Six in ten high school students who are sexually active reported they used condoms at their most recent sexual intercourse. Condom use among this group increased from 46 percent in 1991, to 63 percent in 2003, and was 59 percent in 2013.
Sexually transmitted infections (STIs, including HIV/AIDS) and unintended pregnancy are major health issues that can be consequences of unprotected sexual activity. In 2010, there were more than 614,000 pregnancies to teenage girls ages 15-19 in the U.S., more than three-quarters of which are unintended. Nearly four million adolescents a year are diagnosed with an STI.
Condoms, if used correctly, can greatly reduce (though not eliminate) the risk of both STIs and unintended pregnancies. Although the majority of adolescents believe that “sex without a condom is not worth the risk”, many teens are misinformed about the protection that condoms provide against STIs and HIV/AIDS.
Several factors are associated with lower likelihood of condom use among teens, including a large age difference between partners,, having experienced sexual abuse,, and substance abuse., Conversely, factors associated with increased condom use in sexual relationships include higher parental education,, more parental communication about contraception, having attended a sexual education course that discusses contraception,, and believing that condoms are effective at preventing pregnancy and STIs., In 2011-2013, 97 percent of sexually experienced teen girls had used a condom at least once.
Condom use at most recent sexual intercourse, as reported by sexually active high school students, increased from 46 percent in 1991 to a high of 63 percent in 2003. Since then, there was a slight decrease, to 59 percent in 2013. (Figure 1)
Differences by Gender
Reported condom use differs by gender. In 2013, 66 percent of sexually active male high school students reported that they or their partner used a condom at most recent sexual intercourse, compared with 53 percent of females. (Figure 1) Gender disparities within race/ethnicity groups differ in size. Black males were 18 percentage points more likely than females to report condom use at last sexual intercourse, Hispanic males were 16 percentage points, and white males were nine percentage points, more likely than their female counterparts to report using a condom. (Figure 2)
Black male students were more likely than white male students to report condom use (73 and 62 percent, respectively) in 2013. No other race/ethnicity differences were statistically significant. (Figure 2)
Differences by grade
In 2013, twelfth-grade males were less likely than their tenth- and eleventh-grade peers to have used a condom at last intercourse. No other grade differences were statistically significant. (Figure 3)
State and Local Estimates
2013 estimates of condom use among high school students (Grades 9-12) are available for select states and cities from the Youth Risk Behavior Survey (YRBS) (Tables 67 and 68).
Estimates of condom use among 15-year-olds in 32 European countries can be found in a summary of the results of the 2009/2010 Health Behavior in School-aged Children (HBSC) study, Health and Policy for Children and Adolescents, no. 6 (page 179).
Estimates of the percentage of 15- to 24-year-olds who reported using a condom the last time they had sex with a non-marital, non-cohabiting partner in the past 12 months are available from UNICEF's State of the World's Children 2008. (See Table 5)
Through its Healthy People 2020 initiative, the federal government has set a national goal of increasing the proportion of sexually active adolescents ages 15 to 19 years who use contraception that both effectively prevents pregnancy and provides barrier protection against disease. There are specific goals to increase the percentage of males and females who used a condom at first and most recent intercourse. There are additional goals to increase the percentage of adolescents who have received formal instruction and/or talked to a parent or guardian about birth control methods, HIV/AIDS prevention, and sexually transmitted infections.
More information is available here. (Goals FP 10, 12, 13)
What Works to Make Progress on This Indicator
see Child Trends’ LINKS database (“Lifecourse Interventions to Nurture Kids Successfully”), for reviews of many rigorously evaluated programs, including the following which have been shown to be effective:
- For confidence and communication about condom use and condom-use self-efficacy
- Communication Skills Training Program
- Technical Skills Condom Use Program
- Positive Prevention
- For increased use of condoms
- Sexually Transmitted Infections (STIs)
- Teen Pregnancy
- Birth Control Pill Use
- Children and Youth with Aids
- Sexually Experienced Teens
- Sexually Active Teens
- Oral Sex Behaviors among Teens
Students were asked the following question: "The last time you had sexual intercourse, did you or your partner use a condom?" Estimates here are limited to those who are currently sexually active (i.e., had sexual intercourse within the last three months). Note that students may also use other methods of contraception, instead of or in addition to condoms.
Centers for Disease Control and Prevention (CDC). (2014). 1991-2013 High School Youth Risk Behavior Survey Data. Accessed on 7/22/2014. Available at http://nccd.cdc.gov/youthonline/.
Raw Data Source
Youth Risk Behavior Survey
Appendix 1 - Percentage of Sexually Active1 High School Students2 Who Reported They Used a Condom at Last Sexual Intercourse: Selected Years, 1991-2013
|1Students who had sexual intercourse in the three months preceding the survey.
