EXECUTIVE SUMMARY

A review of national 2011-2015 data indicates that more teens are using contraception: 95% of males and 90% of females ages 15-19 reported using a contraceptive method at last sex.

  • While more teen girls are reporting use of the contraceptive injectable, implant, emergency contraception, patch, and the intrauterine device, use of the pill remains common, data indicate.
  • Although use of long-acting reversible contraceptives increased among teens, the most commonly used methods remain the condom, the pill, and withdrawal. Among sexually experienced teen females in 2011-2015, 97% had ever used condoms, 60% had ever used withdrawal, and 56% had ever used the pill.

A review of national 2011-2015 data indicates that more teens are using contraception: 95% of males and 90% of females ages 15-19 reported using a contraceptive method at last sex. While more teen girls are reporting use of the contraceptive injectable, implant, emergency contraception, patch, and the intrauter-ine device, use of the pill remains common, data indicate.1

Use of long-acting reversible contraception (LARC), such as intrauterine devices (IUDs) and the contraceptive implant, among adolescents still is relatively rare, but increasing, notes the report’s lead author, Joyce Abma, PhD, social scientist at the Centers for Disease Control and Prevention’s (CDC’s) National Center for Health Statistics. The current report used data through 2015, looking at the percentage of teens who had ever used LARC methods among females who had ever had sex, she notes.

“This percent was too small to report in 2002, but increased to 3% in 2006-2010, and to 6% in 2011-2015,” says Abma. “Looking at each LARC method, use of the IUD was stable between 2006-2010 and 2011-2015, at 3%, while use of the implant increased over that time period, from 0.6% to 3%.”

Although use of LARC increased among teens, by far the most commonly used methods are the condom, the pill, and withdrawal, Abma states. Among sexually experienced teen females in 2011-2015, 97% had ever used condoms, 60% had ever used withdrawal, and 56% had ever used the pill.

Take a Closer Look

The current report is based on data from the National Survey of Family Growth (NSFG), which gathers information on family life, marriage, divorce, pregnancy, infertility, use of birth control, and men’s and women’s health. For selected indicators, researchers also looked at NSFG surveys from 1988, 1995, 2002, and 2006 through 2010, as well as the 1988 and 1995 National Survey of Adolescent Males, conducted by the Urban Institute.

Data for the NSFG surveys were collected through in-person interviews with men and women ages 15-44 in the household population of the United States; the 2011-2015 interviews were conducted between September 2011 and September 2015, with 20,621 men and women, including 4,134 teenagers (2,047 females and 2,087 males). The response rate was 72.5% for male teens and 73.0% for female teens.

What did the analysis show? In 2011-2015, about 40% of never-married female teens (4.0 million) and never-married male teens (4.4 million) had had sexual intercourse at least once by the time of the interview. These levels of sexual experience among teenagers are similar to those seen in 2002 and 2006-2010 data, researchers note. When looking at longer-term trends, from 1988 to 2011-2015, data indicate declines in the percentage of teenagers who were sexually experienced.1

More teen girls are using contraception at first sex: from 74.5% in 2002 to 81.0% in 2011-2015. Male teens’ use of a condom at first sex increased from 70.9% in 2002 to 79.6% in 2006-2010, and remained stable at 76.8% in 2011-2015.1

Watch the Trends

Abma points to a separate 2015 report that looked at LARC use among women of all ages, including ages 15-24.2 Using NSFG data from the 1982, 1988, 1995, 2002, 2006-2010, and 2011-2013 cycles, it examines trends in current LARC use among women ages 15-44 and describes patterns of use by age, race and Hispanic origin, and parity.

Data in this analysis indicate that use of IUDs and implants increased nearly fivefold in the last decade among women ages 15-44, from 1.5% in 2002 to 7.2% in 2011-2013. Current LARC use was higher among women ages 25-34 compared with women ages 15-24 at all time points except 1988 and 1995.

After remaining relatively unchanged from 1982 to 2002, LARC use among women ages 15-24 increased nearly fourfold between 2002 (0.6%) and 2006-2010 (2.3%) and doubled again for 2011-2013 (5.0%).

Expanded Use at Title X Clinics

Efforts to improve access to LARC among teens seeking contraception at Title X service sites have increased use of these methods, according to 2015 research.3 (Contraceptive Technology Update reported on the data; see the July 2015 article, “Title X Clinics See Upswing in Long-acting Reversible Contraceptives by Teens,” at http://bit.ly/2uTBvZg.)

