Sexual and Reproductive Health of U.S. Teens

CDC Morbidity and Mortality Teen Report

Teens and Sex. Photo Courtesy of Stockbyte / Getty Images

Data released from the CDC July 17, 2009 Morbidity and Mortality Weekly Report reveals that many young people (tweens, teens, and young adults) in the United States engage in risky sexual behavior and experience negative reproductive health outcomes. Although it seems that the majority of negative outcomes stemming from sexual activity have been declining for the past decade, the most recent data suggest that progress may, in fact, be slowing, and certain negative sexual health outcomes are increasing.

The CDC's Lorrie Gavin, PhD, and colleagues reported that increases in teenage births, AIDS infections and other sexually transmitted diseases all indicate that progress in teen sexual health may have slowed in recent years leading researchers to conclude that the sexual and reproductive health of America's teens remains an important public health concern.

The report is a summary of data for 2002-2007 concerning the sexual and reproductive health of young people from ages 10 to 24 from multiple sources, including the National Vital Statistics System, HIV/AIDS Reporting System, the National Health and Nutrition Examination Survey, the Nationally Notifiable Disease Surveillance System, the National Survey of Family, and the National Youth Risk Behavior Survey Growth.

The following is a summary of this report on U.S. teens:

Sexual Behaviors:

  • Among teens between the ages of 15-17 years, 3o% of the females and 31.6% of the males reported having had sex, compared with those aged 18-19 years (70.6%, females; 64.7% males).

  • Among teenagers aged 15-19 years, 13.1% of females and 14.8% of males reported having had sex at age before 15 years old.

  • 58.7% of girls ages 15-19 reported that their first sex partners were 1 to 3 years older than they were, and 22.4% reported that their first partners were 4 or more years older than they were.
    Other Sexual Experiences of Teens Ages 15-17:
    • 42% of girls and 44% of boys reported engaging in oral sex with an opposite-sex partner.

    • 5.6% of female teens and 8.1% of male teens indicated that they had anal sex with an opposite-sex partner.

    • 8.4% of girls and 3.9% of boys report having had a sexual experience with the same-sex partner.

    • Among never-married, sexually active teens between the ages of 15-19 years of age, 75.2% of females and 82.3% of males reported using a birth control method the first time they had sex. These methods included:
    • Teens (83.2% of females and 90.7% of males) were also more likely to have used contraception during their most recent intercourse:
      • Condoms – females, 54.3%; males, 70.7%
      • Birth control pills – females, 34.2%; males, 31%
      • Withdrawal – females, 13%; males, 16.4%
    • For 15- to 19-year-old teens who had sex during the previous 4 weeks, 68.2% of males and 41% of females reported always using a condom whereas 26.5% of males and 42.5% reported never using a condom.

      Sex Education:

      • 85.5% of female teens and 82.6% of male teens (ages 15-19) reported having received formal sex education before reaching age 18 that included how to say no to sex.

      • 69.9% of teen females and 66.2% of teen males reported receiving instruction on the various methods of birth control.

      • Among teens ages 18-19 years, 49.8% of females and 35.1% of males had talked with a parent before reaching age 18 years about birth control methods.

      • Approximately three fourths of teens ages 15-17 (74.6% of females and 71.5% of males) reported having talked to their parents about at least one of five sex education topics: how to say no to sex, contraceptive methods, where to get birth control, STDs, and/or how to use a condom.

      Teen Pregnancy, Births and Abortions:

      • In 2004, approximately 2.4 million pregnancies occurred among U.S. girls under the age of 25.

      • 30% of these pregnancies (729,000) were experienced by teens 15-19 years and 16,000 girls between the ages 10-14 became pregnant.
      Of the Total Number of Pregnancies in 2004:
      • Number of live births:
        • 10-14 years old: 6,396
        • 15-17 years old: 138,943
        • 18-19 years old: 296,493
        • 20-24 years old: 1,080,437
      • Number of induced abortions (rounded):
        • 10-14 years old: 7,000
        • 15-17 years old: 71,000
        • 18-19 years old: 128,000
        • 20-24 years old: 406,000
      • Plus, 341,000 pregnancies (total for all age groups) resulted in fetal losses (e.g., stillbirths or miscarriages).

