SEXUAL ACTIVITY
•Although only 13% of teens have had sex by age 15, most initiate sex in their later teen years. By their 19th birthday, seven in 10 female and male teens have had intercourse.[1]
•On average, young people have sex for the first time at about age 17,[2,3] but they do not marry until their mid-20s.[4] This means that young adults may be at increased risk for unintended pregnancy and STIs for nearly a decade or longer.
•Teens are waiting longer to have sex than they did in the recent past. In 2006–2008, some 11% of never-married females aged 15–19 and 14% of never-married males that age had had sex before age 15, compared with 19% and 21%, respectively, in 1995.[1]
•However, after declining substantially between 1995 and 2002, the proportion of teens who had ever had sex did not change significantly from 2002 to 2006–2008.[1]
•In 2006–2010, the most common reason that sexually inexperienced teens gave for not having had sex was that it was “against religion or morals” (38% among females and 31% among males). The second and third most common reasons for females were “don’t want to get pregnant” and “haven’t found the right person yet.”[5]
•Among sexually experienced teens, 70% of females and 56% of males report that their first sexual experience was with a steady partner, while 16% of females and 28% of males report first having sex with someone they had just met or who was just a friend.[5]
•Seven percent of young women aged 18–24 who had had sex before age 20 report that their first sexual experience was nonvoluntary. Those whose first partner was three or more years their senior were more likely to report this than were other women in the same age-group.[1]
•Teens in the United States and Europe have similar levels of sexual activity. However, European teens are more likely than U.S. teens to use contraceptives generally and to use the most effective methods; they therefore have substantially lower pregnancy rates.[6]
•Three percent of males and 8% of females aged 18–19 in 2002 reported their sexual orientation as homosexual or bisexual; the proportions reporting same-sex behaviors were similar.[7]
•The use of contraceptives during first premarital sex has been increasing, rising from 56% among women whose first premarital sex occurred before 1985, to 76% among those who first had sex in 2000–2004, to 84% among those whose first sex occurred in 2005–2008.[9]
CONTRACEPTIVE USE
•A sexually active teen who does not use a contraceptive has a 90% chance of becoming pregnant within a year.[8]
•The majority of sexually experienced teens (78% of females and 85% of males) used contraceptives the first time they had sex.[5]
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•The condom is the most common contraceptive method used at first intercourse; 68% of females and 80% of males use it the first time they have sex. [5]
•In 2006–2010, some 96% of sexually experienced female teens had used a condom at least once, 57% had ever used withdrawal and 56% had used the pill. Smaller proportions had used other methods.[5]
•In the same period, one in five sexually active female teens (20%) and one-third of sexually active male teens (34%) reported having used both the condom and a hormonal method the last time they had sex.[5] Dual method use offers protection against both pregnancy and STIs.
•In 2006–2010, some 86% of female teens and 93% of male teens reported using contraceptives at last sex. These proportions represent a marked improvement since 1995, when only 71% of female teens and 82% of male teens had reported using a method at last sex. However, the proportions were unchanged between 2002 and 2006–2010.[5]
•Nearly one in five female teens at risk for unintended pregnancy (19%) were not using any contraceptive method at last intercourse.[9]
ACCESS TO CONTRACEPTIVE SERVICES
•No state explicitly requires parental consent or notification for contraceptive services. However, two states (Texas and Utah) require parental consent for contraceptive services paid for with state funds.[10]
•Twenty-one states and the District of Columbia explicitly allow minors to obtain contraceptive services without a parent’s involvement. Another 25 states have affirmed that right for certain classes of minors, while four states have no law. In the absence of a specific law, courts have determined that minors’ privacy rights include the right to obtain contraceptive services.[10]
•In 2002, some 90% of publicly funded family planning clinics counseled clients younger than 18 about abstinence, the importance of communicating with parents about sex or both topics.[11]
•Nearly two million women younger than 20 were served by publicly supported family planning centers in 2005; these teens represented one-quarter of the centers’ contraceptive clients.[12]
•In 2006, only 5% of American high schools made condoms available to students.[12]
STIs
•Young people aged 13–24 made up about 17% of all people diagnosed with HIV/AIDS in the United States in 2008.[13]
•Although 15–24-year-olds represent only one-quarter of the sexually active population, they account for nearly half (9.1 million) of the 18.9 million new cases of STIs each year.[14]
•Human papillomavirus (HPV) infections account for about half of STIs diagnosed among 15–24-year-olds each year. HPV is extremely common, often asymptomatic and generally harmless. However, certain types, if left undetected and untreated, can lead to cervical cancer.[14]
•Two HPV vaccines—Gardasil and Cervarix are currently available, and both prevent the types of infections most likely to lead to cervical cancer. The Centers for Disease Control now recommends HPV vaccinations for both girls and boys, starting at age 11.
