Sexually Experienced Teens Updated: December 2015 Sexually Experienced Teens December 2015 Nearly half of high school students report they have ever had sexual intercourse. This proportion declined between 1991 and 2001, from 54 to 46 percent; since that time it has fluctuated slightly, and was at 47 percent in 2013. Importance Engaging in sexual intercourse puts male and female teens at risk for pregnancy and sexually transmitted infections (STIs).1 A younger age at first sexual intercourse is also associated with a greater likelihood of having nonconsensual or unwanted sex,2 having multiple sexual partners,3,4 and decreased contraceptive use.5 Additionally, youth who engage in early sexual intercourse are more likely to engage in later delinquent behaviors,6 are at greater risk of experiencing depression,7 and are less likely to reach post-secondary levels of education.8 Many factors are associated with age of sexual initiation. Teens who grow up in stable families 9,10 with more resources are less likely to have sex at a young age. Teens who have good relationships with their parents—e g., are close to their parents, communicate about sex, and whose parents set rules and monitor their child’s whereabouts—are less likely to have sex at an early age.11,12 Conversely, youth who are disengaged from school, involved in delinquent activities, or who have higher levels of externalizing behaviors are at increased risk for early sex.13,14 However, not all teens who have ever had sex are currently sexually active. For example, according to data from the National Survey of Family Growth, 29 percent of teens report that they have had sex in the past three months, but only 24 percent have had sex in the past month. About one-quarter of teens (ages 15-19, 23 percent) have had only one sex partner in the past twelve months; however, older teens (18- to 19-year-olds) are more likely to have had sex with more than one person (34 percent).15 2 Sexually Experienced Teens December 2015 Trends The proportion of high school students who reported they had ever had sexual intercourse declined between 1991 and 2001, from 54 to 46 percent. Between 2001 and 2011 this figure fluctuated only slightly, and was at 47 percent in 2013. (Figure 1) Figure 1 Percentage of Students in Grades 9 through 12 Who Report Ever Having Had Sexual Intercourse,1 by Race and Hispanic Origin2, 1991-2011 All Students 100 White, non-Hispanic 81.5 Black, non-Hispanic Percent 80 Hispanic 60.8 60 40 60.6 54.1 53.1 49.2 46.8 50.0 43.7 20 0 1989 1992 1995 1998 2001 2004 2007 2010 2013 1Sexually experienced is defined as ever having had sexual intercourse in one’s life. 2Race/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/. Differences by Gender In 2013, approximately equal shares of male and female high school students overall (48 and 46 percent, respectively) reported ever having sexual intercourse. However, both black and Hispanic males were significantly more likely to report ever having sexual intercourse than their female peers (68 versus 53 percent, and 52 versus 47 percent, respectively). (Appendix 1) 3 Sexually Experienced Teens December 2015 Differences by Race and Hispanic Origin16 Black high school students overall are the most likely to have reported ever having had sexual intercourse (61 percent in 2013). In comparison, 49 percent of Hispanics and 44 percent of whites reported having ever had sexual intercourse; the difference between these two groups is not statistically significant. The disparity between black students and those in the other two groups has generally declined over time. (Figure 1) Among female students in 2013, blacks were more likely to be sexually experienced than whites (53 versus 45 percent), but no other differences were statistically significant. Among male students, blacks were the most likely to be sexually experienced (68 percent), followed by Hispanics (52 percent), and whites (42 percent). (Appendix 1) Differences by Grade and Age The percentage of students who are sexually experienced increases with every grade. In 2013, 30 percent of ninth-graders reported they had ever had sexual intercourse, compared with 41 percent of tenth-graders, 54 percent of eleventh-graders, and 64 percent of twelfth-graders. This difference between grades has been increasing since 2001, as sexual experience among twelfth-graders has been increasing, and sexual experience among ninth-graders has been decreasing. (Figure 2) Percentage of Students in Grades 9 through 12 Who Report Ever Having Had Sexual Intercourse,1 by Grade, 1991-2011 Figure 2 Grade 9 100 Grade 10 Grade 11 Percent 80 60 Grade 12 66.7 62.4 60.5 64.1 49.7 54.1 48.2 41.4 40 39.0 38.6 30.0 20 0 1989 1Sexually 1992 1995 1998 2001 2004 2007 2010 2013 experienced is defined as ever having had sexual intercourse in one’s life. 