Analysis of the data indicates that use of LARC methods among teens seeking birth control services increased from less than 1% to 7% from 2005 to 2013.

When looking at the type of LARC, use of IUDs for teens ages 15-19 increased from 3,685 (0.4%) to 17,349 (2.8%), and use of implants increased from 427 (0.04%) to 26,347 (4.3%). Use of IUDs was more prevalent than use of implants during 2005-2011 but was surpassed by implants in 2012 and 2013.1

Use of LARC methods increased from 0.6% to 7.6% among teens ages 18-19, and from 0.3% to 6.5% among teens ages 15-17. For both age groups, the increase in use of implants exceeded the increase in use of IUDs (teens ages 15-17: 0.05% to 4.5% for implants, and 0.2% to 2.0% for IUDs; teens ages 18-19: 0.04% to 4.1% for implants, and 0.5% to 3.4% for IUDs).1

Advocate for LARC Methods

Intrauterine contraceptives and the contraceptive implant offer top-tier pregnancy prevention, and their use is supported by the American College of Obstetricians and Gynecologists and the American Academy of Pediatrics. Both national organizations have issued statements that LARC methods are safe, effective, and appropriate options for teens.4,5 (Contraceptive Technology Update reported on the subject; see the January 2014 article, “LARC Methods: 7 Things You Need to Know,” available at http://bit.ly/1T73i2V.)

The U.S. Selected Practice Recommendations for Contraceptive Use states that LARC methods, such as intrauterine contraception and the contraceptive implant, are safe, effective, and appropriate options for adolescents.6 The CDC advises that providers recognize that healthy adolescents may use LARC methods safely. Clinicians who work with teens should make sure that their patients who are sexually active or considering sex know about all methods of contraception, it states.

Robert Hatcher, MD, MPH, professor emeritus of gynecology and obstetrics at Emory University School of Medicine in Atlanta, suggests that the increased use of LARC methods in teenagers (as noted above) and the increased use of LARC methods in all women using contraception (from 2.4% in 2002 to 11.6% in 2013) is important.7,8 However, in 9,256 women provided contraceptives in the St. Louis CHOICE Project, 76% of all women chose to use a LARC method, Hatcher observes. If everyone followed the techniques used in the St. Louis clinics, LARC use would improve still further in the years ahead, he states.

“To review: The effectiveness of LARC methods is the first thing anyone making contact with the CHOICE program learns, and two, at all sites, a woman can immediately receive an IUD or an implant that day,” notes Hatcher. “Three, the cost for each woman served is $0.00.”9,10

REFERENCES

  1. Abma JC, Martinez GM. Sexual activity and contraceptive use among teenagers in the United States, 2011-2015. Natl Health Stat Report 2017;104:1-22.
  2. Branum AM, Jones J. Trends in long-acting reversible contraception use among U.S. women aged 15-44. NCHS Data Brief 2015;188:1-18.
  3. Romero L, Pazol K, Warner L, et al. Vital signs: Trends in use of long-acting reversible contraception among teens aged 15-19 years seeking contraceptive services — United States, 2005-2013. MMWR Morb Mortal Wkly Rep 2015;64:363-369.
  4. Committee on Adolescent Health Care and Long-Acting Reversible Contraception Working Group, The American College of Obstetricians and Gynecologists. Committee Opinion #539. Adolescents and long-acting reversible contraception: Implants and intrauterine devices. Obstet Gynecol 2012;120:983-988.
  5. American Academy of Pediatrics, Committee on Adolescence. Policy statement: Contraception for adolescents. Pediatrics 2014;134:e1244-e1256.
  6. Curtis KM, Jatlaoui TC, Tepper NK, et al. U.S. Selected Practice Recommendations for Contraceptive Use, 2016. MMWR Recomm Rep 2016;65:1-66.
  7. Finer LB, Jerman J, Kavanaugh ML. Changes in use of long-acting contraceptive methods in the United States, 2007-2009. Fertil Steril 2012;98:893-897.
  8. Daniels K, Daugherty J, Jones J. Current contraceptive status among women aged 15-44: United States, 2011–2013. NCHS Data Brief 2014;(173):1-8.
  9. Peipert JF, Madden T, Allsworth JE, Secura GM. Preventing unintended pregnancies by providing no-cost contraception. Obstet Gynecol 2012;120:1291-1297.
  10. Winner B, Peipert JF, Zhao Q, et al. Effectiveness of long-acting reversible contraception. N Engl J Med 2012;366:1998-2007.