2 Estimates do not include youth who dropped out of school and therefore may not reflect total national values. Additionally, no data was collected from students in California, Georgia, Louisiana, Minnesota, North Dakota, Oregon, Pennsylvania, Utah, Vermont, Virginia, and Washington in 2011. There is no data from Colorado, Indiana, and Iowa for 2013. Other states were not included in previous surveys.
3Race/ethnicity estimates from 1999 and later are not directly comparable to earlier years due to federal changes in race definitions. In surveys conducted in 1999 and later, respondents were allowed to select more than one race when selecting their racial category. Estimates presented only include respondents who selected one category when choosing their race.
Source: Centers for Disease Control and Prevention (CDC). (2014). 1991-2013 High School Youth Risk Behavior Survey Data. Accessed on 7/22/2014. Available at http://nccd.cdc.gov/youthonline/.
Kost, K. & Henshaw, S. (2014). U.S. teenage pregnancies, births and abortions, 2010: National and state trends and trends by age, race and ethnicity. Guttmacher Institute. Available at http://www.guttmacher.org/pubs/USTPtrends10.pdf.
Finer L. B., & Zolna, M. R. (2011) Unintended pregnancy in the United States: incidence and disparities, 2006. Contraception, 84(5), 478-485.
Weinstock H., Berman S., & Cates Jr. W. (2004). Sexually transmitted diseases among American youth: Incidence and prevalence estimates, 2000, Perspectives on Sexual and Reproductive Health, 36(1), 6-10.
Kaiser Family Foundation. (2003). Adolescents and young adults: Sexual health, knowledge, attitudes and experiences. Washington DC: Kaiser Family Foundation. Available at:http://www.kff.org/youthhivstds/upload/National-Survey-of-Adolescents-and-Young-Adults-Sexual-Health-Knowledge-Attitudes-and-Experiences-Summary-of-Findings.pdf
DiClemente R., Wingood G., Crosby R., Sionean C., Cobb B., Harrington K., et al. (2002). Sexual risk behaviors associated with having older sex partners: A study of black adolescent females, Sexually Transmitted Diseases, 29(1), 20-24.
Manning W. D., Longmore M. A., & Giordano P. C. (2000) The relationship context of contraceptive use at first intercourse, Family Planning Perspectives, 32(3), 104-110.
Saewyc E. M., Magee L. L., & Pettingell S. (2004) Teenage pregnancy and associated risk behaviors among sexually abused adolescents, Perspectives on Sexual and Reproductive Health, 36(3), 98-105.
Upchurch D. M., & Kusunoki Y. (2004). Associations between forced sex, sexual and protective practices, and sexually transmitted diseases among a national sample of adolescent girls, Women's Health Issues, 14(3), 75-84.
Poulin C., & Graham L. (2001). The association between substance use, unplanned sexual intercourse and other sexual behaviors among adolescent students, Addiction, 96(4), 607-621.
Santelli J. S., Robin L., Brener N. D., & Lowry R. (2001) Timing of alcohol and other drug use and sexual risk behaviors among unmarried adolescents and young adults, Family Planning Perspectives, 33(5), 200-205.
Brewster K. L., Cooksey E. C., Guilkey D. K., & Rindfuss R. R. (1998) The changing impact of religion on the sexual and contraceptive behavior of adolescent women in the United States, Journal of Marriage and the Family, 60(2), 493-504.
Hutchinson S., Jemmott J. B., III, Braverman P., & Fong G. T. (2003) The role of mother-daughter sexual risk communication in reducing sexual risk behaviors among urban adolescent females: A prospective study, Journal of Adolescent Health, 33(2), 98-107.
Whitaker D. J., & Miller K. S. (2000) Parent-adolescent discussions about sex and condoms: Impact on peer influences of sexual risk behavior, Journal of Adolescent Research, 15(2), 251-273.
Mauldon J., & Luker K. (1996) The effects of contraceptive education on method use at first intercourse, Family Planning Perspectives, 28(1), 19-24.
Manlove J., Ikramullah E., & Terry-Humen E. (2008). Condom use and consistency among U.S. teen males, Journal of Adolescent Health, 43(4), 325.
DiClemente R. J., Durbin M., Siegel D., Krasnovsky F., Lazarus N., Camacho T. (1992) Determinants of condom use among junior high school students in a minority, inner-city school district.Pediatrics,89, 197-202.
Hingson R.W., Strunin L., Berlin B. M., Heeren T. (1990) Beliefs about AIDS, use of alcohol and drugs, and unprotected sex among Massachusetts adolescents.American Journal of Public Health,80, 295-299.
 Martinez, G. M. & Abma, J. C. (2015). Sexual activity, contraceptive use, and childbearing of teenagers aged 15-19 in the United States, Data Brief No. 209. National Center for Health Statistics. Available at http://www.cdc.gov/nchs/data/databriefs/db209.pdf
Hispanics may be any race. Estimates for whites and blacks in this report do not include Hispanics.
Child Trends Databank. (2014). Condom Use. Available at: http://www.childtrends.org/?indicators=condom-use
Last updated: July 2014