Teens’ contraceptive use marked by inconsistency
Good news: More teens are delaying sex, and those who choose to have sex are using contraception at first intercourse. Bad news: The percentage of teen females who used contraception the last time they had sex dropped from 77% in 1988 to 69% in 1995, according to just-released figures from Child Trends, a Washington, DC-based nonprofit nonpartisan research center that studies children, youth, and families.1
The statistics contained in the new report are a red flag, says Sarah Brown, director of the Washington, DC-based National Campaign to Prevent Teen Pregnancy, which released the full report along with three other items dealing with teen contraceptive use:
• Protection as Prevention: Contraception for Sexually Active Teens, a review of current research on contraceptive use by teens; programs and services for sexually active teens; and policy issues;
• The Next Best Thing: Helping Sexually Active Teens Avoid Pregnancy, a series of suggestions for helping sexually active teens avoid pregnancy;
• Risky Business, A 2000 Poll: Teens Tell Us What They Really Think of Contraception and Sex, a nationally representative survey.
"Nearly one-third of teen girls were completely unprotected the last time they had sex, and of those girls, another one-third used contraception inconsistently," she notes. "And while more teens are now using contraception the first time they have sex, they are less likely than in previous years to use contraception the most recent time they have had sex."
Why aren’t teens using contraception all the time? Partner pressure, says one of every two teens surveyed by the National Campaign.2 Drinking and drug use also play a large role, noted more than 50% of the teens. The nationally representative survey questioned 515 teens ages 12 to 17.
While the poll showed that nearly nine of 10 teens believe it’s important to use contraception each and every time they have sex, they are not following through in their actions. Brown sees those statistics as an equation for disaster. "Too many teens, boys and girls alike, are still telling us that they don’t use contraception because their partner doesn’t want to. And the reasons the partners give for not wanting to use birth control are the same as they ever were: It doesn’t feel as good,’ or Just this once,’ or I thought if I brought birth control you would think I was pushy.’"
Data reviewed by the Child Trends researchers shows that almost 20% of teen females reported that they have had sex before age 15, a percentage that has almost doubled since 1988, says Jennifer Manlove, PhD, senior research associate. This finding is of concern, since younger teens are less likely to use contraception consistently and are at a greater risk of early pregnancy or sexually transmitted diseases, she notes. "Teens who report that they are the youngest up for sex are more likely to report that that encounter was nonvoluntary."
Hispanic teens are at particular risk for unplanned pregnancy, according to the Child Trends findings. The percentage of Hispanic teens who are sexually experienced increased from 49% in 1988 to 55% in 1995, while percentages for other ethnic groups declined, researchers note.
"Hispanic teens are least likely to use contraception either at first sex or at most recent sex," notes Manlove. "This group showed the greatest declines in contraceptive use at most recent sex."
Providing contraceptive services to sexually active adolescents remains controversial in the United States, says Claire Brindis, DrPH, professor of pediatrics and health policy in the department of pediatrics, division of adolescent medicine and Institute for Health Policy Studies at the University of California, San Francisco school of medicine and the director of the Center for Reproductive Health Policy Research in San Francisco. Brindis is co-author of Protection as Prevention: Contraception for Sexually Active Teens.
"Evaluations of programs that offer contraceptive information and services to adolescents consistently demonstrate no evidence that they encour- age teens to increase sexual activity or to initiate sexual intercourse earlier than they otherwise would have done," states Brindis. "In addition, public opinion surveys indicate that although parents and teens clearly prefer that school-age teens not be sexually active, they also agree that those teens who are sexually active should have access to contraception."
It remains challenging to ensure adequate access to contraceptive care, particularly care provided in a confidential and nonjudgmental manner, says Brindis. Once teens initiate contraceptive use, she notes, several factors are needed to ensure effective compliance: basic knowledge about available methods of contraception; skills to use the method correctly; support in using a method, particularly from a partner; ability to afford the method chosen; and motivation to prevent pregnancy and to use contraception effectively and consistently.
"Our first priority should always be to encourage teens to delay sexual activity, to protect their physical health, their emotional health, and their opportunities for the future," Brown says. "However, no matter how much support we give young people to say no,’ many will still become sexually active." The National Campaign has issued a publication, The Next Best Thing: Helping Sexually Active Teens Avoid Pregnancy, to help highlight what it considers some of the most compelling issues in the challenge to convince sexually active teens to use contraception consistently and carefully every time. "In The Next Best Thing, we note that access to contraception is necessary but not sufficient. Restricting sexually active teens from having access to contraception would be a mistake, but simply making contraceptive methods available to teens is not enough to motivate them to protect themselves."
References
1. Terry E, Manlove J. Trends in Sexual Activity and Contraceptive Use. Washington, DC: National Campaign to Prevent Teen Pregnancy; 2000.
2. International Communications Research for National Campaign to Prevent Teen Pregnancy. Risky Business, A 2000 Poll: Teens Tell Us What They Really Think of Contraception and Sex. Washington, DC; Feb. 3-6, 2000.
• National Campaign to Prevent Teen Pregnancy, 1776 Massachusetts Ave. N.W., Suite 200, Washington, DC 20036. Telephone: (202) 478-8500. To order The Next Best Thing: Helping Sexually Active Teens Avoid Pregnancy, Protection as Prevention: Contraception for Sexually Active Teens, or Trends in Sexual Activity and Contraceptive Use Among Teens, click on "Publications" on www.teenpregnancy.org.
• Child Trends, 4301 Connecticut Ave. N.W., Suite 100, Washington, DC 20008. Telephone: (202) 362-5580. Fax: (202) 362-5533. Web: www.childtrends.org. To review the policy brief, Trends in Sexual Activity and Contraceptive Use Among Teens, go to the following Web page: www.childtrends.org/r_ac.cfm.
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