Assessing State-Level Variations in High School Students’ Sexual and Contraceptive Behavior: The 2019 Youth Risk Behavior Surveys

Abstract

Key Points Sexual activity is a normal part of adolescent development, regardless of where young people live. ➔ There is greater variation between states in prescription method use than in condom use, suggesting that barriers to contraceptive care influence students’ method choice. ➔ High school students in Southern states tend to have higher rates of sexual activity but lower rates of contraceptive use than those in other U.S. regions. ➔ Recent patterns suggest that contraceptive use continues to be the main driver of declines in adolescent pregnancy. This report presents new state-level estimates of sexual activity and contraceptive use among high school students in the United States. The data are from the 2019 Youth Risk Behavior Surveillance System (YRBSS), which is managed by the U.S. Centers for Disease Control and Prevention (CDC). Because the 2019 YRBSS included more states than in prior years, we are able to better identify differences across states and regions, as well as describe recent trends. In particular, we examine variations in adolescents’ sexual activity and their use of condoms and of other contraceptive methods, because of their important implications for exposure to STIs and pregnancy. The YRBSS offers a unique opportunity to examine sexual and reproductive health at the state level among high school students.