      • Thus, more than one third of abortions occurred among teens ages 15-17 years and nearly two thirds among those aged 18-19 years. The number of abortions for females 20-24 years-old almost doubled the number for teens 15-19.

      • In 2006, among teens 15-19:
        • 57% (435,436) births occurred to teen mothers (and preliminary data indicate that this number increased to 445,045 in 2007)
        • 27% ended in induced abortion
        • 16% in fetal losses
      • Almost one third of the births occurred among girls 15-17.

      • 92% of births among 15-17 year-old teens and 81% among females 18-19 years of age were to unmarried, single mothers.

      • Teen pregnancies appeared to be unintended (unwanted or mistimed). Among teens ages 15-17, 88.0% of births during the preceding 5 years were the result of unintended pregnancies.

      Prenatal Care and Smoking:

      • Girls under the age of 15 were more likely than teens ages 15-19 or young women ages 20-24 years to receive late or no prenatal care, to have a preterm or very preterm babies, and to have a low or very low birth-weight infants.

      • 15% of females 20-24 years and 15.1 % of 18-19 years smoked during their pregnancies.

      • Teens 15-17 years were three times more likely to smoke (10.3%) during pregnancy as youths ages 10-14 years (3.3%).

      Teens and HIV/AIDS:

      • In 2006, about 22,000 teens and young adults ages 10-24 in 33 states were living with HIV or AIDS.

      • Those between the ages of 20-24 were the most likely to have received an AIDS diagnosis in 2006 (71% of females and 80% of males).

      • Among teens ages 10-17, more females than males are living with HIV/AIDS.

      • For those who are living with HIV/AIDS:
        • 2,480 are 10-14 years old
        • 2,281 are 15-17
        • 2,422 are 18-19
        • 14,707 are 20-24
      • The annual rate of AIDS diagnoses among boys ages 15-19 has nearly doubled in the last 10 years, from 1.3 cases per 100,000 in 1997 to 2.5 cases in 2006.

      Next Page: STDs, Geography and Race Disparities, and Trends Over Time

      Teens and Sexually Transmitted Infections:

      • About one million young people in the U.S. had chlamydia, gonorrhea, or syphilis in 2006. That group accounted for nearly half of all incidents of STDs even though it only represented 25% of the sexually active population.

      • Chlamydia was the most commonly reported STD, followed by gonorrhea, and then syphilis.

      • After decreasing for more than 20 years, teen gonorrhea infection rates have leveled off while syphilis rates have been increasing.
        Reported Chlamydia Cases in 2006:
        • 10-14 years old: girls - 12,364; boys - 1,238
        • 15-17 years old: girls - 130,569; boys - 23,665
        • 18-19 years old: girls - 162,823; boys - 35,155
        • 20-24 years old: girls - 284,763; boys - 93,035

        • A large proportion of STDs occurred in youths between ages 10 and 14 with about 18,000 diagnosed with a STD in 2006.

        • One-quarter of females ages 15-19 years and 45% of those ages 20-24 years had evidence of infection with human papilloma virus during 2003—2004.

        Disparities in Race/Ethnicity and Geographic Residence:

        • Rates of all three STDS were highest among non-Hispanic blacks for all age groups.

        • Of females ages 15-19 reported having had sex, 40.4% were Hispanic, 46.4% were white (non-Hispanic) and 57.0% were black (non-Hispanic).

        • 22.9% black teen females reported having their first sexual experience before the age of 15 as compared to 11.6% of white females.

        • Hispanic females were more likely (35.2%) than white females (19.6%) and black females (19.0%) to report having had sex for the first time with a partner who was substantially older (4 or more years).

        • 40.8% of Hispanic teen females reported using no method of contraception during their last sexual experience, compared with 25.2% of black female teens and 10.3% of white female teens.

