The Truth About Adolescent Sexuality

Sexual Partners

• 14.2 percent of students (17.2 percent of males and 11.4 percent of females) reported having had sexual intercourse with four or more partners
• 21.6 percent of twelfth graders, 15.2 percent of eleventh graders, 12.6 percent of tenth graders, and 9.6 percent of ninth graders reported having had sexual intercourse with four or more partners
• 26.6 percent of Black students, 14.9 percent of Hispanic students, and 12 percent of White students reported having had sexual intercourse with four or more partners

Alcohol and Drug Use During Last Intercourse

• Among currently sexually active students, 25.6 percent (30.9 percent of males and 20.7 percent of females) reported using drugs or alcohol during last intercourse
• Among currently sexually active students, 25.4 percent of twelfth graders, 24.7 percent of eleventh graders, 27.7 percent of tenth graders, and 24 percent of ninth graders reported using drugs or alcohol during last intercourse
• Among currently sexually active students, 17.8 percent of Black students, 24.1 percent of Hispanic students, and 27.8 percent of White students reported using alcohol or drugs during last intercourse

NATIONAL LONGITUDINAL STUDY ON ADOLESCENT HEALTH (ADD HEALTH)

ADD Health is a comprehensive national study that examines adolescent health behaviors and other factors that influence their health. A total of 12,118 adolescents in grades 7 through 12 were interviewed. The study found that:2

• 17 percent of seventh and eighth graders reported having had sexual intercourse
• 49.3 percent of ninth through twelfth graders reported having had sexual intercourse
• 39.9 percent of female and 37.3 percent of male adolescents in grades seven through 12 reported having had sexual intercourse
• 11.8 percent of sexually experienced girls in grades seven and eight and 19.4 percent of sexually experienced girls in grades nine to 12 reported having been pregnant

COMPARING THE 1991, 1995, AND 2001 YRBS

The CDC has administered the YRBS biannually since 1991. The results provide a decade of important data on the behaviors of American adolescents. By looking at a sample of results from the 1991, 1995, and 2001 YRBS, educators can gain valuable insight into the sexual behaviors and needs of young people across the country.

Sexual Intercourse History

• 45.6 percent of students reported having ever had sexual intercourse in 2001 compared to 53.1 percent in 1995 and 54.1 percent in 1991
• 26.7 percent of students reported having ever had sexual intercourse but not in the three months preceding the survey in 2001 compared to 28.5 percent in 1995 and 30.7 percent in 1991
• 6.6 percent of students reported having initiated sexual intercourse before age 13 in 2001 compared to 8.9 percent in 1995 and 10.2 percent in 1991

Sexual Partners

• 14.2 percent of students reported having had sexual intercourse with four or more partners in 2001 compared to 17.8 percent in 1995 and 18.7 percent in 1991
• 33.4 percent of students reported being "currently sexually active" (defined as having had sexual intercourse with one or more partners in the three months preceding the survey) in 2001 compared to 37.9 percent in 1995 and 37.5 percent in 1991

Contraceptive Use and Reported Pregnancies

• Among "currently sexually active" students, 57.9 percent reported having used condoms during last intercourse in 2001 compared to 54.4 percent in 1995 and 46.2 percent in 1991
• 4.7 percent of students reported having been pregnant or having gotten someone pregnant in 2001 compared to 6.9 percent in 1995 and 6.0 percent in 1991 "Currently sexually active" was defined as having had sexual intercourse in the three months prior to the survey.

NEW STUDY PROVIDES ADDITIONAL INFORMATION ON ADOLESCENT SEXUAL BEHAVIOR

The Kaiser Family Foundation recently released the National Survey of Adolescents and Young Adults: Sexual Health Knowledge, Attitudes, and Experiences. The survey looks at a nationally representative sample of more than 1,800 young people in three key age groups: young adolescents (ages 13 to 14), adolescents (ages 15 to 17), and young adults (ages 18 to 24). It asked these individuals about their knowledge and attitudes toward sexuality as well as about their sexual experience, including sexual intercourse, oral sex, and intimacy. Questions about personal experiences were only asked of participants ages 15 and older. The survey found that:3

Sexual Intercourse

• 37 percent of adolescents ages 15 to 17 (42 percent of males and 33 percent of females) reported having had sexual intercourse
• 80 percent of young adults ages 18 to 24 (83 percent of males and 78 percent of females) reported having had sexual intercourse
• Among adolescents ages 15 to 17 who had engaged in sexual intercourse, 11 percent reported having first had intercourse at 12 or 13, 44 percent at 14 or 15, and 37 percent at 16 or 17
• Among young adults ages 18 to 24 who had engaged in sexual intercourse, two percent reported having first had intercourse at 11 or younger, six percent at 12 or 13, 23 percent at 14 or 15, 41 percent at 16 or 17, and 25 percent at 18 or older
• Among adolescents ages 15 to 17 who had engaged in sexual intercourse, 42 percent reported one lifetime partner, 39 percent reported two to five lifetime partners, seven percent reported six to nine lifetime partners, and four percent reported 10 or more lifetime partners
• Among young adults ages 18 to 24 who had engaged in sexual intercourse, 20 percent reported one lifetime partner, 39 percent reported two to five lifetime partners, 13 percent reported six to nine lifetime partners, and 14 percent reported 10 or more lifetime partners