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/. 4 Sexually Experienced Teens December 2015 Among younger teens, males are more likely to be sexually experienced, but this difference disappears by age 17. In 2011-2013, 18 percent of 15-year-old males and 13 percent of females were sexually experienced. By age 17, the percentage was 44 and 43 percent, respectively, by age 19, the percentage was 69 and 68 percent, respectively.17 State and Local Estimates 2013 estimates of sexual experience among high school students (Grades 9-12) are available for select states and cities from the Youth Risk Behavior Survey (YRBS) at http://www.cdc.gov/mmwr/pdf/ss/ss6304.pdf (See Table 64) International Estimates Estimates of sexual experience among 15-year-olds in 36 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, at http://www.euro.who.int/en/what-we-publish/abstracts/social-determinants-of-health-andwell-being-among-young-people.-health-behaviour-in-school-aged-children-hbsc-study (page 174) National Goals Through its Healthy People 2020 initiative, the federal government has set national goals to decrease the proportion of adolescents under age 17 who are sexually experienced, with subgoals for males and females, ages under 15 years and over 15 years. Additionally, there are goals to increase the proportion of sexually active adolescents who used a condom at first intercourse. More information is available at: http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=13 (goals FP 9 and 10) 5 Sexually Experienced Teens December 2015 What Works to Make Progress on This Indicator See Ball, V., and Moore, K. A. (2008). What works for adolescent reproductive health: Lessons from experimental evaluations of programs and interventions. A Child Trends Fact Sheet. Available at: www.childtrends.org/wp-content/uploads/2013/03/Child_Trends2008_05_20_FS_WhatWorksRepro.pdf A variety of programs and policies—including comprehensive family life education, access to contraceptive care, early childhood programs, and youth development programs—have been linked to both delays in age at first sex, as well as engagement in healthier sexual behaviors among those who have had sex.18 Some examples include: Positive Prevention19 (http://www.positiveprevention.com/index.html) and Teen Star20 (http://www.teenstar.org/), which have been found to delay the onset of sexual activity and to reduce the frequency of sexual activity among sexually active high school students and adolescents. Additionally, Reach for Health – Service Learning Program21 has been shown to be effective at reducing the proportion of minority, urban middle-schoolers who have initiated sex by 10th grade. Also, see the U.S. Office of Adolescent Health’s list of interventions meeting its criteria for effectiveness in pregnancy prevention: http://www.hhs.gov/ash/oah/oahinitiatives/teen_pregnancy/db/programs.html Related Indicators Sexually Active Teens: www.childtrends.org/?indicators=sexually-active-teens Sexually Transmitted Infections: www.childtrends.org/?indicators=sexuallytransmitted-infections-stis Teen Pregnancy: www.childtrends.org/?indicators=teen-pregnancy Birth Control Pill Use: http://www.childtrendsdatabank.org/?q=node/131 Condom Use: www.childtrends.org/?indicators=birth-control-pill-use Oral Sex Behaviors among Teens: www.childtrends.org/?indicators=oral-sexbehaviors-among-teens Adolescents Who Have Ever Been Raped: www.childtrends.org/?indicators=adolescents-who-have-ever-been-raped 6 Sexually Experienced Teens December 2015 Statutory Rape: Sex Between Young Teens and Older Individuals: www.childtrends.org/?indicators=statutory-rape-sex-between-young-teens-and-olderindividuals Definition Sexually experienced is defined as ever having had vaginal sexual intercourse in one’s lifetime. 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 Sources 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 7 Sexually Experienced Teens December 2015 Appendix 1 - Percentage of High School Students1 Who Report Ever Having Had Sexual Intercourse: Selected Years, 1991-2013 1991 1993 1995 1997 1999 2001 2003 2005 2007 2009 2011 2013 54.1 53.0 53.1 48.4 49.9 45.6 46.7 46.8 47.8 46.0 47.4 46.8 Non-Hispanic White 50.0 48.4 48.9 43.6 45.1 43.2 41.8 43.0 43.7 42.0 44.3 43.7 Non-Hispanic Black 81.5 79.7 73.4 72.7 71.2 60.8 67.3 67.6 66.5 65.2 60.0 60.6 Hispanic 53.1 56.0 57.6 52.2 54.1 48.4 51.4 51.0 52.0 49.1 48.6 49.2 9 39.0 37.7 36.9 38.0 38.6 34.4 32.8 34.3 32.8 31.6 32.9 30.0 10 48.2 46.1 48.0 42.5 46.8 40.8 44.1 42.8 43.8 40.9 43.8 41.4 11 62.4 57.5 58.6 49.7 52.5 51.9 53.2 51.4 55.5 53.0 53.2 54.1 12 66.7 68.3 66.4 60.9 64.9 60.5 61.6 63.1 64.6 62.3 63.1 64.1 Male 57.4 55.6 54.0 48.9 52.2 48.5 48.0 47.9 49.8 46.1 49.2 47.5 Non-Hispanic White 52.7 49.3 48.9 