Trends in adolescent contraceptive use, unprotected and poorly protected sex, 1991-2003.
OBJECTIVE
To estimate trends in use and nonuse of effective protection among adolescents 1991-2003, 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.
Anderson
John E
JE
Division of HIV/AIDS Prevention, National Center for HIV, HIV, and STD Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. jea1@cdc.gov
Santelli
John S
JS
Morrow
Brian
B
D000293:Adolescent; D000294:Adolescent Behavior; D003270:Contraceptive Agents / Q000627:therapeutic use*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000517:prevention & control; D012189:Retrospective Studies; D012309:Risk-Taking; D012749:Sexually Transmitted Diseases / Q000517:prevention & control; D047568:Unsafe Sex / Q000706:statistics & numerical data*
D003270:Contraceptive Agents