NATIONAL CAMPAIGN TO PREVENT TEEN PREGNANCY: NEW STUDY ON ADOLESCENT SEXUAL BEHAVIOR

The National Campaign to Prevent Teen Pregnancy recently released Fourteen and Younger: The Sexual Behavior of Young Adolescents. This comprehensive report contains seven papers based on six different sets of data on young people (three national and three local). It sheds light on sexual relationships and activity among young teens. The report found:

Sexual Intercourse

• Approximately one in five adolescents has engaged in sexual intercourse before his or her fifteenth birthday
• Boys who are 14 and younger are slightly more likely to have had intercourse than girls of the same age
• A substantial proportion of teens who are 14 and younger who have had intercourse are not currently sexually active
• More than one in 10 girls who first had intercourse before age 15 describe it as non-voluntary and many more describe it as relatively unwanted

Contraceptive Use

• Between half and three-quarters of young people ages 12 to 14 who reported having had intercourse used contraception the first time they had sex
• Slightly more than half of girls ages 12 to 14 and about two-thirds of boys who reported having had intercourse say they used some form of contraception the most recent time they had sex

Oral Sex

• 36 percent of adolescents ages 15 to 17 (40 percent of males and 32 percent of females) reported having had oral sex
• 66 percent of young adults ages 18 to 24 (73 percent of males and 58 percent of females) reported having had oral sex
• 61 percent of White adolescents and young adults (ages 15 to 24), 41 percent of African- American adolescents and young adults, 47 percent of Latino adolescents and young adults, and 40 percent of Asian adolescents and young adults reported having had oral sex
• 82 percent of adolescents and young adults (ages 15 to 24) who had engaged in sexual intercourse reported having had oral sex as did 12 percent of adolescents and young adults who had not had sexual intercourse
• 24 percent of adolescents ages 15 to 17 (18 percent male and 33 percent female) reported having had oral sex to avoid having intercourse

Intimacy

• 56 percent of adolescents ages 15 to 17 (65 percent male and 47 percent female) reported having "been with someone in an intimate or sexual way (including but not limited to intercourse)"
• 85 percent of young adults ages 18 to 24 (87 percent male and 84 percent female) reported having "been with someone in an intimate or sexual way (including but not limited to intercourse)"
• 27 percent of adolescents and young adults (ages 15 to 24) who had not had sexual intercourse reported having "been with someone in an intimate or sexual way"

WHAT ARE THEY THINKING AND DOING?

In recent years, a lot of attention has been paid to the topic of young people and oral sex. The media suggests they are engaging in oral sex at an alarming rate. There is also speculation that they do not think oral sex is "sex" and that they view oral sex as a way to avoid the risk of pregnancy and STDs. Some adults have wondered whether the recent increased focus on "virginity" has led young people to seek behaviors other than vaginal intercourse. According to a recent analysis by The Alan Guttmacher Institute, "The reports in the press that oral sex has become widespread among adolescents cannot be confirmed or refuted because the data to do so have never been collected."

A few small surveys, have, however, provided us with some insight into how adolescents view oral sex. For example, one survey of 510 adolescent ages 12 to 17 found that 31 percent of female participants and 44 percent of male participants "strongly agree" or "somewhat agree" that oral sex is not as big a deal as sexual intercourse. In another survey of 519 adolescents ages 12 to17, 21 percent considered oral sex to be "safe sex." In a third survey of 505 adolescents ages 12 to 17, 27 percent of participants reported oral sex as an activity that is "almost always" or "most of the time" part of a more serious dating relationship while 24 percent reported oral sex as an activity that is "almost always" or "most of the time" part of a casual relationship.

More research is needed on this topic to help educators and parents understand behaviors and motivation. In the meantime, young people need to understand that oral sex can lead to some STDs, and they need to know how to protect themselves if they engage in this behavior.

In Their Own Right: Addressing the Sexual and Reproductive Health Needs of American Men, a report released by The Alan Guttmacher Institute, is an analysis of research that examined the continuous need for awareness of men's health issues. The report, which focused on heterosexual men, provided an overview of some fundamental patterns in men's sexual and reproductive lives. The report found that:

Sexual Intercourse

• 42 percent of men ages 15 to 17 had engaged in sexual intercourse. Of these, 86 percent had engaged in intercourse in the past year, 47 percent had engaged in intercourse in the past month, and 36 percent had engaged in intercourse 10 or more times in the past year
• 75 percent of men ages 18 to 19 had engaged in sexual intercourse. Of these, 91 percent had engaged in intercourse in the past year, 61 percent had engaged in intercourse in the past month, and 56 percent had engaged in intercourse 10 or more times in the past year
• 3.2 percent of young men had engaged in sexual intercourse by age 12; 6.1 percent had engaged in intercourse by age 13; 13.4 percent had engaged in intercourse by age 14; 22.7 percent had engaged in intercourse by age 15; 36.3 percent had engaged in intercourse by age 16; 52.4 percent had engaged in intercourse by age 17; 66.1 percent had engaged in intercourse by age 18; and 78.4 percent had engaged in intercourse by age 19

Other Sexual Behavior

• Among men ages 15 to 19 who had never had vaginal intercourse, 67 percent reported that they had touched a woman's breasts, 22 percent had been stimulated to the point of orgasm by a partner, 18 percent had received oral sex, and 14 percent had given oral sex

