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Among sexually active high school students, whites are far more likely than black or Hispanic students to report using birth control pills (26, versus eight and nine percent, respectively), as of 2013.

Importance

Although similar percentages of teens are sexually active in the United States and western European countries, the U.S. has a much higher teen pregnancy rate.[1],[2] This is due in part to less consistent use of contraception and the use of contraceptive methods that are less effective.[3],[4] While abstinence is the most effective way to avoid pregnancy, oral contraceptives (i.e., birth control pills) are as much as 99.7 percent effective in preventing pregnancy, when used correctly.[5]

Youth who choose to use oral contraceptives for pregnancy prevention need to have access to them, and also use them correctly and consistently. Birth control pill use varies by age and length of relationship, with older students as well as those in longer-term relationships more likely to use the pill.[6] However, teens in longer-lasting relationships are also less likely to use contraception consistently.[7],[8] Growing up in a two-parent household,[9],[10] having a strong relationship with parents,[11],[12] attending religious services,[13],[14] and being engaged in school[15] are all associated with greater contraceptive use. Having attended a sex education course, specifically one that offers instruction on contraception, is also associated with more consistent contraceptive use.[16],[17]

Aside from oral contraceptives, other chemical contraceptives are increasingly available. In 2011-2013, 15 percent of sexually active teenage girls had ever used Depo-Provera, five percent had used a contraceptive ring, three percent an intrauterine device, and two percent, each, had used a patch or implant. There has been increasing use of emergency contraception as well, from eight percent of teen girls in 2002 to 22 percent in 2011-2013.[18]

Although birth control pills effectively protect against an unwanted pregnancy, they will not protect against sexually transmitted infections(STIs).[19] Sexually active teenagers, if choosing to use the birth control pill, must also use an additional method, such as a condom, to protect themselves against acquiring an STI.

Trends

33_fig1In 2013, 19 percent of sexually active high school students reported using birth control pills at their most recent sexual intercourse. Between 1991 and 1999, this proportion declined, going from 21 to 16 percent of students. Since then, however, it has remained relatively constant, fluctuating between 16 and 20 percent. The proportion of sexually active students who reported using birth control was 19 percent in 2013. (Figure 1)

Differences by Gender

33_fig2The percentage of males who report that their partners used birth control pills at most recent sexual intercourse is significantly lower than the percentage of females who report using birth control pills. In 2013, 15 percent of sexually active male high school students reported birth control pill use by their partners, compared with 22 percent of females. (Figure 1) This may reflect a real difference, or it may reflect a lack of knowledge among males regarding their partners’ use of birth control pills. In 2013 there was no significant difference between males and females among black or Hispanic students. (Figure 2)

Differences by Race and Hispanic Origin[20]

In 2013, sexually active white youth were three times as likely as Hispanic and black youth were to report using birth control pills at most recent sexual intercourse (26 percent, compared with nine and eight percent, respectively). These differences were more pronounced among females than males. (Figure 2)

Differences by grade

33_fig3Reported birth control pill use at most recent sexual intercourse is higher among older youth. In 2013, 11 percent of all sexually active ninth-graders reported using birth control pills, compared with 24 percent of twelfth-graders. Among females, the proportions were 15 percent of ninth-graders and 28 percent of twelfth-graders. Among males, the proportions were eight percent of ninth-graders and 19 percent of twelfth-graders. (Figure 3)

State and Local Estimates

2013 estimates of birth control use among high school students (Grades 9-12) are available for select states and cities from the Youth Risk Behavior Survey (YRBS): see Table 68.

International Estimates

Estimates of birth control use among 15-year-olds in 34 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 177).

Estimates of worldwide birth control pill use from the early late1990s/2000s among sexually active married couples are available through the Centers for Disease Control and Prevention or the United National Population Division.

National Goals

Through its Healthy People 2020 initiative, the federal government has set a national goal to increase the proportion of sexually active adolescents who use condoms and hormonal or intrauterine contraception at both first and last intercourse. Additionally, there are goals to increase the proportion of adolescents who receive formal and informal instruction in birth control methods, and increase the proportion of health insurance plans that cover contraceptive supplies and services.

More information is available here.

What Works to Make Progress on This Indicator

Sex education programs have been shown to increase the use of contraception among teens and young adults.

