Trends in Contraceptive Use among U.S. High School Students 1991 to 2001

John S. Santelli, U.S. Centers for Disease Control and Prevention (CDC)
Brian Morrow, U.S. Centers for Disease Control and Prevention (CDC)

Teen pregnancy in the United States declined steadily during the 1990s. We used national Youth Risk Behavior Surveys to estimate trends in contraceptive use at last sexual intercourse among high school students between 1991 and 2001. We calculated weighted-average contraceptive failure rates (WACFR), to summarize the overall effectiveness of contraceptive use among groups. Contraceptive use improved for girls but not boys. The largest improvements occurred among 9th grade, Hispanic, and non-Hispanic black girls. Improvement in contraceptive use among girls included declines in use of withdrawal and no method and increasing condom use. Overall, use of hormonal methods among girls changed little during this time. Based on the WACFR index, in 2001 almost one quarter of sexually active teens would have been expected to become pregnant within a year. Although contraceptive failure among teens is common, these data demonstrate significant improvement in contraceptive practice among high school students during the 1990s.