HETEROSEXUAL ACTIVITY AMONG LESBIAN, BISEXUAL, AND QUESTIONING WOMEN

A study of 3,816 young women who identify as lesbian, as bisexual, or as unsure of their sexual orientation suggests these women are at an increased risk of pregnancy and poor contraceptive practice. The study found that:

Sexual Activity

• Bisexual/lesbian respondents (33 percent) were as likely as their heterosexual peers (29 percent) to have ever had penile-vaginal intercourse while those unsure of their sexual orientation (22 percent) were less likely to have engaged in intercourse.
• Of the respondents who had ever had intercourse, 62 percent of bisexual/lesbian young women said they had first done so before the age of 14 as compared to 45 percent of heterosexual respondents and 46 percent of those unsure of their sexual orientation. However, when controlled for self-reported history of sexual abuse, this difference was no longer statistically significant.
• Among sexually experienced respondents, bisexual/lesbian women were significantly more likely to engage in penile-vaginal intercourse daily or several times a week (22 percent) than their heterosexual peers (15 percent) or those unsure of their sexual orientation (17 percent).

The authors provide several hypotheses for why lesbian and bisexual teens may have heterosexual experiences. First, they note that sexual abuse, incest, and rape are more prevalent among lesbian and bisexual young women. In addition, young women might engage in heterosexual relationships before identifying as lesbian or bisexual, or, finally, they might engage in heterosexual relationships as a way to try to "cure" themselves of homosexual interests.

STUDY EXAMINES WHERE YOUNG PEOPLE ENGAGE IN SEXUAL INTERCOURSE

A study of 2,034 high school students in an urban district examined the link between lack of adult supervision and adolescent sexual activity. As part of the study, researchers also examined where young people typically engage in sexual behavior. The study found that:

• 75.1 percent of males and 59.4 percent of females left unsupervised for five or fewer hours per week reported having had sexual intercourse compared to 87.6 percent of males and 72.5 percent of females left unsupervised for 30 or more hours per week
• 5.7 percent of males and 15.3 percent of females left unsupervised for five or fewer hours per week reported having had an STD compared to 13.6 percent of males and 19.5 percent of females left unsupervised for 30 or more hours per week
• 43 percent of males and 27.9 percent of females reported last having had sexual intercourse in their own homes
• 30.4 percent of males and 59 percent of females reported last having had sexual intercourse in their partner's home
• 17 percent of males and 5.6 percent of females reported last having had sexual intercourse in a friend's home
• 56 percent of young people who had had intercourse reported that the last time was on a weekday: 18 percent before 3 p.m.; 17 percent between 3 and 6 p.m.; and 21 percent after 6 p.m.

ADOLESCENT SEXUAL DECISION-MAKING-HOW DO THEY DECIDE?

Adolescents are making decisions about sex everyday, and it is important to understand what factors impact their choices. Teens have said that the opinions of their parents, their partners, their friends, and their religious community affect their decisions. Other influences include their relationships and their fear of pregnancy and STDs.

STUDY EXAMINES SEXUAL BEHAVIOR OF ADOLESCENT MALES WITH SAME SEX AND OPPOSITE SEX PARTNERS

Researchers looked at data from surveys of 3,267 sexually experienced high school students in Massachusetts collected in 1995, 1997, and 1999. The surveys measured the prevalence of risk behaviors among adolescent males who indicated they had had some sexual contact with another person. The study found that:

Sexual Activity

• 28 percent of respondents with partners only of the opposite sex reported four or more lifetime sexual intercourse partners
• 19 percent of respondents with partners only of the same sex reported four or more lifetime sexual intercourse partners
• 63 percent of respondents with partners of both sexes reported four or more lifetime sexual intercourse partners
• 7 percent of respondents with partners only of the opposite sex reported four or more sexual intercourse partners in the previous three months
• 6 percent of respondents with partners only of the same sex reported four or more sexual intercourse partners in the previous three months
• 43 percent of respondents with partners of both sexes reported four or more sexual intercourse partners in the previous three months "Sexual intercourse" was not defined in the surveys.

SURVEY EXAMINES MOTIVATION

Seventeen Magazine and the Henry Kaiser Family Foundation conducted a national survey of 510 adolescents ages 12 to 17. This survey examined the influences that affect young people's decisions about sex and relationships. Questions on personal sexual experience were only asked of participants ages 15 to 17. These participants were asked why they had or had not "had sex." The survey found that:

• Among participants ages 15 to 17 who had not "had sex," 83 percent said it was because they were "worried about pregnancy," 74 percent said it was a "conscious decision" they had made to wait, 73 percent said they were "worried about STDs," 64 percent said it was because they "worry about what their parents might think," 63 percent said it was because they "have not met the right person," 63 percent said they felt they are "far too young," and 52 percent said it was because of their "religious beliefs"
• Among participants ages 15 to 17 who had "had sex," 51 percent said when they had sexual intercourse for the first time it was because they "met the right person," 45 percent said it was because "the other person wanted to," 32 percent said it was because they were "just curious," 28 percent said it was because they "hoped it would make the relationship closer," and 16 percent said it was because "many of their friends already had"

SURVEYS ASK TEENS' REASONS FOR NOT HAVING SEX

The National Campaign to Prevent Teen Pregnancy compiled a summary of findings from two nationally representative surveys of 1,025 adolescents ages 12 to 17. The summary stated that:

