Trends in adolescent contraceptive use, unprotected and poorly protected sex, 1991-2003

Purpose: To estimate trends in use and nonuse of effective protection among adolescents 19912003, and to assess factors associated with poorly protected sex in 2003. Methods: We analyzed seven Youth Risk Behavior Surveys (YRBSs) of 9th-12th graders conducted from 1991 through 2003. We estimated trends in use of condoms, effective contraception, withdrawal, and no method, using linear logistic regression models, and evaluated correlates of the use of no method or withdrawal in 2003. Results: Throughout 1991-2003, about one third of students reported that they had been sexually active in the previous 3 months. Condom use increased significantly throughout 1991-2003, from 46.2% ( +/- 3.3%) in 1991 to 63.0% (+/- 2.5%) in 2003, and the percentage reporting use of either withdrawal or no method steadily declined, from 32.6% (+/- 2.7%) to 18.8% (+/- 2.1%). In 2003, use of withdrawal or no method was greater among females, Hispanics, those who had been pregnant or had caused a pregnancy, and those who reported feeling sad or hopeless or had considered suicide. Conclusions: Reported unprotected sex decreased, while use of condoms increased. A high-risk group engaging in poorly protected sex was identified, accounting for 6.4% of students. (c) 2006 Society for Adolescent Medicine. All rights reserved.