Forgive me if I used that title already. I vaguely remember writing an article two years ago when the 2009 Youth Risk Behavior Survey (YRBS), the Centers for Disease Control and Prevention’s (CDC’s) biennial survey of high school students, came out with its interminable lists of data on teen behaviors, from wearing bicycle helmets to texting while driving to drinking soda (or pop depending on where you live). Of course, I always flip right to the pages on sexual behavior (this year it’s tables 64 through 76 for others like me) because as much as I want to know whether teens ate a piece of fruit or drank a glass of 100 percent fruit juice every day, I admit that I’m more interested in whether they used a condom the last time they had sexual intercourse.
The YRBS is an interesting snapshot of what teens are doing when it comes to sex but it is also very limited. First because it only talks to teens who are currently in high school which means that it misses some of the most at-risk teens. Second because it avoids questions of same-sex sexual behaviors (though some states do ask these questions in their surveys). And also, because it asks very specific questions that look at sexual behavior through the lens of risk. This may be understandable given that a few pages before these questions the survey asks about the use of heroin and methamphetamines; but I always wish sex, by virtue of the fact that unlike meth it can be a healthy behavior for teens, could somehow be treated differently. Still, the survey gives us some valuable insight particularly since much the same questions have been asked of teens every two years since 1991.
Here are some of the highlights about sexual behavior from the 2011 survey.
- 47.4 percent of high school students (49.2 percent of males and 45.6 percent of females) reported ever having had sexual intercourse.
- The percent of students who have ever had sexual intercourse increases steadily with grade level—32.9 percent of 9th graders, 43.8 percent of 10th graders, 53.2 percent of 11th graders, and 63.1 percent of 12th graders.
- 6.2 percent of high school students (9 percent of males and 4.3 percent of females) reported having had sexual intercourse for the first time before age 13.
- 15.3 percent of high school students (17.8 percent of males and 12.6 percent of females) reported having had 4 or more sexual partners.
- 33.7 percent of high school students reported being sexually active which is defined as having had sexual intercourse within the three months prior to the survey.
The YRBS also asks currently sexually active students what form of birth control, if any, they had used at last intercourse. Here is what it found:
- 60.2 percent of currently sexually active high school students (67 percent of males and 53.6 percent of females) reported having used a condom the last time they had intercourse.
- 18 percent of currently sexually active high school students (13.4 percent of males and 22.6 percent of female) reported that either they or their partner had used birth control pills the last time they had intercourse.
- 5.3 percent of currently sexually active high school students (3.2 percent of males and 7.5 percent of females) reported that either they or their partner had used Depo-Provera (the shot), Nuva Ring, Implanon (the implant), or an IUD the last time they had sexual intercourse.
In addition to breaking down these behaviors by sex and school year, the YRBS breaks it down by ethnicity. Here is what it found in 2011.
- The prevalence of having ever had sexual intercourse was higher among black (60 percent) and Hispanic (48.6 percent) than white (44.3 percent) high school students.
- The prevalence of having had sexual intercourse before age 13 was higher among black (13.9 percent) and Hispanic (7.1 percent) than white (3.9 percent) high school students.
- The prevalence of reporting being currently sexually active was higher among black (41.3) than white (32.4 percent) or Hispanic (33.5 percent) high school students.
- Among currently sexually active students, the prevalence of having used a condom at last intercourse was higher among black (65.3 percent) than Hispanic (58.4 percent) students and higher among black male (75.4 percent) than white male (66.3 percent) and Hispanic male (63.4 percent) high school students.
What is most telling about this year’s YRBS is that there is almost no change in any of these markers of sexual “risk” behavior from the previous survey. As the authors explain, the prevalence of having ever had sexual intercourse decreased during 1991–2001 (from 54.1 percent of high school students to 45.6 percent) but has not changed significantly since 2001. In 2009, 46 percent of high school students reported having ever had sexual intercourse compared to the 47.4 percent in 2011, this slight tick upwards, however, does not represent a significant change. This same trend of seeing improvements between 1991 and 2001 and then stagnation since then is repeated for almost all behaviors with slight variations. For example, the prevalence of condom use increased between 1991 and 2003 (from 46.3 percent to 63 percent) but has remained stagnant since. Similarly, the prevalence of high school students who reported having had sex before age 13 decreased between 1991 and 2005 but has remained the same since.
The other really interesting thing about this year’s results is the number of places where the authors note wide variations across states and urban school districts. For example, the percentage of students who reported having had sex before age 13 ranges from 3.6 to 11.8 percent across states and from 4.9 to 15.6 percent across large urban school districts. The prevalence of currently sexually active students who used condoms the last time they had intercourse also varied widely across states from 43.9 percent to 70.8 percent and across large urban school districts from 52.1 percent to 75.1 percent. It would be really interesting if we could use these variations to pinpoint what policies and programs may be helping young people protect themselves because it is clear that when looking at the nation as a whole the policies and programs we have in place right now are not working.
Don’t get me wrong, I am never one who says the sky is falling when it comes to young people and sexual behavior. I think the fact that 60 percent of sexually active young people used a condom the last time they had sex shows us that many high school students (even those who aren’t virgins) can and do behave responsibly. I’m even more impressed that 9.5 percent of currently sexually active high school students reported using dual methods of contraception meaning that even though they were using a hormonal method like the birth control pill, shot, ring, or implant or had an IUD, they also used a condom presumably to protect themselves against STDs.
Still, the word stagnant is all over this article. We made progress between 1991 and 2001 – a nice decade in which fewer teens became sexually active and more teens used condoms — but that decade ended over a decade ago. We have to ask ourselves what we have done wrong in the last 10 years to have impeded progress.
The YRBS does not tell us everything we want to know about teen sexual behavior. I, for one, would like to know who their partners were, if there was a difference in their contraceptive use depending on their relationship status, whether they enjoyed their experiences, and why so many students who have had intercourse are not currently sexually active — is it a choice or simply lack of opportunity? I’d like to know if they learned about condoms in school and I would love to see if states where kids learned about condoms in school had better condom usage rates. I could go on and on (and I will in another article, I’m sure). For now though, what the YRBS does tell us is that 12.9 percent of currently sexually active high school students did not use any form of birth control the last time they had intercourse and 26 percent of high school students haven’t even learned about HIV and AIDS in school. What it does tell us is that we have made no progress in recent years. What it does tell us is that we can do better.