• Half of adolescents surveyed said that fear of pregnancy and STDs is the main reason why adolescents do not have sex
• 26 percent of adolescents said the main reason why adolescents do not have sex is because of religion, morals, and values

SURVEY ASKS TEENS ABOUT OUTSIDE FACTORS

Seventeen Magazine and the Henry Kaiser Family Foundation conducted a national survey of 505 adolescents ages 15 to 17 that examined experiences and attitudes related to sexual relationships. Participants were asked about outside factors that influenced their decisions. The survey found:

• 90 percent of participants said "how well you know the other person" influenced what they might do sexually with someone, 89 percent said "how much you trust your partner," 71 percent said "what the other person wants to do," 69 percent said "whether they have been drinking or using drugs," 68 percent said "what your parents may think," 60 percent said "what religion says about sex and relationships," 44 percent said "what your friends might think," and 34 percent said "what your friends are doing sexually"

SURVEY ASKS TEENS ABOUT THE IMPACT OF ALCOHOL AND DRUG USE

The Kaiser Family Foundation recently released the National Survey of Adolescents and Young Adults: Sexual Health Knowledge, Attitudes, and Experiences. The survey looks at a nationally representative sample of more than 1,800 young people in three key age groups: young adolescents (ages 13 to 14), adolescents (ages 15 to 17), and young adults (ages 18 to 24). Participants were asked about their knowledge and attitudes toward sexuality as well as about their sexual experience, including sexual intercourse, oral sex, and intimacy. Participants were also asked how alcohol and drug use may influence their decisions. Questions about personal experiences were only asked of participants ages 15 and older. The survey found:

• 35 percent of sexually active participants ages 15 to 24 said "alcohol or drugs [had] ever influenced their decision to do something sexual"
• 28 percent of sexually active participants ages 15 to 24 said they had "ever done more sexually than they had planned because they had been drinking or using drugs"
• 26 percent of sexually active participants ages 15 to 24 said they had "ever worried about STDs or pregnancy because of something they did sexually while drinking or using drugs"
• 22 percent of sexually active participants ages 15 to 24 said they had "ever had unprotected sex (not used a condom) because they were drinking or using drugs"
• 15 percent of sexually active participants ages 15 to 24 said they had "ever used alcohol or drugs to help them feel more comfortable with a sexual partner"
• 11 percent of sexually active participants ages 15 to 24 said they "were drinking or using drugs the most recent time they had sexual intercourse"
• 10 percent of sexually active participants ages 15 to 24 said they "were drinking or using drugs the first time they had sexual intercourse"

ADOLESCENT CONTRACEPTIVE USE-ARE THEY PROTECTING THEMSELVES?

Adolescents live in a world where there is constant worry about unintended pregnancy and STDs, including HIV. During the past decade, condom use among teens has steadily increased with a majority of sexually active teens now reporting using condoms the last time they had intercourse.10 Still, many teens do not use condoms or other contraceptive methods consistently and continue to choose less reliable methods such as the "rhythm method" or withdrawal.

YRBS LOOKS AT CONTRACEPTIVE USE

The U.S. Centers for Disease Control and Prevention regularly publishes the Youth Risk Behavior Surveillance (YRBS) that measures sexual behaviors, alcohol and other drug use, tobacco use, unhealthy dietary behaviors, physical inactivity, and behaviors that contribute to unintentional injuries and violence. The YRBS is conducted every two years with students in grades nine through 12 at high schools across the country. It provides the most current information about adolescent sexual behavior including history of sexual intercourse, number of sexual partners, and contraceptive use. The 2001 YRBS found that:

MOTHERS' INFLUENCE: CONNECTIONS THAT PROMOTE POSTPONING SEXUAL INTERCOURSE

The Center for Adolescent Health and Development at the University of Minnesota recently published a monograph examining mother-teen relationships to determine how mothers affect sexual behavior among teens that are not yet sexually active. The monograph was based on two studies that utilized data from the National Longitudinal Study of Adolescent Health. The two studies looked at over 5,000 adolescents and their mothers for one year. Researchers found that caring, connectedness, consistency, and clarity with teens are important - especially for younger teens. Specifically, they found that:

• When mothers reported satisfaction with their relationships with their daughters, their daughters were more likely to report that they had not had sexual intercourse. Similarly, high levels of mother-child connectedness are independently related to delays in sexual intercourse among eighth and ninth grade boys and girls as well as among tenth and eleventh grade boys. The effect of connectedness appears to diminish for older girls.
• Teens who feel that their mothers disapprove of their having sexual intercourse are more likely to delay intercourse. However, simply stating this disapproval is not enough. Parents must clearly explain and reinforce this message.
• "Connectedness" was defined as adolescents' feeling close to their mothers, knowing that their mothers cared for them, having open communication with their mothers, and feeling satisfied in their relationships with their mothers.

