Dramatically reduced teen pregnancy rates in the United States between 1995 and 2002 resulted largely from increased contraceptive use rather than from sexual abstinence, according to a recent study. These findings "raise questions about current U.S. government policies that promote abstinence from sexual activity as the primary strategy to prevent adolescent pregnancy," the investigators write in the American Journal of Public Health.
Researchers from New York's Guttmacher Institute analyzed data on teens who were between the ages of 15 and 19 when they were interviewed in 1995 (n = 1,396) or 2002 (n = 1,150) for the National Survey of Family Growth, which is conducted every seven years by the Centers for Disease Control and Prevention.
They calculated that the overall risk of pregnancy in this population declined by 38% (reducing the pregnancy rate by 23.5%), with 86% of that decline resulting from contraceptive use and 14% from abstinence. In 15-to-17-year-olds, increased use of contraceptives accounted for 77% of the drop in pregnancy risk, whereas contraceptive use alone explained the decline among 18-to-19-year-olds.
Contraceptive use increased dramatically between 1995 and 2002, especially in 15-to-17-year-olds. The percentage of young women in this age group whose partners used condoms (during the most recent sexual intercourse), rose from 38% to 58%, and the percentage using birth control pills rose from 19% to 39%. Teens ages 15 to 19 more than doubled their use of two or more contraceptives (from 11% to 26%). The most common combination was the pill and a condom, likely because of concerns about contracting HIV and other sexually transmitted diseases.
Among developed countries, the United States has the highest rate of teen pregnancy. The changes observed in this study parallel patterns seen in other developed nations, where greater access to and use of contraceptives have lowered teen pregnancy rates. The authors conclude that according to their analysis, the current emphasis in U.S. policy, both at home and abroad, on funding scientifically unproven abstinence-only programs rather than providing accurate information about contraception "is misguided."
Carol Potera