Executive Summary
A new analysis of national data indicates that in 2011-2013, 44% of female teens and 47% of male teens ages 15-19 had experienced sexual intercourse, a percentage that has declined significantly — 14% for female, 22% for male — over the past 25 years.
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This finding follows recent news that in 2013, the U.S. birth rate for teenagers ages 15-19 dropped 57% from its peak in 1991, which parallels a decline in the teen pregnancy rate.
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By age 19, about two of three never-married teenagers have had sexual intercourse, with the majority of male and female teenagers using a contraceptive method at first sexual intercourse, data show. The methods teens most often used were the condom, withdrawal, and the oral contraceptive pill.
A new analysis of national data carries good news: In 2011-2013, 44% of female teens and 47% of male teens ages 15-19 had experienced sexual intercourse, a percentage that has declined significantly — 14% for females, 22% for males — over the past 25 years.1
This decrease follows recent news that in 2013, the U.S. birth rate for teenagers ages 15-19 dropped 57% from its peak in 1991, which parallels a decline in the teen pregnancy rate.2-3 (Contraceptive Technology Update reported on the data. See “Title X clinics see upswing in use of long-acting reversible contraceptives by teens,” July 2015, and “Record low teen pregnancy — What is next?” June 2012.)
According to the report from the Centers for Disease Control and Prevention’s National Center for Health Statistics (NCHS), in the early teen years (ages 15 and 16) males were more likely than females to have had sexual intercourse. By age 17, the probabilities of having had sexual intercourse were similar for males and females, the report notes. For males, by age 15, 18% had ever had sexual intercourse. By age 17, this percentage increased to 44%, and by age 19, 69% of males had ever had sexual intercourse. When looking at female adolescent data, statistics indicate that by age 15, 13% had ever had sexual intercourse. By age 17, this percentage increased to 43%, and by age 19, 68% of females had ever had sexual intercourse.1
By age 19, about two of three never-married teens have had sexual intercourse, with most male and female teens using a contraceptive method at first sexual intercourse. The methods teens most often used were the condom, withdrawal, and the oral contraceptive pill, data indicate. Female adolescents who used a method of contraception at first sexual intercourse were less likely to have had a birth in their teens than those who didn’t use contraception at first intercourse, statistics show.1
“Understanding these patterns and trends in sexual activity, contraceptive use, and their impact on teen pregnancy can help provide context regarding the recent decline in the U.S. teen birth rate,” write the report’s authors, Gladys Martinez, PhD, and Joyce Abma, PhD, demographers in the NCHS’s Division of Vital Statistics’ Reproductive Statistics Branch.
Have things changed?
How has contraceptive method use changed over the past decade among female teens who had sexual intercourse at least once? Highlights from the report reveal the following:
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In 2011-2013, 97% of female teens who had sexual intercourse at least once had used the condom at least once.
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Sixty percent of female teens had ever used withdrawal, and 54% had ever used the Pill in 2011-2013. The differences in pill and withdrawal use between 2002 and 2011-2013 were not statistically significant.
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Use of emergency contraception by female teens who had sexual intercourse at least once has increased over the past decade from 8% in 2002 to 22% in 2011-2013.
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Compared with 2006-2010, a smaller percentage of female teenagers ever used the patch in 2011-2013, (from 10% to 2%) and ever used the contraceptive injection (from 20% to 15%). In 2011-2013, approximately 3% of female teens who had sexual intercourse at least once had ever used an intrauterine device (IUD), and 2% had used a hormonal implant, similar to 2006-2010’s percentages.1
Continue the progress
One of the nation’s great success stories of the past two decades has been the historic declines in teen pregnancy and childbearing, says Bill Albert, chief program officer of The National Campaign to Prevent Teen and Unplanned Pregnancy in Washington, DC.
“Progress has been made in all 50 states and among all racial/ethnic groups,” observes Albert. “Thanks to teens themselves, a tough social issue that many once considered intractable turns out not to be so.”
There are only two ways to drive down the teen pregnancy rate: less sex and/or more contraception, notes Albert. Numerous data sets and analyses, including the most recent data from the NCHS, now show that the decline in teen pregnancy has been fueled by the “magic formula” of less sex and more contraception, Albert comments. “The new data also makes clear that the declines in teen sex and increases in contraceptive use have either slowed or come to a complete halt,” says Albert. “This raises the very real specter that what goes down can go back up again. That is, without continued attention, investment, and action, one of the nation’s great success stories of the past two decades could reverse.”
So what can clinicians do to aid in furthering the progress? The new NCHS data suggest that awareness and use of IUDs and the implant, what Albert terms “no-bother birth control,” are low, compared to other methods. Data indicated that uptake of these methods in the United States is significantly less than in many other countries with lower rates of teen pregnancy and unplanned pregnancy.4
“Given their effectiveness and ease of use, IUDs and the implant are critical to helping women plan their pregnancies — largely because, once in place, they change the default from having to take constant action to avoid an unplanned pregnancy, such as taking a pill every day, to having to take action to become pregnant, i.e., through removal of the device,” says Albert. “We believe that improving communication about IUDs and the implant — the words, the images, and the ideas — can have a significant positive impact on young women’s perception of these methods and believe a significant shift in communication approaches is needed to counter existing misinformation, misperceptions, and concerns about IUDs and the implant.”
REFERENCES
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Martinez GM, Abma JC. Sexual activity, contraceptive use, and childbearing of teenagers aged 15-19 in the United States. NCHS data brief, no. 209. Hyattsville, MD: National Center for Health Statistics. 2015.
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Martin JA, Hamilton BE, Osterman MJK, et al. Births: Final data for 2013. National vital statistics reports; vol. 64 no. 1. Hyattsville, MD: National Center for Health Statistics. 2015.
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Kost K, Henshaw S. U.S. Teenage pregnancies, births and abortions, 2008: National trends by age, race and ethnicity;2012. Accessed at http://bit.ly/zINgwC.
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McNicholas C, Peipert JF. Long-acting reversible contraception (LARC) for adolescents. Curr Opin Obstet Gynecol 2012; 24(5):293-298.