Condom Use

• Among currently sexually active students, 57.9 percent (65.1 percent of males and 51.3 percent of females) reported using condoms during last intercourse
• Among currently sexually active students, 49.3 percent of twelfth graders, 58.9 percent of eleventh graders, 60.1 percent of tenth graders, and 67.5 percent of ninth graders reported using condoms during last intercourse
• Among currently sexually active students, 67.1 percent of Black students, 56.8 percent of Hispanic students, and 53.5 percent of White students reported using condoms during last intercourse

Birth Control Pills

• Among currently sexually active students, 18.2 percent (21.1 percent of females and 14.9 percent of males) reported that either they or their partner used birth control pills before last intercourse
• Among currently sexually active students, 26.3 percent of twelfth graders, 18.6 percent of eleventh graders, 15.8 percent of tenth graders, and 7.6 percent of ninth graders reported that either they or their partner used birth control pills before last intercourse
• Among currently sexually active students, 7.9 percent of Black students, 9.6 percent of Hispanic students, and 23.4 percent of White students reported that either they or their partner used birth control pills before last intercourse
• "Currently sexually active" was defined as having had sexual intercourse in the three months prior to the survey.

NEW STUDY SHEDS ADDITIONAL LIGHT ON ADOLESCENT CONTRACEPTION USE

The Kaiser Family Foundation recently released the National Survey of Adolescents and Young Adults: Sexual Health Knowledge, Attitudes, and Experiences. The survey looks at a nationally representative sample of more than 1,800 young people in three key age groups: young adolescents (ages 13 to 14), adolescents (ages 15 to 17), and young adults (ages 18 to 24). These participants were asked about their knowledge and attitudes toward sexuality as well as about their sexual experience, including sexual intercourse, oral sex, and contraceptive use. Questions about personal experiences were only asked of participants ages 15 and older. The survey found:

• 70 percent of adolescents ages 15 to 17 who had engaged in sexual intercourse reported using birth control or protection all of the time, 21 percent most of the time, five percent some of the time, and four percent never
• 57 percent of young adults ages 18 to 24 who had engaged in sexual intercourse reported using birth control or protection all of the time, 23 percent most of the time, 12 percent some of the time, and seven percent never
• 90 percent of adolescents and young adults ages 15 to 24 who had engaged in sexual intercourse reported ever using condoms, 60 percent reported using condoms regularly, and 58 percent reported having used a condom the last time they had intercourse; however, 63 percent reported ever having had intercourse without a condom
• 62 percent of adolescents and young adults ages 15 to 24 who had engaged in sexual intercourse reported ever using birth control pills, 42 percent reported ever using withdrawal or "pulling out," and eight percent reported ever using the rhythm or calendar method

NATIONAL SURVEY OF FAMILY GROWTH LOOKS AT CONTRACEPTIVE CHOICE

The U.S. Department of Health and Human Services' National Center for Health Statistics collects data from women ages 15 to 44 on topics including pregnancy and birth, sexual intercourse, and contraception for the National Survey of Family Growth. The report found:13

• Among female adolescents ages 15 to 19 who have ever had intercourse, 93.5 percent reported having ever used a condom, 52.1 percent reported having ever used birth control pills, 9.8 reported having ever used an injectable contraceptive,13.3 had ever used periodic abstinence, 42.6 had ever used the withdrawal method, 0.4 percent had ever used a diaphragm, 0.4 percent had ever used family planning, and 11.5 had ever used other methods Includes morning-after pill, foam, cap, sponge, jelly or spermicidal cream (without diaphragm).

ANALYSIS LOOKS AT CONTRACEPTIVE USE AMONG MEN

In Their Own Right: Addressing the Sexual and Reproductive Health Needs of American Men, a report released by The Alan Guttmacher Institute, is an analysis of national research that examined the continuous need for awareness of men's health issues. The report, which focused on heterosexual men, provided an overview of some fundamental patterns in men's sexual and reproductive lives. The report found:

• Among young men ages 15 to 17 who had engaged in intercourse in the prior month, 47 percent used only a condom and 20 percent used a condom with another method of contraception
• Among young men ages 18 to 19 who had engaged in intercourse in the prior month, 35 percent used only a condom, and 20 percent used a condom with another method of contraception
• At first intercourse, 60 percent of men ages 15 to 19 used only a condom, 7 percent used a condom with another method of contraception, 2 percent used withdrawal, and 4 percent used only female contraceptive methods, 27 percent did not use protection of any kind
• At most recent intercourse, 40 percent of men ages 15 to 19 used only a condom, 20 percent used a condom with another method of contraception, 2 percent used withdrawal, and 18 percent used only female contraceptive methods, 20 percent did not use protection of any kind Birth control pill, implant, injectable, IUD, female sterilization, female condom, spermicide, douche, vaginal film, or periodic abstinence

ADOLESCENT CONTRACEPTIVE DECISIONS-HOW DO THEY CHOOSE?

There are many reasons why adolescents may choose to use a specific type of contraception. Teens say they consider, among other things, how well the method protects against unintended pregnancy and STDs as well as convenience, cost, and confidentiality.