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:

Related Indicators

Definition

Among sexually active students (those who reported they had sex in the three months preceding the survey), those who selected “Birth control pills” in response to the question: “The last time you had sexual intercourse, what one method did you or your partner use to prevent pregnancy (Select only one response)?” Note that students may also use other methods of contraception or protection, such as condoms, whether or not they use birth control pills. In 2013, ten percent of female high school students and seven percent of males reported using both a condom and a hormonal form of birth control at last sexual intercourse.[21]

No data were collected from students in California, Georgia, Louisiana, Minnesota, North Dakota, Oregon, Pennsylvania, Utah, Vermont, Virginia, and Washington in 2011. There are also no data from Colorado, Indiana, and Iowa for 2013. Other states were not included in previous surveys.

Data Source

Centers for Disease Control and Prevention (CDC). (2014). 1991-2013 High School Youth Risk Behavior Survey Data. Accessed on 8/4/2014. Available at http://nccd.cdc.gov/youthonline/.

Raw Data Source

Youth Risk Behavior Survey

http://www.cdc.gov/nccdphp/dash/yrbs/index.htm

 

Appendix 1 – Percentage of Sexually Active1 High School Students2 Who Reported Using Birth Control Pills at Last Sexual Intercourse: Selected Years, 1993-2013

1991 1993 1995 1997 1999 2001 2003 2005 2007 2009 2011 2013
All Students 20.8 18.4 17.4 16.6 16.2 18.2 17.0 17.6 16.0 19.8 18.0 19.0
Race/Hispanic Origin3
Non-Hispanic White 23.4 20.4 21.4 20.6 21.0 23.4 22.3 22.3 20.8 26.8 24.0 25.9
Non-Hispanic Black 16.8 15.1 10.2 11.9 7.7 7.9 7.9 10.0 9.1 8.1 10.1 8.2
Hispanic 13.2 12.4 11.4 9.5 7.8 9.6 11.2 9.8 9.1 10.8 10.6 9.0
Grade
9 9.1 9.0 10.9 7.8 12.0 7.6 8.7 7.5 8.7 10.2 9.4 11.4
10 18.3 13.7 12.2 12.0 9.3 15.8 12.7 14.3 11.6 14.7 14.9 16.7
11 21.1 16.8 15.4 15.6 15.3 18.6 19.6 18.5 15.0 20.7 17.5 19.3
12 27.0 25.8 25.0 24.0 24.9 26.3 22.6 25.6 23.5 27.6 25.1 23.7
Male 16.5 14.7 14.3 13.0 11.8 14.9 13.1 14.6 13.1 16.5 13.4 15.1
Race/Hispanic Origin3
Non-Hispanic White 19.2 17.1 17.0 16.7 15.7 19.3 17.3 17.2 17.0 21.6 16.4 20.1
Non-Hispanic Black 10.7 10.5 8.3 9.4 3.4 7.8 4.4 9.4 6.3 6.6 9.2 9.0
Hispanic 10.0 9.8 13.5 6.9 5.4 8.7 10.3 10.3 9.0 11.5 10.8 10.8
Grade
9 9.7 7.5 9.7 7.6 11.3 5.6 6.6 6.4 8.3 10.7 10.4 7.7
10 12.8 10.0 8.5 7.6 5.9 12.8 11.8 10.3 9.5 14.0 8.7 13.7
11 15.0 11.7 13.3 12.4 11.6 14.8 14.8 16.6 11.0 18.9 12.3 15.1
12 23.1 22.7 21.0 19.0 17.3 23.1 17.5 21.9 20.8 19.6 19.7 19.3
1991 1993 1995 1997 1999 2001 2003 2005 2007 2009 2011 2013
Female 25.0 22.3 20.4 20.5 20.4 21.1 20.6 20.6 18.7 23.0 22.6 22.4
Race/Hispanic Origin3
Non-Hispanic White 27.6 24.0 25.4 24.7 25.9 26.7 26.5 27.1 24.0 31.4 30.9 30.7
Non-Hispanic Black 22.8 20.6 12.2 14.7 11.9 7.8 11.7 10.7 12.1 9.8 11.3 7.3
Hispanic 16.8 15.3 9.4 12.9 10.5 10.4 12.1 9.4 9.1 9.9 10.4 7.3
Grade
9 8.3 11.1 12.6 8.0 12.8 9.2 11.6 8.8 9.2 9.7 8.3 14.7
10 23.5 17.4 15.7 16.6 12.8 18.2 13.5 18.0 13.7 15.6 20.8 19.2
11 27.0 22.2 17.2 18.7 18.4 22.4 24.1 20.2 18.9 22.5 22.7 23.2
12 30.6 29.0 28.6 29.7 31.4 28.9 27.2 28.9 25.6 34.4 30.0 27.6
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 were collected from students in California, Georgia, Louisiana, Minnesota, North Dakota, Oregon, Pennsylvania, Utah, Vermont, Virginia, and Washington in 2011. There are also no data from Colorado, Indiana, and Iowa for 2013. Previous years’ surveys did not include all states.

