Behavioral Risks Associated with Early Sexual Debut— Data from the National Survey of Family Growth

To determine current risk factors and sexual behaviors among US adolescents, data from the National Survey of Family Growth (NSFG) were collected from nationally representative samples of 4,134 teenagers (2,047 females and 2,087 males) between September 2011 and September 2015. The response rate was 72.5% for male teenagers and 73.0% for female teenagers.

This report presents the best available data regarding the behavioral determinants of pregnancy and sexually-transmitted infections (STIs) among American teenagers.

  1. The percentage of sexually active teenagers has remained stable over the past decade after a 10% drop during the first few years of the new millennium.
  2. Among US high school students surveyed in 2015, 41% of never married persons reported that they have had sexual intercourse.
    • Of these, 42.4% of never-married female teenagers (4.0 million) and 44.2% of never-married male teenagers (4.4 million) had had sexual intercourse at least once by the time of the interview
    • Female teenagers’ use of contraception during their first sexual intercourse increased from 74.5% in 2002 to 81.0% in 2011–2015
    • Among male adolescents, the use of a condom during their first sexual intercourse increased from 70.9% in 2002 to 76.8% in 2011–2015
    • 5.8% of female teenagers had used a long-acting intrauterine device or implant to prevent pregnancy in 2015
  3. 30% of teens reported they had sexual intercourse during the previous three months. Of these:
    • 43% did not use a condom the last time they had sex
    • 14% did not use any method to prevent pregnancy
    • 21% reported they had consumed alcohol or used drugs before their most recent sexual intercourse
    • Non-Hispanic white teenagers, were most likely to use contraception during their first sexual intercourse, whereas Hispanic and non-Hispanic black teens were least likely
  4. Sexual risk behaviors place teens at risk for HIV infection, other sexually transmitted diseases (STDs), and unintended pregnancy
    • Young people (aged 13 to 24) accounted for an estimated 22% of all new HIV diagnoses in the United States in 2015
    • Among young people (aged 13 to 24) diagnosed with HIV in 2015, 81% were gay and bisexual males
    • Half of the nearly 20 million new STDs reported each year were among young people between the ages of 15 to 24
    • Nearly 230,000 babies were born to teenage girls (15 to 19) in 2015
  5. Confidentiality Concerns
    • About 7% of persons aged 15 to 25 would not seek sexual or reproductive healthcare because of concerns that their parents might find out about it
    • Females aged 15 to 25, with confidentiality concerns, were less likely to receive sexual and reproductive health services in the past year compared with those without these concerns
    • Less than one-half of teenagers aged 15 to 17 (38.1%) spent some individual time in the past year during a visit with a doctor or other healthcare provider without a parent, relative, or guardian in the room
    • Teenagers aged 15 to 17 who spent some time alone during a visit with a healthcare provider were more likely to have received sexual or reproductive health services in the past year compared with those who had not
  6. Abstinence
    • 57.6% of females and 55.8% of males reported they have not had intercourse in the 2011–2015 survey
    • The most common reason female teenagers chose for abstaining from sex (among the categories provided), was that it was ‘‘against their religion or morals”

Why Does This Matter?

The sexual behavior of adolescents in the US has resulted in disproportionate physical and mental health consequences for females. Besides pregnancy and STIs, early sexual debut among females is a risk factor for depression and suicidality. Approximately 60% of females state they have regrets regarding their first sexual experience. Given the skyrocketing prevalence of suicide among children and adolescent girls, enhancing abstinence skills, in addition to current risk reduction approaches, may encourage more children and adolescents to delay their sexual debut until a time when they can better understand the consequences associated with sexual behavior.