SURVEYS EXAMINE TEENS' PERCEPTION OF CONTRACEPTION

The Kaiser Family Foundation recently released the National Survey of Adolescents and Young Adults: Sexual Health Knowledge, Attitudes, and Experiences. The survey looks at a nationally representative sample of more than 1,800 young people in three key age groups: young adolescents (ages 13 to 14), adolescents (ages 15 to 17), and young adults (ages 18 to 24). The survey examined participants' knowledge and attitudes about "safer sex" and contraception choices, and how these factors influence their decisions. The survey found:15

• 86 percent of participants ages 15 to 24 consider condoms to be "effective" in preventing pregnancy, 77 percent consider condoms to be "effective" in preventing HIV/AIDS, and 77 percent consider condoms to be "effective" in preventing other STDs
• 86 percent of participants 15 to 24 consider birth control pills to be "effective" in preventing pregnancy, 21 percent consider birth control pills to be "effective" in preventing HIV/AIDS, and 18 percent consider birth control pills to be "effective" in preventing other STDs
• 89 percent of participants ages 15 to 24 consider sex with a condom to be "safer sex," 71 percent consider using other kinds of birth control to be "safer sex," 37 percent consider oral sex to be "safer sex," 24 percent consider sex during the 'safe' times of the month to be "safer sex," and 21 percent consider 'pulling out' to be "safer sex" 16
• 95 percent of participants ages 15 to 24 said their decisions about what types of contraception to use are influenced by "how well it prevents pregnancy," 88 percent said "how well it protects against HIV/AIDS and other STDs," 84 percent said by "their partner's preference," and 26 percent said by "cost"17

SURVEY ASKS TEENS IF CONTRACEPTION IS IMPORTANT

The National Campaign to Prevent Teen Pregnancy compiled a summary of findings from two nationally representative surveys of 510 adolescents ages 12 to 17. The survey found that:18

• 88 percent of adolescents say that it is important for adolescents to use birth control each and every time they have sex

SURVEY EXAMINES WHY TEENS DON'T ALWAYS USE BIRTH CONTROL

The National Campaign to Prevent Teen Pregnancy compiled a summary of findings from two nationally representative surveys of 510 adolescents ages 12 to 17. The survey found that:19

• 49.3 percent of males and 54.2 percent of females agree that pressure from their partners is one of the main reasons that adolescents do not use birth control
• 53.6 percent of adolescents ages 12 to 14 also agree that one of the main reasons adolescents do not use birth control is that their partners do not want to

STUDY EXAMINES CONDOM USE AMONG ADOLESCENT MALES

Researchers looked at data from surveys of 3,267 sexually experienced high school students in Massachusetts collected in 1995, 1997, and 1999. The surveys measured the prevalence of risk behaviors among adolescent males who indicated they had had some sexual contact with another person. The study found:1

Condom Use

• 66 percent of respondents with partners of the opposite sex reported condom use at most recent intercourse
• 61 percent of respondents with partners of the same sex reported condom use at most recent intercourse
• 33 percent of respondents with partners of both sexes reported condom use at most recent intercourse
• Sexual intercourse was not defined in the survey

STUDY EXAMINES CONTRACEPTIVE NEEDS AMONG LESBIAN AND BISEXUAL WOMEN

A study of 3,816 young women who identify as lesbian, as bisexual, or as unsure of their sexual orientation found that those women who identified as lesbian or bisexual were equally as likely as their heterosexual peers to engage in penile-vaginal intercourse. The study suggests these women are at an increased risk of pregnancy because of poor contraceptive practice. The study found:

• Among sexually experienced respondents, 44 percent of those unsure of their sexual orientation reported no use of contraception as compared to 30 percent of bisexual/lesbian respondents and 23 percent of heterosexual respondents
• Of the respondents who used contraceptive methods, 85 percent of heterosexual women, 88 percent of bisexual/lesbian women, and 91 percent of those unsure of their sexual orientation reported using effective methods Effective methods were not defined in the study.

SURVEY LOOKS AT HOW TEENS FEEL WHEN THEIR PARTNER TALKS ABOUT CONTRACEPTION

The Kaiser Family Foundation recently released the National Survey of Adolescents and Young Adults: Sexual Health Knowledge, Attitudes, and Experiences. The survey looks at a nationally representative sample of more than 1,800 young people in three key age groups: young adolescents (ages 13 to 14), adolescents (ages 15 to 17), and young adults (ages 18 to 24). The survey examined participants' knowledge and attitudes about "safer sex" and contraception choices, and how these factors influence their decisions. The survey found:

• 94 percent of participants ages 15 to 24 said if a romantic partner suggested using a condom that the person was "being responsible," 93 percent said they would feel "glad the person brought it up," 90 percent said they would feel "relieved," 90 percent said they would feel "respected," 88 percent said they would feel "cared for," 48 percent said they would feel "like their partner was suspicious of their past sexual history," 46 percent said they would feel "suspicious of their partner's sexual history," and 9 percent said they would feel "insulted" if a sexual partner suggested using a condom

ADOLESCENT RELATIONSHIPS-WHAT DO THEY MEAN?

"Hooking up." "Messing around." "Friends with benefits." Adolescents use many labels to define their relationships. Regardless of the titles, relationships vary in terms of seriousness, commitment, and, of course, length. These are often deciding factors for how "far" adolescents will go sexually, how comfortable they feel discussing sexual issues with their partners, and whether they use condoms or contraception. In addition, gender roles vary within relationships and can impact who makes decisions.

