national survey. Journal of Obstetrics and Gynaecology Canada. July 2009; 627-640.
   
   
10. CDC. Youth Risk Behavior Surveillance System—United States, 2007. MMWR, 57(SS-4).
    
    
11. Kaiser Family Foundation. Sexual Health of Adolescents and Young Adults in the United States: 2008. Available at: http://kff.org/womenshealth/upload/3040_04.pdf. Accessed 6/30/2011.