Trends in U.S. adolescent sexual behavior and contraceptive use, 2006-2019

Lindberg, Laura Duberstein; Firestein, Lauren; Beavin, Cynthia

doi:10.1016/j.conx.2021.100064

Cited by 59 publications

(37 citation statements)

References 21 publications

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“…8 9 The most common method of contraception used by sexually active adolescents is condoms, with 30% of adolescents reporting using a condom alone at their last sexual encounter. 2…”

Section: Sexual Activity Among Adolescentsmentioning

confidence: 99%

“…1 In the National Survey of Family Growth (NSFG), more than half of adolescents (54% of adolescent women, 52% of adolescent men) reported engaging in at least one sexual behavior and the rate of penile-vaginal sex reported by males aged 15 to 17 declined from 31% in 2011-2015 to 23% in 2015-2019. 2 Rates of penile-vaginal sex reported by female adolescents has remained stable, but same-sex sexual behaviors among female adolescents increased from 12% in 2011-2015 to 15% in 2015-2019. 2…”

Section: Sexual Activity Among Adolescentsmentioning

confidence: 99%

“…2 Rates of penile-vaginal sex reported by female adolescents has remained stable, but same-sex sexual behaviors among female adolescents increased from 12% in 2011-2015 to 15% in 2015-2019. 2…”

Section: Sexual Activity Among Adolescentsmentioning

confidence: 99%

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Contraception in Adolescents

2021

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Adolescents are at risk for unwanted pregnancy when they become sexually active, and contraception is an important part of mitigating this risk. Use of contraceptive methods, and long-acting reversible contraceptive methods such as implants and intrauterine devices in particular, has increased among adolescents. Although sexual activity has declined and contraceptive use has increased among adolescents in the United States in recent years, the unintended pregnancy rate remains high. All of the currently available contraceptive methods are safe and effective for adolescents to use; however, adolescents may have specific concerns about side effect profiles and unscheduled bleeding that should be addressed during contraceptive counseling. Healthcare providers should prioritize adolescents' needs and preferences when approaching contraceptive counseling, and also consider the unique access and confidentiality issues that adolescents face when accessing contraception.

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“…8 9 The most common method of contraception used by sexually active adolescents is condoms, with 30% of adolescents reporting using a condom alone at their last sexual encounter. 2…”

Section: Sexual Activity Among Adolescentsmentioning

confidence: 99%

Section: Sexual Activity Among Adolescentsmentioning

confidence: 99%

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Contraception in Adolescents

2021

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“…Relevant attitudinal shifts include less conservative social norms around adolescent sexual behavior generally, as well as increased acceptance of same-sex behaviors [8,9]. In more recent years, expansion of contraceptive coverage in health insurance has expanded access to a breadth of contraceptive methods and guidelines supporting the use of LARC for adolescents have increased uptake of these methods [10]. Additionally, with high school dropout rates declining by more than half from 1995 to 2017, the school-based YRBS may have become more comparable to the household-based NSFG over time, potentially reducing previously observed differences [11].…”

Section: Introductionmentioning

confidence: 99%

Comparability of estimates and trends in adolescent sexual and contraceptive behaviors from two national surveys: National Survey of Family Growth and the Youth Risk Behavior Survey

et al. 2021

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Objective To compare adolescents’ reports of sexual and contraceptive behaviors between the National Survey of Family Growth (NSFG) and the Youth Risk Behavior Survey (YRBS). Methods For each survey, we estimated the year- and sex-specific prevalence of sexual and contraceptive behaviors among a comparably defined sample of US respondents ages 15–19 currently attending high school. We used logistic regression to test for changes in prevalence from 2007–2019 and conducted sensitivity analyses to investigate between-survey differences. Results We found differences in both prevalence and trends between the YRBS and NSFG when limited to a comparably defined sample. Compared to the NSFG, adolescents in the YRBS were more likely to report being sexually experienced, less likely to report use of prescription methods for both sexes, and less likely to report condoms among males. Only the YRBS estimated significant declines in sexual experience for both sexes, and significant increases in prescription methods and declines in condom use among males. Differences between surveys in the prevalence of specific contraceptive methods reflected greater combined use of methods in the NSFG. We identified differences in question-wording and other aspects that may influence these differential patterns. Conclusions The NSFG and YRBS produced inconsistent prevalence estimates and trends for sexual and contraceptive behaviors among in-school adolescents. Further efforts to improve these national surveillance systems are critical to inform policy and research efforts that support adolescent sexual and reproductive health and wellbeing.

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“… 2 Unintended pregnancy is a preventable outcome with negative consequences for both adolescents and their offspring. 3 In recent years, adolescent pregnancy rates have declined, a trend partially explained by increased adolescent use of implants and intrauterine devices (IUDs), 4 collectively termed long‐acting reversible contraception (LARC). Although LARC methods are recommended as safe and effective contraceptive options for adolescents, 5 , 6 less effective contraception, such as condoms and withdrawal, remain the most common methods used by adolescents in the United States.…”

Section: Introductionmentioning

confidence: 99%

A comparison of contraceptive services for adolescents at school‐based versus community health centers in Oregon

Boniface

Rodríguez

Heintzman

et al. 2021

Health Services Research

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Objective To compare Oregon school‐based health centers (SBHCs) with community health centers (CHCs) as sources of adolescent contraceptive services. Data sources Oregon electronic health record data, 2012–2016. Study design We compared clinic‐level counseling rates and long‐acting reversible contraception (LARC) provision, adolescent populations served, and visit‐level LARC provision time trends. We evaluated adjusted associations between LARC provision and Title X participation by clinic type. Data collection/extraction methods We used diagnosis and procedure codes to identify contraceptive counseling and provision visits, excluding visits for adolescents not at risk of pregnancy. Principal findings CHCs were more likely to provide LARC on‐site than SBHCs (67.2% vs. 36.4%, respectively). LARC provision increased more at SBHCs (5.8‐fold) than CHCs (2‐fold) over time. SBHCs provided more counseling visits per clinic (255 vs. 142) and served more young and non‐White adolescents than CHCs. The adjusted probability of LARC provision at Title X SBHCs was higher than non‐Title X SBHCs (4.4% [3.9–4.9] vs. 1.7% [1.4–2.0]), but there was no significant association at CHCs. Conclusions In Oregon, CHCs and SBHCs are both important sources of adolescent contraceptive services, and Title X plays a crucial role in SBHCs. Compared with CHCs, SBHCs provided more counseling, showed a larger increase in LARC provision over time, and served more younger and non‐White adolescents.

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Trends in U.S. adolescent sexual behavior and contraceptive use, 2006-2019

Cited by 59 publications

References 21 publications

Contraception in Adolescents

Contraception in Adolescents

Comparability of estimates and trends in adolescent sexual and contraceptive behaviors from two national surveys: National Survey of Family Growth and the Youth Risk Behavior Survey

A comparison of contraceptive services for adolescents at school‐based versus community health centers in Oregon

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