SURVEY LOOKS AT "DATING" VS. "CASUAL RELATIONSHIPS"

Seventeen Magazine and the Henry Kaiser Family Foundation conducted a national survey of 505 adolescents ages 15 to 17. It examined experiences and attitudes related to sexual relationships. It asked teens about the kinds of sexual activity that might take place in either casual relationships or more serious dating relationships. The survey found that:21

• 82 percent of participants reported kissing as an activity that is "almost always" or "most of the time" part of a dating relationship while 70 percent of adolescents reported kissing as an activity that is "almost always" or "most of the time" part of a casual relationship
• 65 percent of participants reported touching as an activity that is "almost always" or "most of the time" part of a dating relationship while 58 percent reported touching as an activity that is "almost always" or "most of the time" part of a casual relationship
• 26 percent of participants reported oral sex as an activity that is "almost always" or "most of the time" part of a dating relationship while 23 percent reported oral sex as an activity that is "almost always" or "most of the time" part of a casual relationship
• 27 percent of participants reported sexual intercourse as an activity that is "almost always" or "most of the time" part of a dating relationship while 24 percent reported sexual intercourse as an activity that is "almost always" or "most of the time" part of a casual relationship
• 71 percent of participants agree that "it is more important to use a condom in a casual sexual relationship than with a boyfriend or girlfriend"
• 3 percent of participants agree that "talking about STDs and birth control is harder when the sexual relationship is casual"

SURVEY LOOKS AT IMPACT OF LONGER RELATIONSHIPS

Seventeen Magazine and the Henry Kaiser Family Foundation conducted a national survey of 505 adolescents ages 15 to 17. This survey examined experiences and attitudes related to sexual relationships. The survey found that:22

• 84 percent of participants agree that the longer they are in a relationship the more likely they are to discuss their sexual history
• 77 percent of participants agree that the longer they are in a relationship the more likely they are to discuss STD testing
• 69 percent of participants agree that the longer they are in a relationship the more likely they are to use condoms

SURVEY EXAMINES GENDER ROLES

Seventeen Magazine and the Henry Kaiser Family Foundation conducted a national survey of 512 adolescents ages 15 to 17. It explored perceptions of gender roles among adolescents. The survey found that:23

• 92 percent of female participants and 77 percent of male participants considered it a "good thing" to be a virgin
• 66 percent of female participants and 69 percent of male participants said it is usually the boy "who makes the first move sexually"
• 62 percent of female participants and 63 percent of male participants said they "equally decide whether a relationship will become sexual"
• 40 percent of female participants and 41 percent of male participants said it is usually the girl "who brings up using condoms"
• Both female and male participants (63 percent) agree it is usually the boy "who provides the condom"
• 52 percent of female participants and 50 percent of male participants said it is usually the girl "who brings up sexually transmitted diseases"

ADOLESCENT SEXUAL ATTITUDES AND KNOWLEDGE-WHAT DO THEY THINK?

It is also important to know what adolescents know about issues related to sexuality, where they get their information, and what information they feel they need. In addition, it is important to understand how young people think and feel about sex.

SURVEY EXAMINES WHAT TEENS WORRY ABOUT

The Kaiser Family Foundation recently released the National Survey of Adolescents and Young Adults: Sexual Health Knowledge, Attitudes, and Experiences. The survey looks at a nationally representative sample of more than 1,800 young people in three key age groups: young adolescents (ages 13 to 14), adolescents (ages 15 to 17), and young adults (ages 18 to 24). Participants were asked about their knowledge and attitudes toward sexuality as well as about their sexual experience, including sexual intercourse, oral sex, and intimacy. Participants were also asked what they worried about when it comes to sexual activity. The survey found:24

• 72 percent of female participants and 69 percent of male participants are "very" or "somewhat" concerned about HIV/AIDS
• 73 percent of female participants and 72 percent of male participants are "very" or "somewhat" concerned about other STDs
• 75 percent of female participants and 64 percent of male participants are "very" or "somewhat" concerned about unintended pregnancy

SURVEYS EXAMINE ATTITUDES TOWARD SEX

The National Campaign to Prevent Teen Pregnancy compiled a summary of findings from two nationally representative surveys of 1,025 adolescents ages 12 to 17. The summary found that:25

• 64 percent of female participants and 53 percent of male participants said that high school age adolescents should not engage in sexual activity
• 87 percent of participants do not think it is embarrassing for adolescents to admit they are virgins

SURVEY ASKS HOW ADOLESCENTS FEEL ABOUT SEX

The Kaiser Family Foundation recently released the National Survey of Adolescents and Young Adults: Sexual Health Knowledge, Attitudes, and Experiences. The survey looks at a nationally representative sample of more than 1,800 young people in three key age groups: young adolescents (ages 13 to 14), adolescents (ages 15 to 17), and young adults (ages 18 to 24). Participants were asked about their knowledge and attitudes toward sexuality. The survey found:26

• 60 percent of female participants and 66 percent of male participants ages 15 to 17 "h4ly agree" or "somewhat agree" that waiting to have sex is a nice idea but nobody really does
• 58 percent of female participants and 59 percent of male participants ages 15 to 17 "h4ly agree" or "somewhat agree" there is pressure to have sex by a certain age
• 47 percent of female participants and 56 percent of male participants ages 15 to 17 "h4ly agree" or "somewhat agree" once you have had sex it is harder to say no the next time
• 27 percent of female participants and 50 percent of male participants ages 15 to 17 "h4ly agree" or "somewhat agree" if you have been seeing someone for a while it is expected that you will have sex
• 38 percent of female participants and 54 percent of male participants ages 15 to 17 "h4ly agree" or "somewhat agree" that oral sex is not as a big of a deal as sexual intercourse

