Advancing Sexual and Reproductive Health and Rights
 
Perspectives on Sexual and Reproductive Health
Volume 40, Number 3, September 2008
DIGEST

Prevalence of Sexual Risk Behaviors Among U.S. High School Students Declined Between 1991 and 2007

In 2007, 48% of U.S. high school students had ever had sexual intercourse, according to findings from the national Youth Risk Behavior Survey (YRBS).[1] The proportion of students who had ever had sex was higher among blacks than among Hispanics and whites (67% vs. 52% and 44%, respectively). Between 1991 and 2007, the proportion of students who had ever had sex decreased, as did the proportions of those who had had four or more partners during their life and who had had sex at least once in the three months before the survey.[2]

Conducted by the Centers for Disease Control and Prevention, the national YRBS monitors priority health risk behaviors among adolescents and young adults. Data collected in the survey are used to determine the prevalence and co-occurrence of risk behaviors, and to monitor trends in behaviors over time. They also are used to measure the nation’s progress in achieving 15 national health objectives for Healthy People 2010.

The school-based survey has been conducted among students in grades 9–12 every two years since 1991. For the 2007 survey, 14,103 self-administered surveys were completed by a nationally representative sample of students in 157 schools; the final sample comprised 14,041 students. All data were weighted; prevalence estimates were computed for all variables. Analysts used t tests to assess differences in prevalence, and logistic regression to assess changes over time.

2007 Data

Nationally, 48% of students had ever had sex, 15% had had four or more partners during their lifetime and 35% had had sex in the three months before the survey (i.e., were sexually active). Among sexually active students, 62% had used a condom and 16% had used the pill at last sex; 23% reported drug or alcohol use before last sex. Ninety percent of all students had ever been taught about AIDS or HIV in school.

Similar proportions of males and females were sexually active (34% and 36%, respectively). Male students were more likely than female students to have ever had sex (50% vs. 46%), to have had sex for the first time before age 13 (10% vs. 4%), to have had four or more partners (18% vs. 12%) and to have been hit, slapped or physically hurt on purpose by a boyfriend or girlfriend in the year preceding the survey (11% vs. 9%). Male students were less likely than female students to have been tested for HIV (11% vs. 15%) and to have been taught about AIDS or HIV in school (89% vs. 90%). Among sexually active students, males were more likely than females to have used alcohol or drugs before last sex (28% vs. 18%). Female students were more likely than male students to report ever having been physically forced to have sex (11% vs. 5%); sexually active females were less likely than males to report condom use at last sex (55% vs. 69%).

Black students were significantly more likely than Hispanic or white students to have ever had sex (67% vs. 52% and 44%), to have had sex before age 13 (16% vs. 8% and 4%), to have had four or more partners (28% vs. 17% and 12%) and to be sexually active (46% vs. 37% and 33%). Black students overall also were more likely than Hispanic or white students to have been physically hurt by a boyfriend or girlfriend in the year before the survey (14% vs. 11% and 8%). Black and Hispanic students were more likely than white students to ever have been forced to have sex (11% and 9% vs. 7%). Twenty-two percent of blacks had been tested for HIV, compared with 13% of Hispanics and 11% of whites. Sexually active black students were significantly less likely than comparable Hispanic or white students to have used alcohol or drugs before last sex (16% vs. 21% and 25%).

Time Trends

Between 1991 and 2007, the proportion of students who had ever had sexual intercourse decreased (from 54% to 48%), as did the proportions reporting four or more lifetime partners (from 19% to 15%) and current sexual activity (from 38% to 35%). The proportion of currently sexually active students who drank or used drugs before last sex increased between 1991 and 2001 (from 22% to 26%), but then decreased until 2007 (to 23%). Similarly, the proportion of all students who had been taught about AIDS or HIV in school increased between 1991 and 1997 (from 83% to 92%), but then decreased to 90% in 2007. The proportion of currently sexually active students reporting condom use at last sex increased between 1991 and 2003 (from 46% to 63%), but did not change in the subsequent survey years.

Among whites, changes between 1991 and 2007 generally mirror those among the full sample.[2] One notable exception is that the proportion of sexually active white students reporting condom use at last sex increased throughout the period (from 47% to 60%).

While the proportion of all black students reporting four or more lifetime sex partners decreased between 1991 and 2007 (from 43% to 28%), the proportion who had ever had sex decreased between 1991 and 2001 (from 82% to 61%) and then remained unchanged through 2007.[2] The proportion of blacks who had been taught about AIDS or HIV in school changed from 84% in 1991 to 90% in 2007; the proportion of sexually active black students reporting condom use at last sex increased from 48% in 1991 to 70% in 1999 and stabilized at that level.

Relatively little change occurred in sexual risk behaviors among Hispanics.5 Between 1991 and 2007, the proportions of Hispanic students who had ever had sex, who had had four or more lifetime sexual partners and who had been taught about AIDS or HIV in school were stable. However, the proportion of sexually active Hispanic students reporting condom use at last sex increased from 37% to 61%, which about matches the proportion among all students.

The analysts note that although the prevalence of a number of health risk behaviors has fallen substantially among U.S. high school students since 1991, many young people “continue to engage in behaviors that place them at risk for the leading causes of mortality and morbidity.”[1] They suggest that “more effective school health programs and other policy and programmatic interventions are needed to reduce risk and improve health outcomes among youth.”

REFERENCES

1. Eaton DK et al., Youth Risk Behavior Surveillance—United States, 2007, Morbidity and Mortality Weekly Report, 2008, Vol. 57, No. SS-4.

2. Centers for Disease Control and Prevention (CDC), Trends in the prevalence of sexual behaviors, National YRBS: 1991–2007, <http://www.cdc.gov/HealthyYouth/yrbs/pdf/yrbs07_us_sexual_behaviors_trend.pdf>, accessed June 9, 2008.