Condom Use
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Headline

Condom use at most recent sexual intercourse among sexually active high school students increased from 46 percent in 1991 to 63 percent in 2005. Over the past two years condom use has remained constant. (See Figure 1)

Importance

Sexually transmitted infections (STIs), including HIV/AIDS, and unintended pregnancy are major health consequences associated with unprotected sexual activity. Although a similar percentage of teens are sexually active in the United States as in western European countries, the U.S. has much higher teen pregnancy and STI rates than does Western Europe.^1,2 This is due to lower consistency and effectiveness of contraceptive use in the U.S.³

Recent studies reveal that the majority of adolescents believe that sex without a condom is not worth the risk.⁴ However a large majority of these adolescents are also misinformed about the protection that condoms provide against STIs and HIV/AIDS.⁵ Over 300,000 teenage girls age 15-17 have pregnancies in the U.S. every year, most of which are unintended,⁶ and nearly 4 million adolescents are diagnosed with an STI.⁷ Condoms, if used correctly, can greatly reduce, though not eliminate, the risk of both STIs and unwanted pregnancies.

Trends

Condom use at most recent sexual intercourse among sexually active high school students increased from 46 percent in 1991 to 63 percent in 2003 and has remained constant through 2005. (See Figure 1)

Differences by Gender

Reported condom use differs greatly by gender. In 2005, 70 percent of sexually active male high school students reported using a condom at most recent sexual intercourse, compared with 56 percent of females. (See Figure 1) In each racial/ethnic group, males are 13 or more percentage points more likely than females to report condom use at last sexual intercourse. (See Table 1)

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Differences by Race and Ethnicity⁶

Condom use is highest among non-Hispanic black students (69 percent) followed by non-Hispanic white students (63 percent) and Hispanic students (58 percent) in 2005. (See Figure 2). This pattern holds for both males and females. (See Table 1)

Differences by Grade

Condom use is higher among younger students than it is among older students. In 2005, 75 percent of sexually active ninth grade students, compared with 62 percent of eleventh graders and 55 percent of twelfth graders, used condoms.(See Figure 3) This is especially true of female students who reported a 25 percentage point lower level of condom use from grade 9 to grade 12 in 2005. (See Figure 3)Part of this drop is due to higher levels of use of other forms of birth control among older students,⁹ although it is still a cause for concern since condoms are the only form of effective control against STDs for those who are sexually active.

Related Indicators

Birth Control Pill Use, Teen Birth, Teen Pregnancy, Teen Abortion

State and Local Estimates

The 2005 state and city estimates from the Youth Risk Behavior Survey can be found at: http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5505a1.htm

International Estimates

Estimates of the percentage of 15- to 24 year-olds who reported using a condom the last time they had sex with a non-marital, non-cohabiting partner in the past 12 months are available from UNICEF's State of the World's Children 2005. http://www.unicef.org/sowc05/english/fullreport.html (See Table 4)

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National Goals

Through its Healthy People 2010 initiative, the federal government has set a national goal to increase the percentage of adolescents who either abstain from sex or use condoms if sexually active from 85 percent in 1999 to 95 percent in 2010. To reach this goal, the Center for Disease Control and Prevention encourages the promotion of abstinence and condom use, as well as access to sources of quality reproductive health care.

More information is available at:
http://www.health.gov/healthypeople/document/HTML/Volume2/25STDs.htm#_Toc489706328 (See Goal 25-11)

What Works: Programs and Interventions that May Influence this Indicator

Click here to view examples of programs and interventions that research has evaluated for this indicator. View programs

Research References

¹Singh, Darroch, Frost & the Study Team (2001). "Socioeconomic Disadvantage and Adolescent Women's Sexual and Reproductive Behavior: The Case of Five Developed Countries." Family Planning Perspectives, 33(6):251-258 & 289.; Singh, S. & Darroch, J.E. (2000). "Adolescent Pregnancy and Childbearing: Levels and Trends in Developed Countries." Family Planning Perspectives, 32(1):14-23.; Panchaud, Singh, Feivelson & Darroch (2000). "Sexually Transmitted Diseases Among Adolescents in Developed Countries." Family Planning Perspectives, 32(1):24-32 & 45.

²Manlove, J., Terry-Humen, E., Romano Papillo, A., Franzetta, K., Williams, S., & Ryan, S. (May 2002). Preventing Teenage Pregnancy, Childbearing, and Sexually Transmitted Diseases: What the Research Shows. Washington, DC: Child Trends. Available at:
http://www.childtrends.org/Files/K1Brief.pdf

³The Alan Guttmacher Institute, "Teenage Sexual and Reproductive Behavior in Developed Countries: Can More Progress Be Made?" at:
http://www.agi-usa.org/pubs/progress_pres.pdf

⁴Kaiser Family Foundation. (2003). Adolescents and Young Adults: Sexual Health, Knowledge, Attitudes and Experiences. Washington DC: Kaiser Family Foundation. Available:
http://www.kff.org/youthhivstds/upload/National-Survey-of-Adolescents-and-Young-Adults.pdf

⁵ Ibid.

⁶Ventura, S. J., Abma, J. C., Mosher, W. D. 2003. Revised Pregnancy Rates, 1990-97, and New Rates for 1998-99: United States. National Vital Statistics Reports, 52(7). Hyattsville, Maryland: National Center for Health Statistics.

⁷U.S. Department of Health and Human Services. Healthy People 2010. 2nd ed. With Understanding and Improving Health and Objectives for Improving Health. 2 vols. Washington, DC: U.S. Government Printing Office, November 2000.

⁸Race/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 here only include respondents who selected one category when choosing their race.

⁹Youth Risk Behavior Survey, 2001, Table 32
http://www.cdc.gov/mmwr/preview/mmwrhtml/ss4905a1.htm#tab32

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Definition

Students were asked the following question: "The last time you had sexual intercourse, did you or your partner use a condom?" Estimates here are limited to those who are currently sexually active (i.e., had sexual intercourse within the last three months). Note that students may (also) use other methods of contraception, instead of or in addition to, condoms.

Data Source

Data for 1991: YRBSS: Youth Online, Comprehensive Results. Retrieved May 24, 2004 from URL:
http://apps.nccd.cdc.gov/yrbss/
Centers for Disease Control and Prevention. Surveillance Summaries:
Data for 1993: March 24 1995. MMWR 1995; 44(No. SS-1): Table 20.
http://www.cdc.gov/mmwr/preview/mmwrhtml/00036855.htm#00001034.htm
Data for 1995: September 27, 1996. MMWR 1996; 45 (No. SS-4): Table 28.
http://www.cdc.gov/mmwr/preview/mmwrhtml/00043812.htm#00001946.htm
Data for 1997: August 14, 1998. MMWR; 47(No. SS-3): Table 28.
http://www.cdc.gov/mmwr/preview/mmwrhtml/00054432.htm#00003369.htm
Data for 1999: June 9, 2000. MMWR 2000; 49(No. SS-5): Table 32.
http://www.cdc.gov/mmwr/preview/mmwrhtml/ss4905a1.htm#tab32
Data for 2001: June 28, 2002. MMWR 2002; 51(No. SS-4): Table 32.
http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5104a1.htm#tab32
Data for 2003: May 21, 2004. MMWR 2004; 53(No. SS-2): Table 44.
http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5302a1.htm#tab44
Data for 2005: June 9, 2006. MMWR 2006; 55 (No. SS-5): Table 46.
http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5505a1.htm

Raw Data Source

Youth Risk Behavior Survey
http://www.cdc.gov/nccdphp/dash/yrbs/index.htm

Approximate Date of Next Update

Summer 2008

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