Advancing Sexual and Reproductive Health and Rights
 
In Brief

Facts on American Teens' Sexual and Reproductive Health


09/2006

SEXUAL ACTIVITY

•Nearly half (46%) of all 15-19-year-olds in the United States have had sex at least once.[1]

•By age 15, only 13% of teens have ever had sex. However, by the time they reach age 19, seven in 10 teens have engaged in sexual intercourse.[2]

•Most young people have sex for the first time at about age 17, but do not marry until their middle or late 20s. This means that young adults are at risk of unwanted pregnancy and sexually transmitted infections (STIs) for nearly a decade.[3]

•Teens are waiting longer to have sex than they did in the past. Some 13% of females and 15% of males aged 15-19 in 2002 had had sex before age 15, compared with 19% and 21%, respectively, in 1995.[4]

•The majority (59%) of sexually experienced teen females had a first sexual partner who was 1-3 years their senior. Only 8% had first partners who were six or more years older.[5]

•More than three-quarters of teen females report that their first sexual experience was with a steady boyfriend, a fiancé, a husband or a cohabiting partner.[6]

Sexual Activity
Sex is rare among very young teens, but becomes more common in the later teenage years.
chart 1

•Ten percent of young women aged 18-24 who had sex before age 20 reported that their first sex was involuntary. The younger they were at first intercourse, the higher the proportion.[7]

•Twelve percent of teen males and 10% of teen females have had heterosexual oral sex but not vaginal intercourse.[8]

•The proportion of teens who had ever had sex declined from 49% to 46% among females and from 55% to 46% among males between 1995 and 2002.[9]

CONTRACEPTIVE USE

•A sexually active teen who does not use contraceptives has a 90% chance of becoming pregnant within a year.[10]

•The majority of sexually experienced teens (74% of females and 82% of males) used contraceptives the first time they had sex.[11]

•The condom is the most common contraceptive method used at first intercourse; it was used by 66% of sexually experienced females and 71% of males.[12]

•Nearly all sexually active females (98% in 2002) have used at least one method of birth control. The most common methods used are the condom (used at least once by 94%) and the pill (used at least once by 61%).[13]

•Nearly one-quarter of teens who used contraceptives the last time they had sex combined two methods, primarily the condom and a hormonal method.[14]

•At most recent sex, 83% of teen females and 91% of teen males used contraceptives. These proportions represent a marked improvement since 1995, when only 71% of teen females and 82% of teen males had used a contraceptive method at last sex.[15]

ACCESS TO CONTRACEPTIVE SERVICES

•Twenty-one states and the District of Columbia explicitly allow all minors to consent to contraceptive services without a parent's involvement (as of August 2006). Two states (Texas and Utah) require parental consent for contraceptive services in state-funded family planning programs.[16]

•Ninety percent of publicly funded family planning clinics counsel clients younger than 18 about abstinence and the importance of communicating with parents about sex.[17]

•Sixty percent of teens younger than 18 who use a clinic for sexual health services say their parents know they are there.[18]

•Among those whose parents do not know, 70% would not use the clinic for prescription contraception if the law required that their parents be notified.[19]

•One in five teens whose parents do not know they obtain contraceptive services would continue to have sex but would either rely on withdrawal or not use any contraceptives if the law required that their parents be notified of their visit.[20]

•Only 1% of all minor adolescents who use sexual health services indicate that their only reaction to a law requiring their parents' involvement for prescription contraception would be to stop having sex.[21]

STIs

•Of the 18.9 million new cases of STIs each year, 9.1 million (48%) occur among 15-24-year-olds.[22]

•Although 15-24-year-olds represent only one-quarter of the sexually active population, they account for nearly half of all new STIs each year.[23]

•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.[24]

•In June 2006, the U.S. Food and Drug Administration approved the vaccine Gardasil as safe and effective for use among girls and women aged 9-26. The vaccine prevents infection with the types of HPV most likely to lead to cervical cancer.

