Factors Influencing Contraceptive Use Among Sexually Active U.S. Middle and High School Students, 2015 to 2019.

Valerie S Chuy,Rachna Talluri,Lawrence Dall,Geethanjali Rajagopal,An-Lin Cheng

doi:10.7759/cureus.20803

Abstract

ObjectiveThe objective of this study is to see whether factors including the age of first sexual intercourse, sexual orientation, age at the time of survey administration, race/ethnicity, and sex affect condom and other types of contraceptive usage among United States middle and high school students.MethodsWe analyzed data from the Centers for Disease Control’s Youth Risk Behavior Surveys from the years 2015 to 2019. Students were asked questions about condom and specific type of contraceptive use (e.g. birth control pills, intrauterine device/implant, shot/patch/ring, withdrawal), age of first sexual intercourse, and sexual orientation, as well as demographic questions. Using a logistic regression model, we tested the linear effects on condom and contraception investigated variables.ResultsDiffering sexual orientations had a significant relationship with both condom and contraceptive usage, with those who identified as lesbian or gay being least likely to use contraception as opposed to those who identified as straight, bisexual, or unsure. Female participants were 31.6% less likely to use contraception overall and 41.7% less likely to use condoms in comparison to male participants. With a one-year increase in the age of first sexual intercourse, contraceptive use overall increased by 23% and condom use specifically increased by 17%. With a one-year increase in a participant’s age at the time of survey administration, contraceptive use decreased by 7.4% and condom use decreased by 21%. Between the years 2015 to 2019, there was an average decrease of 5.3% in the usage of condoms.ConclusionWe found significant differences in contraceptive and/or condom usage between students of different sexual orientations, sex, age of first sexual intercourse, age at the time of survey administration, and between different years studied. These differences could be attributed to differences in sex education, cultural background, and availability of resources. Further investigations should be conducted to delineate these differences.

Highlights

Though the United States adolescent pregnancy rates have been declining, according to the American College of Obstetricians and Gynecologists (ACOG), the United States continues to have the “highest adolescent pregnancy and birth rates among developed countries” [1]
Differing sexual orientations had a significant relationship with both condom and contraceptive usage, with those who identified as lesbian or gay being least likely to use contraception as opposed to those who identified as straight, bisexual, or unsure
With a one-year increase in the age of first sexual intercourse, contraceptive use overall increased by 23% and condom use increased by 17%

Summary

Introduction

Though the United States adolescent pregnancy rates have been declining, according to the American College of Obstetricians and Gynecologists (ACOG), the United States continues to have the “highest adolescent pregnancy and birth rates among developed countries” [1] This disproportionately affects certain groups: Black and Hispanic adolescents of lower socioeconomic status. Disparities regarding contraception availability in clinics and schools, as well as comprehensive sex education, have been cited as possible reasons for the decrease in adolescent pregnancy across the United States and different racial/ethnic groups Programs addressing these disparities, such as school-based health centers, have not been applied to a great enough scale to notice if they significantly influence adolescent pregnancy rates [1].

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Discussion

Conclusion