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/.

Endnotes


[1]Santelli, J. S., Lindberg, L. D., Finer, L. B., & Singh, S. (2007). Explaining recent declines in adolescent pregnancy in the United States: The contribution of abstinence and improved contraceptive use, American Journal of Public
Health, 97
(1), 150-156.

[2]Kost K., Henshaw , S. K., & Carlin, L. (2010). U.S. teenage pregnancies, births and abortions: National and state trends and trends by race and ethnicity. Washington, DC: Guttmacher Institute.

[3] Abma, J. C., Martinez, G. M., Mosher, W. D., & Dawson, B. S. (2004). Teenagers in the United States: Sexual activity, contraceptive use, and childbearing, 2002. Vital Health Statistics, 23(24). Hyattsville, MD: National Center for Health Statistics.

[4]Mosher, W. D., & Jones, J. (2010). Use of contraception in the United States: 1982-2008. Hyattsville, MD: National Center for Health Statistics. Vital and Health Statistics, 23(29).

[5]Hatcher, R. A., Trussell, J., Stewart, F., Cates, W., Stewart, G. K., Guest, F., et al. (2004). Contraceptive technology (18th revised ed.). New York: Ardent Media.

[6]Suellentrop, K. (2008). Science says: Teen sexual behavior. Washington, DC: The National Campaign to Prevent Teen and Unplanned Pregnancy.

[7]Ford, K., Sohn, W., & Lepkowski, J. (2001). Characteristics of adolescents’ sexual partners and their association with use of condoms and other contraceptive methods. Family Planning Perspectives, 33(3), 100-105, 132.

[8]Manlove J, Ryan S, & Franzetta K. (2003). Patterns of contraceptive use within teenagers’ first sexual relationships. Perspectives on Sexual and Reproductive Health, 35(6), 246-255.

[9]Miller, B., (2002). Family influences on adolescent sexual and contraceptive behavior. The Journal of Sex Research,39(1), 22-26.

[10]Manlove, J., Ryan, S., & Franzetta, K. (2004). Contraceptive use and consistency in teens’ most recent sexual relationships. Perspectives on Sexual and Reproductive Health, 36(6), 265-275.

[11]Miller, B., (2002). Op. cit.

[12]Rodgers, K. B. (1999). Parenting processes related to sexual risk-taking behaviors of adolescent males and females. Journal of Marriage and the Family,61, 99-109.

[13]Manlove, J., Ryan, S., & Franzetta, K. (2004). Contraceptive use and consistency in teens’ most recent sexual relationships. Perspectives on Sexual and Reproductive Health, 36(6), 265-275.

[14]Miller, L., & Gur, M. (2002). Religiousness and sexual responsibility in adolescent girls. Journal of Adolescent Health, 31(5), 401-406.

[15]Darroch, J. E., Landry, D. J., & Oslak, S. (1999). Age differences between sexual partners in the United States. Family Planning Perspectives, 31(4), 160-167.

[16]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.

[17]Mauldon, J., & Luker, K. (1996). The effects of contraceptive education on method use at first intercourse. Family Planning Perspective,28(1), 19-24.

[18]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

[19]Hatcher, R. A., Trussell, J., Stewart, F., Cates, W., Stewart, G. K., Guest, F., et al. (2004). Op. cit.

[20]Hispanics may be any race. Totals for whites and blacks in this report do not include Hispanics.

[21]US Department of Health and Human Services. (June 13, 2014). Youth risk behavior surveillance: United States 2013. MMWR Surveillance Summaries, 63(4): Table 71. Available at: http://www.cdc.gov/mmwr/pdf/ss/ss6304.pdf.

 

Suggested Citation:

Child Trends Databank. (2014). Birth control pill use. Available at: https://www.childtrends.org/?indicators=birth-control-pill-use

 

Last updated: August 2014