PREGNANCY

•Each year, almost 750,000 women aged 15-19 become pregnant. Overall, 75 pregnancies occur every year per 1,000 women aged 15-19; this rate has declined 36% since its peak in 1990.[25]

•The majority of the decline in teen pregnancy rates is due to more consistent contraceptive use; the rest is due to higher proportions of teens choosing to delay sexual activity.[26]

Teen Pregnancy Outcomes
Nearly a third of all teen pregnancies end in abortion.
chart 2

•Black women have the highest teen pregnancy rate (134 per 1,000 women aged 15-19), followed by Hispanics (131 per 1,000) and non-Hispanic whites (48 per 1,000).[27]

•The pregnancy rate among black teens decreased 40% between 1990 and 2000, more than the overall U.S. teen pregnancy rate declined during the same period (36%).[28]

•Eighty-two percent of teen pregnancies are unplanned; they account for about one in five of all unintended pregnancies annually.[29]

•Two-thirds of all teen pregnancies occur among 18-19-year-olds.[30]

•Teen pregnancy rates are much higher in the United States than in many other developed countries-twice as high as in England and Wales or Canada, and eight times as high as in the Netherlands or Japan.[31]

CHILDBEARING

•Eleven percent of all U.S. births are to teens.[32]

•Fifty-seven percent of pregnancies among 15-19-year-olds ended in birth in 2002, compared with 64% among all women.[33]

•In 2002, there were 43 births per 1,000 women aged 15-19. The rate has dropped by 31% since 1991, when it was 62 per 1,000.[34]

•Seven percent of teen mothers receive 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.[35]

•Teen mothers are now more likely than in the past to complete high school or obtain a GED, but they are still less likely than women who delay childbearing to go on to college.[36]

ABORTION

•There were 214,750 abortions among 15-19-year-olds in 2002.[37]

•Twenty-nine percent of pregnancies among 15-19-year-olds ended in abortion in 2002, compared with 21% among all women.[38]

•The reasons teens give most frequently for having an abortion are concern about how having a baby would change their lives, inability to afford a baby now and feeling insufficiently mature to raise a child.[39]

•Thirty-four states (as of August 2006) require that a minor seeking an abortion involve her parents in the decision.[40]

•Six in 10 minors who have abortions do so with at least one parent's knowledge. The great majority of parents support their daughter's decision to have an abortion.[41]

References

[1] Abma JC et al., Teenagers in the United States: sexual activity, contraceptive use, and childbearing, 2002, Vital and Health Statistics, 2004, Series 23, No. 24.

[2]Abma JC et al., Teenagers in the United States: sexual activity, contraceptive use, and childbearing, 2002, Vital and Health Statistics, 2004, Series 23, No. 24.

[3] Alan Guttmacher Institute (AGI), In Their Own Right: Addressing the Sexual and Reproductive Health Needs of American Men, New York: AGI, 2002.

[4] Abma JC et al., Teenagers in the United States: sexual activity, contraceptive use, and childbearing, 2002, Vital and Health Statistics, 2004, Series 23, No. 24.

[5]Abma JC et al., Teenagers in the United States: sexual activity, contraceptive use, and childbearing, 2002, Vital and Health Statistics, 2004, Series 23, No. 24.

[6]Abma JC et al., Teenagers in the United States: sexual activity, contraceptive use, and childbearing, 2002, Vital and Health Statistics, 2004, Series 23, No. 24.

[7] Abma JC et al., Teenagers in the United States: sexual activity, contraceptive use, and childbearing, 2002, Vital and Health Statistics, 2004, Series 23, No. 24.

[8] 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.

[9]Abma JC et al., Teenagers in the United States: sexual activity, contraceptive use, and childbearing, 2002, Vital and Health Statistics, 2004, Series 23, No. 24.

[10] Harlap S, Kost K and Forrest JD, Preventing Pregnancy, Protecting Health: A New Look at Birth Control Choices in the United States, New York: AGI, 1991.

[11]Abma JC et al., Teenagers in the United States: sexual activity, contraceptive use, and childbearing, 2002, Vital and Health Statistics, 2004, Series 23, No. 24.

[12]Abma JC et al., Teenagers in the United States: sexual activity, contraceptive use, and childbearing, 2002, Vital and Health Statistics, 2004, Series 23, No. 24.

[13]Abma JC et al., Teenagers in the United States: sexual activity, contraceptive use, and childbearing, 2002, Vital and Health Statistics, 2004, Series 23, No. 24.

[14]Abma JC et al., Teenagers in the United States: sexual activity, contraceptive use, and childbearing, 2002, Vital and Health Statistics, 2004, Series 23, No. 24.

[15]Abma JC et al., Teenagers in the United States: sexual activity, contraceptive use, and childbearing, 2002, Vital and Health Statistics, 2004, Series 23, No. 24.