43.3 45.4 45.1 40.5 42.2 43.6 39.6 44.0 42.2 Non-Hispanic Black 88.1 89.2 81.0 80.3 75.7 68.8 73.8 74.6 72.6 72.1 66.9 68.4 Hispanic 64.1 63.5 62.0 57.7 62.9 53.0 56.8 57.6 58.2 52.8 53.0 51.7 45.6 43.5 40.6 41.8 44.5 40.5 37.3 39.3 38.1 33.6 37.8 32.0 All Students Race/Hispanic Origin3 Grade Race/ Hispanic Origin3 Grade 9 10 50.9 47.4 50.0 41.7 51.1 42.2 45.1 41.5 45.6 41.9 44.5 41.1 11 64.5 59.5 57.1 49.3 51.4 54.0 53.4 50.6 57.3 53.4 54.5 54.3 12 68.3 70.2 67.1 60.1 63.9 61.0 60.7 63.8 62.8 59.6 62.6 65.4 8 Sexually Experienced Teens December 2015 1991 1993 1995 1997 1999 2001 2003 2005 2007 2009 2011 2013 50.8 50.2 52.1 47.7 47.7 42.9 45.3 45.7 45.9 45.7 45.6 46.0 Non-Hispanic White 47.1 47.4 49.0 44.0 44.8 41.3 43.0 43.7 43.7 44.7 44.5 45.3 Non-Hispanic Black 75.9 70.4 67.0 65.6 66.9 53.4 60.9 61.2 60.9 58.3 53.6 53.4 Hispanic 43.3 48.3 53.3 45.7 45.5 44.0 46.4 44.4 45.8 45.4 43.9 46.9 9 32.2 31.6 32.1 34.0 32.5 29.1 27.9 29.3 27.4 29.3 27.8 28.1 10 45.3 44.9 46.0 43.5 42.6 39.3 43.1 44.0 41.9 39.6 43.0 41.7 Female Race/ Hispanic Origin3 Grade 1 11 60.2 55.1 60.2 50.3 53.8 49.7 53.1 52.1 53.6 52.5 51.9 53.9 12 65.1 66.3 66.0 61.9 65.8 60.1 62.3 62.4 66.2 65.0 63.6 62.8 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. 3 Race/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/. 9 Sexually Experienced Teens December 2015 Endnotes 1 Kaiser Family Foundation. (2005). U.S. teen sexual activity. Washington, DC: Author. 2 Abma, J. C, Martinez, G. M., and Copen, C. E. (2010). Teenagers in the United States: Sexual activity, contraceptive use, and childbearing, National Survey of Family Growth 2006-2008. National Center for Health Statistics. Vital Health Statistics, 23(30). 3 Ibid. 4 Santelli, J. S., Brener, N. D., Lowry, R., Bhatt, A., & Zabin, L. (1998). Multiple sexual partners among U.S. adolescents and young adults. Family Planning Perspectives, 30(6), 271-275. 5 Manlove, J., Ikramullah, E., Mincieli, L., Holcombe, E. & Danish, S. (2009). Trends in sexual experience, contraceptive use, and teenage childbearing: 1992– 2002. Journal of Adolescent Health, 5, 413-423. 6 Armour, S. and Haynie, D. (2007). Adolescent sexual debut and later delinquency. Journal of Youth and Adolescence, 36, 141-152. 7 Hallfors, D., Waller, M. W., Bauer, D, Ford, C. A., and Halpern, C. T. (2005). Which comes first in adolescence – Sex and drugs, or depression? American Journal of Preventive Medicine, 29(3), 163-170. 8 Spriggs, A, and Halpern C. (2008) Timings of sexual debut and initiation of postsecondary education by early adulthood. Perspectives on Sexual and Reproductive Health, 40 (3), 152-161. 9 Price, M. & Hyde, J. (2009). When two isn’t better than one: Predictors of early sexual activity in adolescence using a cumulative risk model. Journal of Youth and Adolescence, 38(8), 1059-1071. 10 11 Manlove, J., Ikramullah, E., Mincieli, L., Holcombe, E. & Danish, S. (2009). Op. Cit. Commendator, K. (2010). Parental influences on adolescent decision making and contraceptive use. Pediatric Nursing, 36(3). 12 Longmore, M. A., Eng, A. L., Giordano, P. C., and Manning, W. D. (2009). Parenting and adolescents' sexual initiation. Journal of Marriage and Family, 71 (4), 969-982. 13 Ibid. 14 Hipwell, A. E., Keenan, K., Loeber, R., and Battista, D. (2010). Early predictors of sexually intimate behaviors in an urban sample of young girls. Developmental Psychology, 46 (2), 366-378. 10 Sexually Experienced Teens December 2015 15 Martinez, G. M., Copen, C. E., Abma, J. C.(2011) and Teenagers in the United States: Sexual activity, contraceptive use, and childbearing, 2006-2010 National Survey of Family Growth. National Center for Health Statistics. Vital Health Statistics, 23 (31). 16 Hispanics may be any race. Totals for whites and blacks in this report do not include Hispanics. 17 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 18 Brindis, C. (2006). A public health success: Understanding policy changes related to teen sexual activity and pregnancy. Annual Review of Public Health, 27(1), 277-297. 19 LaChausse, R.G. (2006). Evaluation of the Positive Prevention HIV/STD curriculum. American Journal of Health Education, 37(4), 203-209. 20 Cabezon, C., Vigil, P., Rojas, I., Leiva, M. E., Riquelme, R., Aranda, W., & Garcia, C. (2005). Adolescent pregnancy prevention: An abstinence-centered randomized controlled intervention in a Chilean public high school. Journal of Adolescent Health, 36, 64-69. 21 O'Donnell, L., Stueve, A., O'Donnell, C., Duran, R., San Doval, A., Wilson, R.F., Haber, D., Perry, E., and Pleck, J.H. (2002). Long-term reductions in sexual initiation and sexual activity among urban middle schoolers in Reach for Health Service Learning Program. Journal of Adolescent Health, 31, 93-100. 11
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