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Contraceptive Use and Pregnancy Risk Among U.S. High School Students, 1991–2003
Author(s) -
Santelli John S.,
Morrow Brian,
Anderson John E.,
Lindberg Laura Duberstein
Publication year - 2006
Publication title -
perspectives on sexual and reproductive health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.818
H-Index - 93
eISSN - 1931-2393
pISSN - 1538-6341
DOI - 10.1111/j.1931-2393.2006.tb00067.x
Subject(s) - medicine , pregnancy , pill , condom , family planning , demography , population , unintended pregnancy , developed country , gynecology , national survey of family growth , obstetrics , family medicine , environmental health , research methodology , genetics , syphilis , human immunodeficiency virus (hiv) , sociology , pharmacology , biology
CONTEXT: Trends in teenagers' contraceptive use have received less attention than trends in adolescent sexual intercourse, despite the importance of contraceptive use to preventing teenage pregnancy. METHODS: Sexually active high school students' use of contraceptives and risk of pregnancy from 1991 to 2003 were examined using data from the national Youth Risk Behavior Survey and published contraceptive failure rates. Changes in pregnancy risk were assessed using weighted least‐squares regression. RESULTS: Between 1991 and 2003, contraceptive use improved among sexually active U.S. high school students. Improvements among women included an increase in the proportion reporting condom use at last sex (from 38% to 58%) and declines in the proportions using withdrawal (from 19% to 11%) and no method (18% to 12%). Hormonal method use changed little, as a decline in pill use (from 25% to 20%) was offset by use of injectables (5% in 2003). Similar patterns were found among men. Women's risk of pregnancy declined 21% over the 12 years. The largest improvements in contraceptive use and pregnancy risk occurred among ninth graders, and whites and blacks. In 2003, 46% of pregnancy risk resulted from failure to use any method of contraception, and 54% resulted from contraceptive failure. CONCLUSIONS: Improvement in the use of contraceptives by sexually active high school students during the 1990s is encouraging. To sustain this trend, programs need to encourage contraceptive use among teenagers who do not use it and to stress consistent and correct use among those who do.