[16] Guttmacher Institute, Minors’ access to contraceptive services, State Policies in Brief, Aug. 1, 2006,<http://www.guttmacher.org/statecenter/spibs/spib_MACS.pdf>, accessed Aug. 7, 2006.

[17] 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.

[18] 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.

[19]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.

[20]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.

[21]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.

[22] 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.

[23] 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.

[24]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.

[25] Guttmacher Institute, U.S. Teenage Pregnancy Statistics: National and State Trends and Trends by Race and Ethnicity, <http://www.guttmacher.org/pubs/2006/09/11/USTPstats.pdf>, accessed Sept. 12, 2006.

[26] Darroch JE and Singh S, Why is teenage pregnancy declining? the roles of abstinence, sexual activity and contraceptive use, Occasional Report, New York: AGI, 1999, No. 1.

[27] Guttmacher Institute, U.S. Teenage Pregnancy Statistics: National and State Trends and Trends by Race and Ethnicity, <http://www.guttmacher.org/pubs/2006/09/11/USTPstats.pdf>, accessed Sept. 12, 2006.

[28]Guttmacher Institute, U.S. Teenage Pregnancy Statistics: National and State Trends and Trends by Race and Ethnicity, <http://www.guttmacher.org/pubs/2006/09/11/USTPstats.pdf>, accessed Sept. 12, 2006.

[29] Finer LB et al., Disparities in rates of unintended pregnancy in the United States, 1994 and 2001, Perspectives on Sexual and Reproductive Health, 2006, 38(2):90–96.

[30] Guttmacher Institute, U.S. Teenage Pregnancy Statistics: National and State Trends and Trends by Race and Ethnicity, <http://www.guttmacher.org/pubs/2006/09/11/USTPstats.pdf>, accessed Sept. 12, 2006.

[31] Darroch JE et al., Teenage sexual and reproductive behavior in developed countries: can more progress be made? Occasional Report, New York: AGI, 2001, No. 3.

[32] Martin JA et al., Births: final data for 2002, National Vital Statistics Reports, 2003, Vol. 52, No. 10.

[33] Guttmacher Institute, U.S. Teenage Pregnancy Statistics: National and State Trends and Trends by Race and Ethnicity, <http://www.guttmacher.org/pubs/2006/09/11/USTPstats.pdf>, accessed Sept. 12, 2006; Guttmacher Institute, Estimates of U.S. Abortion Incidence, 2001–2003, <http://www.guttmacher.org/pubs/2006/08/03/ab_incidence.pdf>, accessed Aug. 10, 2006; and Martin JA et al., Births: final data for 2002, National Vital Statistics Reports, 2003, Vol. 52, No. 10.

[34] Martin JA et al., Births: final data for 2002, National Vital Statistics Reports, 2003, Vol. 52, No. 10.

[35] Martin JA et al., Births: final data for 2002, National Vital Statistics Reports, 2003, Vol. 52, No. 10.

[36] Hofferth SL et al., The effects of early childbearing on schooling over time, Family Planning Perspectives, 2001, 33(6):259–267.

[37] Guttmacher Institute, U.S. Teenage Pregnancy Statistics: National and State Trends and Trends by Race and Ethnicity, <http://www.guttmacher.org/pubs/2006/09/11/USTPstats.pdf>, accessed Sept. 12, 2006.

[38] Guttmacher Institute, U.S. Teenage Pregnancy Statistics: National and State Trends and Trends by Race and Ethnicity, <http://www.guttmacher.org/pubs/2006/09/11/USTPstats.pdf>, accessed Sept. 12, 2006; Guttmacher Institute, Estimates of U.S. Abortion Incidence, 2001–2003, <http://www.guttmacher.org/pubs/2006/08/03/ab_incidence.pdf>, accessed Aug. 10, 2006; and Martin JA et al., Births: final data for 2002, National Vital Statistics Reports, 2003, Vol. 52, No. 10.

[39] Dauphinee LA, Guttmacher Institute, New York, personal communication, Mar. 23, 2006.

[40] Guttmacher Institute, Parental involvement in minors’ abortions, State Policies in Brief, Aug. 1, 2006, <http://www.guttmacher.org/statecenter/spibs/spib_PIMA.pdf>, accessed Aug. 8, 2006.

[41] Henshaw SK and Kost K, Parental involvement in minors’ abortion decisions, Family Planning Perspectives, 1992, 24(5):196–207 & 213.