        • The majority (56.5%) of black females (ages 15-19) reported having used at least one family planning or medical service during the preceding 12 months, compared with 41.2% of Hispanic females and 49.4% of white females.

        • Among teen males (ages 15-19), 29.6% of black males reported having had four or more lifetime sexual partners, compared with 25.4% of Hispanic males and 12.1% of white males.

        • Reported use of condoms at first and most recent sexual experience was higher among black males ages 15-19 years (85.3% and 86.1%, respectively) than white males (68.6% and 69.2%, respectively) and Hispanic males (66.5% and 59.9%, respectively).

        • Of teens ages 15-19, Hispanic girls (132.8 per 1,000 population) and black girls (128 per 1,000 population) reported the highest pregnancy rates, compared to white girls (45.2 per 1,000 population).

        • Black mothers ages 15-19 were more likely to have a low or very low birth-weight infant than mothers in all other racial and ethnic populations. The proportion of preterm and very preterm births was also higher among black teen mothers than among other groups.

        • In 2006, black teens experienced the highest rates of AIDS and HIV/AIDS diagnoses and the highest rate for living with HIV/AIDS across all age groups (rates among black teens were 3-5 times higher than those among Hispanic teens, the population that had the second highest rates).

        • 129.5 per 100,000 black females ages 15-19 were living with HIV/AIDS compared with 40.2 per 100,000 Hispanic females of the same age.

        • In 2006, rates for chlamydia, gonorrhea and syphilis were highest among blacks for all age groups.

        • Among teens ages 15-19, the highest rates of chlamydia occurred among black females (8,858.1 cases per 100,000 population), compared with black males (2,195.4 cases per 100,000 population) and white females (1,374.9 cases per 100,000 population), with a similar pattern among teens in the same age group for gonorrhea.

        • For syphilis, black males ages 20-24 years experienced the highest rates (41.0 cases per 100,000 population), compared with black females (14.8 cases per 100,000 population) and white males (3.7 cases per 100,000 population) of the same age.

        • The southern states generally had the highest rates of negative sexual and reproductive health outcomes, including early pregnancies and STDs.

        • Birth rates for teens were lower among states in the north and northeast and higher among states in the south and southwest.

        • The highest rates of teens living with AIDS were clustered in the eastern and southern regions of the United States.

        • For all age groups, rates for chlamydia, gonorrhea, and syphilis were higher in the south.

        Trends Over Time for Currently Sexually Active High School Teens (between 1991-2007)

        • The percentage of teens who ever had sexual intercourse decreased from 54.1% in 1991 to 47.8% in 2007.

        • The percentage of teens who were currently sexually active (i.e., had sexual intercourse with at least one person during the 3 months before the survey) decreased from 37.5% in 1991 to 35.0% in 2007.

        • The percentage of teens who reported that either they or their partner had used birth control pills to prevent pregnancy before last sexual intercourse remained stable.

        • The percentage of teens who reported that either they or their partner had used a condom during last sexual intercourse increased from 46.2% in 1991 to 61.5% in 2007.

        • The percentage of teens who reported drinking alcohol or using drugs before last sexual intercourse remained stable.

        • A significant decrease was observed in the prevalence of sexual experience among black teens (from 81.5% in 1991 to 66.5% in 2007) and white teens (from 50.0% in 1991 to 43.7% in 2007). Among Hispanic teens, no significant change was detected.

        Based on their report, the researchers concluded,

        “The data presented in this report indicate that the sexual and reproductive health of America's young persons remains an important public health concern: a substantial number of youths are affected, disparities exist, and earlier progress appears to be slowing and perhaps reversing. These patterns exist for a range of health outcomes (i.e., sexual risk behavior, pregnancy and births, STDs, HIV/AIDS, and sexual violence), highlighting the magnitude of the threat to young persons' sexual and reproductive health.”

        Source:

        Gavin L, MacKay AP, Brown K, et al. “Sexual and Reproductive Health of Persons Aged 10-24 Years -- United States, 2002-2007.” Morbidity and Mortality Weekly Report 17 Jul 2009 58(SS-6);1-58.

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