SURVEY TESTS KNOWLEDGE ABOUT STDS

The Kaiser Family Foundation has recently released the National Survey of Adolescents and Young Adults: Sexual Health Knowledge, Attitudes, and Experiences. The survey looks at a nationally representative sample of more than 1,800 young people in three key age groups: young adolescents (ages 13 to 14), adolescents (ages 15 to 17), and young adults (ages 18 to 24). It tested participants' knowledge about STDs, condoms and other contraception. The survey found that:27

• 19 percent of participants ages 15 to 17 do not know STDs can be spread through oral sex and 3 percent of participants do not know STDs can be spread through sexual intercourse
• 60 percent of participants ages 15 to 17 do not know STDs can cause some kinds of cancer, 33 percent do not know STDs can increase the risk for HIV/AIDS, and 24 percent do not know STDs can cause infertility
• 25 percent of participants ages 15 to 17 "agree" that if someone they were dating had an STD they would know, 20 percent "agree" that STDs can only be spread when symptoms are present, 12 percent "agree" that "unless you have had sex with a lot of people, STDs are not something you have to worry about," and 10 percent "agree" that "STDs are a nuisance but they do not have any serious health effects"

SURVEYS ASK WHERE TEENS GET INFORMATION

The National Campaign to Prevent Teen Pregnancy compiled a summary of findings from two nationally representative surveys of 510 adolescents ages 12 to 17. The summary found that:28

• 62 percent of adolescents ages 12 to 14 and 65 percent of adolescents ages 15 to 17 said they have had helpful conversations with their parents about sex The National Campaign to Prevent Teen Pregnancy compiled a summary of findings from two nationally representative surveys of 501 adolescents ages 12 to 17. The summary found that:29
• 61 percent of adolescents surveyed said the media have provided them with information or advice about sex in the past month, 57 percent said their friends have, and 55 percent said their parents have

REFERENCES

1. J. Grunbaum, et al., "Youth Risk Behavior Surveillance (YRBS)-United States, 2001," Morbidity and Mortality Weekly Report, vol. 51, no. SS-4, June 28, 2002, pp. 1-64.
2. P. Bearman, Reducing the Risk: Connections That Make a Difference in the Lives of Youth, (Bethesda, MD: 1997), p. 14.
3. T. Hoff, et al., National Survey of Adolescents and Young Adults: Sexual Health Knowledge, Attitudes, and Experiences, (Menlo Park,CA: Henry Kaiser Family Foundation, 2003), p. 14.
4. In Their Own Right: Addressing the Sexual and Reproductive Health Needs of American Men, (New York, NY: The Alan Guttmacher Institute, 2002), p. 83.
5. D. Cohen, et al.,"When and Where Do Youths Have Sex? The Potential Role of Adult Supervision," Pediatrics, vol. 110, no. 6 (2002), pp. 2-17.
6. SexSmarts: Decision-Making,( Menlo Park, CA: Henry Kaiser Family Foundation and Seventeen Magazine, September 2000).
7. The Cautious Generation? Teens Tell Us About Sex, Virginity, and "The Talk," ( Washington, DC: The National Campaign to Prevent Teen Pregnancy, 2003) pp. 1-2.
8. SexSmarts: Relationships, (Menlo Park, CA: Henry Kaiser Family Foundation and Seventeen Magazine, October 2002).
9. Hoff, et al., National Survey of Adolescents and Young Adults, p. 22.
10. Grunbaum, et al., "Youth Risk Behavior Surveillance (YRBS)-United States, 2001," Morbidity and Mortality Weekly Report.
11. Ibid.
12. Hoff, et al, National Survey of Adolescents and Young Adults, p. 31
13. J.C. Abma, A. Chandra,W.D. Mosher, et al., "Fertility, Family Planning, and Women's Health: New Data from the 1995 National Survey of Family Growth," Vital Health Statistics, 1997, vol. 23, no. 19, p. 49.
14. In Their Own Right, p. 23.
15. Hoff, et al., National Survey of Adolescents and Young Adults, p. 33.
16. Ibid., p. 25.
17. Ibid., p. 32.
18. Risky Business:Teens Tell Us What They Really Think of Contraception and Sex, (Washington, DC: The National Campaign to Prevent Teen Pregnancy, 2000) p.1.
19. Ibid.
20. Hoff, et al., National Survey of Adolescents and Young Adults, p. 35.
21. SexSmarts: Relationships.
22. Ibid.
23. SexSmarts: Gender Roles, (Menlo Park, CA: Henry Kaiser Family Foundation and Seventeen Magazine, December 2002).
24. Hoff, et al., National Survey of Adolescents and Young Adults, p. 7.
25. The Cautious Generation?, pp. 1-2.
26. Hoff, et al., National Survey of Adolescents and Young Adults, p. 12
27. Ibid., p. 24.
28. The Cautious Generation?, p. 4.
29. Not Just Another Thing to Do:Teens Talk about Sex, Regret, and the Influence of Their Parents, (Washington, DC:The National Campaign to Prevent Teen Pregnancy, June 30, 2000), p. 1. sexuality 130 West 42nd Street, Suite 350 New York, NY 10036-7802 Phone: 212/819-9770 Fax: 212/819-9776 Email: siecus@siecus.org 1706 R Street, N.W. Washington, DC 20009 Phone: 202/265-2405 Fax: 202/462-2340 www.siecus.org