•In 2009, 44% of females aged 13–19 had received one or more doses of the vaccine against HPV; 27% had completed the recommended three doses.[17]
•All 50 states and the District of Columbia explicitly allow minors to consent to STI services without parental involvement, although 11 states require that a minor be of a certain age (generally 12 or 14) to do so. Thirty-one states explicitly include HIV testing and treatment in the package of STI services to which minors may consent.[18]
PREGNANCY
•Each year, almost 750,000 U.S. women aged 15–19 become pregnant.[19] Two-thirds of all teen pregnancies occur among 18–19-year-olds.[19]
•Overall, 68 pregnancies occurred per 1,000 women aged 15–19 in 2008. The 2008 rate was a record low and represented a 42% decline from the peak rate of 117 per 1,000, which occurred in 1990.[19]
•The majority of the decline in teen pregnancy rates in the United States (86%) is due to teens’ improved contraceptive use; the rest is due to increased proportions of teens choosing to delay sexual activity.[21]
•Despite having declined, the U.S. teen pregnancy rate continues to be one of the highest in the developed world. It is more than twice as high as rates in Canada (28 per 1,000 women aged 15–19 in 2006) and Sweden (31 per 1,000).[22]
•In 2005, New Mexico had the highest teenage pregnancy rate (93 per 1,000); rates in Nevada, Arizona, Texas and Mississippi followed. The lowest rates were in New Hampshire (33 per 1,000), Vermont, Maine, Minnesota and North Dakota.[20]
•Eighty-two percent of teen pregnancies are unplanned; teens account for about one-fifth of all unintended pregnancies annually.[23]
•Fifty-nine percent of pregnancies among 15–19-year-olds in 2008 ended in birth, and 26% in abortion.[19]
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•Black and Hispanic women have the highest teen pregnancy rates (117 and 107 per 1,000 women aged 15–19, respectively); non-Hispanic whites have the lowest rate (43 per 1,000).[19]
•The pregnancy rate among black teens decreased 48% between 1990 and 2008, more than the overall U.S. teen pregnancy rate declined during the same period (42%).[19]
•Most female teens report that they would be very upset (58%) or a little upset (29%) if they got pregnant, while the rest report that they would be a little or very pleased.[1]
CHILDBEARING
•Ten percent of all U.S. births are to girls aged 19 or younger.[24]
•Most births to teen mothers are first births. Eighteen percent are second or higher order births.[24]
•The share of births to teen mothers that are nonmarital rose from 79% in 2000 to 86% in 2009. Yet, over the last several decades, the share of all nonmarital births that are to teenagers has been declining, from 52% in 1975 to 21% in 2009.[24, 25]
•In 2009, some 39 births occurred per 1,000 women aged 15–19; this rate marks a 37% decline from the peak rate of 62 reached in 1991.[24]
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•Six percent of teen mothers aged 15–19 received late or no prenatal care. Babies born to teens are more likely to be low birth-weight than are those born to women in their 20s and 30s.[26]
•Teen childbearing is associated with reduced educational attainment. Teen mothers are substantially less likely than women who delay childbearing to complete high school or obtain a GED by age 22 (66% vs. 94%).[27] Fewer than 2% of teens who have a baby before age 18 attain a college degree by age 30.[28]
FATHERHOOD
•Most teen males report that they would be very upset (46%) or a little upset (34%) if they got someone pregnant, while the remaining 20% report that they would be pleased or a little pleased.[5]
•Teen fatherhood rates vary considerably by race. In 2006, the rate among black males aged 15–19 who became fathers (34 per 1,000) was more than twice that among whites (15 per 1,000).[29]
•The rate of teen fatherhood declined 25% between 1990 and 2006, from 24 to 18 per 1,000 males aged 15–19. This decline was far more substantial among blacks than among whites (38% vs. 18%).[29]
ABORTION
•Women aged 15–19 had 192,090 abortions in 2008.[19]
•The reasons teens most frequently give for having an abortion are that they are concerned about how having a baby would change their lives, cannot afford a baby now and do not feel mature enough to raise a child.[30]
•As of October 2011, laws in 36 states required that a minor seeking an abortion involve her parents in the decision.[31]
References
1. Abma JC et al., Teenagers in the United States: sexual activity, contraceptive use, and childbearing, National Survey of Family Growth 2006–2008, Vital and Health Statistics, 2010, Series 23, No. 30.
2. Chandra A et al., Fertility, family planning, and reproductive health of U.S. women: data from the 2002 National Survey of Family Growth, Vital and Health Statistics, 2005, Series 23, No. 25
3. Martinez GM et al., Fertility, contraception, and fatherhood: data on men and women from Cycle 6 (2002) of the National Survey of Family Growth, Vital and Health Statistics, 2006, Series 23, No. 26.
4. U.S. Bureau of the Census, America’s Families and Living Arrangements, Washington, DC: U.S. Government Printing Office, 2009.
5. Martinez G et al., Teenagers in the United States: sexual activity, contraceptive use, and childbearing, 2006-2010 National Survey of Family Growth, Vital and Health Statistics, 2011, Series 23, No. 31.
