Teen Trends in Sexual Activity and Birth Control Can Help Target Education on Safe-Sex

A sweeping new report published by the US Department of Health and Human Services (HHS), a division of the Centers for Disease Control and Prevention, highlights what’s changed—and what hasn’t—in the landscape of teen sexual activity, contraception, and pregnancy over the past couple of decades.

Using information collected during in-person interviews, the researchers were able to form a portrait of US teens’ intimate activity based on information provided by more than 4100 teens between the ages of 15 and 19 for the time period between 2011 and 2015. (The report also includes data from previous years as references for selected indicators.)

Notably, less than half of all teens claimed to have had intercourse; 42.4% of never-married girls ages 15 through 19 had intercourse, while 44.2% of never-married boys between 15 and 19 had done so. This percentage has held relatively steady over the last 15 years but reflects a significant drop-off from 1988, when 51.1% of girls had engaged in intercourse and 60.4% of boys had done so. The data mirror a decline in teen pregnancy and birth rates during the same period; in 2015, the United States hit a new low of 22.3 births per 1000 teenage girls.

Contraception awareness and use remained relatively high over the years, rising from 97.7% of teen girls in 2002 who reported that they had ever used it, to 99.4% of teen girls saying they had ever used it when questioned during the period from 2011 to 2015. Even when first experiencing intercourse, 81% of girls questioned between 2011 and 2015 reported using contraception, compared with 74.5% who said they used it during their first time when surveyed in 2002. Among girls who had experienced sex in the previous 3-month period, 89.9% questioned in the most recent study period said they had used contraception, compared with 83.2% in 2002 and 79.9% in 1988.

Although increased contraception is a positive development, experts say there are still gains to be made, especially as more contraceptive methods are available now than in the past.

“The pill is still very commonly used and has not decreased since 2002 despite the availability of newer hormonal methods such as Depo-Provera,” Joyce Abma, PhD, a scientist at the National Center for Health Statistics, part of the HHS, and an author of the study, told Contagion^®. “Among female teens who had ever had sex, over half (56%) had used the pill at some point, according to the 2011-2015 data; 17% had used Depo-Provera; and 23% had used emergency contraception at some point. However, the condom and pill have higher failure rates than those methods and are still the most commonly used methods among teens.”

In addition, although overall rates of teen intercourse and pregnancy have dropped and contraceptive use has risen, there are significant differences among white, black, and Hispanic teens, particularly among males. During the period from 2011 to 2015, 58.6% of black males indicated they had ever had intercourse, compared with 45.7% of Latino males, and 42.8% of white males. Among girls, 46.6% of black females had experienced intercourse, compared with 41.4% of Hispanic females, and 44.3% of white females, although by age 19 more Hispanic girls had engaged in intercourse than had white girls. Socioeconomic and family structure matter, too: Teens whose mothers gave birth before the age of 20, teens whose mothers did not attend college, and teens who did not live with both biological parents were more likely to engage in intercourse than those who had a more traditional family unit, whose mothers were more educated, and who started their families later.

The findings show that 19.3% of females and 21.2% of male teens cited “didn’t want to get [a female] pregnant” as the top reason for not choosing to have sex, with 88.5% of female teens indicating that they would be “a little or very upset if they became pregnant.”

According to the report authors, understanding the behaviors driving contraception use among teenagers “provides insights into the ways in which those determinants are changing with time, how they differ by sociodemographic groups, and what circumstances are most associated with them. The information can be used to monitor and understand trends in teen sexual behavior and contraception use.”

Laurie Saloman, MS, is a health writer with more than 20 years of experience working for both consumer and physician-focused publications. She is a graduate of Brandeis University and the Medill School of Journalism at Northwestern University. She lives in New Jersey with her family.