Sexual Behavior Among High School Students -- United States, 1990

Since the 1970s, sexually transmitted diseases (STDs) (including human immunodeficiency virus infection and acquired immunodeficiency syndrome), unintended pregnancies, and other problems that result from sexual activity have increased among adolescents in the United States (1,2). For example, approximately 1 million adolescent girls become pregnant each year (1) and 86% of all STDs occur among persons aged 15-29 years (3). This article presents self-reported data from 1990 about the prevalence of sexual intercourse, contraceptive use, condom use, and STDs among U.S. high school students.

The national school-based Youth Risk Behavior Survey is a component of CDC's Youth Risk Behavior Surveillance System that periodically measures the prevalence of priority health-risk behaviors among youth through comparable national, state, and local surveys (4). A three-stage sample design was used to obtain a representative sample of 11,631 students in grades 9-12 in the 50 states, the District of Columbia, Puerto Rico, and the Virgin Islands. Students were asked if they had ever had sexual intercourse and if they had had sexual intercourse during the 3 months preceding the survey (i.e., currently sexually active). Students also were asked to identify the method, if any, they or their partner used to prevent pregnancy the last time they had sexual intercourse; if they had ever been told by a doctor or nurse that they had an STD; and if they or their partner used a condom to prevent STDs the last time they had sexual intercourse.

Of all students in grades 9-12, 54.2% reported ever having had sexual intercourse; 39.4% reported having had sexual intercourse during the 3 months preceding the survey (Table 1). Male students were significantly more likely than female students to ever have had sexual intercourse (60.8% and 48.0%, respectively) and to have had sexual intercourse during the 3 months preceding the survey (42.5% and 36.4%, respectively). Black students were significantly more likely than white or Hispanic students to ever have had sexual intercourse (72.3%, 51.6%, and 53.4%, respectively) and to have had sexual intercourse during the 3 months preceding the survey (53.9%, 38.0%, and 37.5%, respectively). The percentage of students ever having had sexual intercourse and having had sexual intercourse during the 3 months preceding the survey increased significantly by grade of student from 9th through 12th grade.

Among currently sexually active students, 77.7% of female and 77.8% of male students used contraception (birth control pills, condoms, withdrawal, or another method) during last sexual intercourse (Table 2). White female students (81.1%) were significantly more likely than black (71.4%) and Hispanic (62.6%) female students to have used contraception.

Four percent of all students reported having had an STD. Black students (8.4%) were significantly more likely to report having had an STD than white (3.1%) or Hispanic (3.5%) students. Among currently sexually active students, 49.4% of male students and 40.0% of female students reported that they or their partner used a condom during last sexual intercourse (Table 3).

Reported by: Div of Reproductive Health and Div of Adolescent and School Health, National Center for Chronic Disease Prevention and Health Promotion, CDC.

Editorial Note

Editorial Note:

National health objectives for the year 2000 include efforts to reduce the proportion of adolescents who have engaged in sexual intercourse to less than or equal to 15% by age 15 and less than or equal to 40% by age 17 (objectives 5.4, 18.3, and 19.9) and among sexually active, unmarried persons less than or equal to 19 years of age, increase to at least 90% the proportion who use contraception (objective 5.6) (2). To reach these objectives, the percentage of students who report ever having had sexual intercourse will have to be reduced substantially, and the percentage of sexually active students who use contraception will have to increase by 16%.

Two of the national health objectives are to increase the use of condoms to 60%-75% among sexually active, unmarried persons aged 15-19 years during last sexual intercourse (objectives 18.4a,b and 19.10a,b) (2). To reach these objectives, sexually active students must increase their use of condoms by 50%.

These changes in behavior will require interventions that integrate the efforts of parents, families, schools, religious organizations, health departments, community agencies, and the media. Education programs should provide adolescents with the knowledge, attitudes, and skills they need to refrain from sexual intercourse (5). For adolescents who are unwilling to refrain from sexual intercourse, programs should help to increase the use of contraceptives and condoms.

References

1. Hayes CD, ed. Risking the future: adolescent sexuality, pregnancy, and childbearing. Vol I. Washington, DC: National Academy Press, 1987.

2. Public Health Service. Healthy people 2000: national health promotion and disease prevention objectives--full report, with commentary. Washington, DC: US Department of Health and Human Services, Public Health Service, 1991; DHHS publication no. (PHS)91-50212.

3. CDC. Division of STD/HIV prevention annual report, 1990. Atlanta: US Department of Health and Human Services, Public Health Service, 1991.

4. Kolbe LJ. An epidemiological surveillance system to monitor the prevalence of youth behaviors that most affect health. Health Education 1990;21:44-8.

5. CDC. Premarital sexual experience among adolescent women--United States, 1970-1980. MMWR 1990;39:929-32.

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