6. Santelli J, Sandfort T and Orr M, Transnational comparisons of adolescent contraceptive use: what can we learn from these comparisons? Archives of Pediatrics & Adolescent Medicine, 2008, 162(1):92–94.
7. Mosher WD et al., Sexual behavior and selected health measures: men and women 15–44 years of age, United States, 2002, Advance Data from Vital and Health Statistics, 2005, No. 362.
8. Harlap S, Kost K and Forrest JD, Preventing Pregnancy, Protecting Health: A New Look at Birth Control Choices in the United States, New York: The Alan Guttmacher Institute, 1991.
9. Mosher WD and Jones J, Use of contraception in the United States: 1982–2008, Vital and Health Statistics, 2010, Series 23, No. 29.
10. Guttmacher Institute, Minors’ access to contraceptive services, State Policies in Brief (as of October 2011), 2011, <http://www.guttmacher.org/statecenter/spibs/spib_MACS.pdf>, accessed Oct. 19, 2011.
11. Lindberg LD et al., Provision of contraceptive and related services by publicly funded family planning clinics, 2003, Perspectives on Sexual and Reproductive Health, 2006, 38(3):139–147.
12. Jones RK et al., Adolescents’ reports of parental knowledge of adolescents’ use of sexual health services and their reactions to mandated parental notification for prescription contraception, Journal of the American Medical Association, 2005, 293(3):340–348.
13. Centers for Disease Control and Prevention (CDC), HIV Surveillance Report, 2008, Vol. 20, 2010, <http://www.cdc.gov/hiv/topics/surveillance/resources/reports>, accessed Oct. 26, 2010.
14. Weinstock H et al., Sexually transmitted diseases among American youth: incidence and prevalence estimates, 2000, Perspectives on Sexual and Reproductive Health, 2004, 36(1):6–10.
15. U.S. Food and Drug Administration, FDA licenses new vaccine for prevention of cervical cancer and other diseases in females caused by human papillomavirus: rapid approval marks major advancement in public health, 2006, <http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/2006/ucm108666.htm>, accessed Nov.19, 2010.
16. U.S. Food and Drug Administration, FDA approves new vaccine for prevention of cervical cancer, 2009, >http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/2009/ucm187048.htm>, accessed Nov. 19, 2010.
17. CDC, National, state, and local area vaccination coverage among adolescents aged 13–17 years — United States, 2009, Morbidity and Mortality Weekly Report, 2010, 59(32):1018–1023.
18. Guttmacher Institute, Minors’ access to STI services, State Policies in Brief, (as of October 2011), 2011, , accessed Oct.19, 2011.
19. Kost K, Henshaw S and Carlin L, U.S. Teenage Pregnancies, Births and Abortions: National and State Trends and Trends by Race and Ethnicity, 2010, >http://www.guttmacher.org/pubs/USTPtrends.pdf<, accessed Jan. 26, 2010.
20. Kost K and Henshaw S, U.S. Teenage Pregnancies, Births and Abortions, 2008: National Trends by Race and Ethnicity, 2012, <http://www.guttmacher.org/pubs/USTPtrends08.pdf>, accessed February 6, 2012.
21. Santelli JS et al., Explaining recent declines in adolescent pregnancy in the United States: the contribution of abstinence and improved contraceptive use, American Journal of Public Health, 2007, 97(1):150–156.
22. McKay A et al., Trends in teen pregnancy rates from 1996–2006: a comparison of Canada, Sweden, USA and England/Wales, Canadian Journal of Human Sexuality, 19(1–2):43–52.
23. Finer LB and Zolna MR, Unintended pregnancy in the United States: incidence and disparities, 2006, Contraception, 2011, doi: 10.1016/j.contraception.2011.07.013
24. Martin JA et al., Births: final data for 2009, National Vital Statistics Reports, 2011, Vol. 60, No.1.
25. Martin JA et al., Births: final data for 2000, National Vital Statistics Reports, 2002, Vol. 50, No. 5.
26. Martin JA et al., Births: final data for 2003, National Vital Statistics Reports, 2005, Vol. 54, No 2.
27. Perper K, Peterson K and Manlove J, Diploma attachment among teen mothers, Fact Sheet, Washington, DC: Child Trends, 2010,<http://www.childtrends.org/Files/Child_Trends-2010_01_22_FS_DiplomaAttainment.pdf>, accessed Mar.1, 2010.
28. Hoffman SD, By the Numbers: The Public Costs of Adolescent Childbearing, Washington, DC: National Campaign to Prevent Teen Pregnancy, 2006.
29. Martin JA et al., Births: final data for 2006, National Vital Statistics Reports, 2009, Vol. 57, No. 7.
30. Dauphinee LA, Guttmacher Institute, New York, personal communication, Mar. 23, 2006.
31. Guttmacher Institute, Parental involvement in minors’ abortions, State Policies in Brief (as of October 2011), 2011 <http://www.guttmacher.org/statecenter/spibs/spib_PIMA.pdf>, accessed Oct. 19, 2011.
