Dual Contraceptive Nonuse - Youth

Dual Contraceptive Nonuse - Youth in United States

United States

Dual contraceptive use among adolescents prevents pregnancies and sexually transmitted diseases (STDs). According to the American College of Obstetricians and Gynecologists (ACOG), the ideal contraceptive practice for sexually active adolescents is dual contraceptive use — both a condom to prevent STDs and a method more effective at preventing unwanted pregnancies. Long-acting reversible contraceptive (LARC) methods such as intrauterine devices and hormonal implants are safe choices recommended for adolescents by ACOG due to higher efficacy, higher continuation rates and higher user satisfaction compared with short-acting contraceptives. Condoms are not ideal as a sole contraceptive due to a high typical-use failure rate.

Among sexually active high school youth, dual contraceptive use is higher among:

• 12th graders compared with ninth and 10th graders.
• Non-Hispanic white youth compared with non-Hispanic Black and Hispanic youth.

Strategies to increase contraceptive use among youth include:

• Making existing services that serve adolescents more responsive to adolescents’ needs by removing policy restrictions to access, ensuring confidentiality and privacy and providing free or subsidized services. 
• Educating health care providers to respond to the diverse contraceptive needs of youth. 

The Guttmacher Institute provides the most recent federal and state policies regarding contraception use in youth.

Healthy People 2030 has multiple objectives related to youth contraceptive use, including:

• Increase the proportion of adolescents who use birth control the first time they have sex. 
• Increase the proportion of adolescent females at risk for unintended pregnancy who use effective birth control.

“ACOG Committee Opinion No. 710: Counseling Adolescents About Contraception.” 2017. Obstetrics & Gynecology 130 (2): e74–80. https://doi.org/10.1097/AOG.0000000000002234.

Chandra-Mouli, Venkatraman, and Elsie Akwara. 2020. “Improving Access to and Use of Contraception by Adolescents: What Progress Has Been Made, What Lessons Have Been Learnt, and What Are the Implications for Action?” Best Practice & Research Clinical Obstetrics & Gynaecology, Modern Methods of Contraception, 66 (July): 107–18. https://doi.org/10.1016/j.bpobgyn.2020.04.003.

Hoffman, Saul D., and Rebecca A. Maynard, eds. 2008. Kids Having Kids: Economic Costs & Social Consequences of Teen Pregnancy. 2nd ed. Washington, D.C.: Urban Institute Press. http://webarchive.urban.org/publications/211515.html.

Manlove, Jennifer, Suzanne Ryan, and Kerry Franzetta. 2003. “Patterns of Contraceptive Use within Teenagers’ First Sexual Relationships.” Perspectives on Sexual and Reproductive Health 35 (6): 246–55.

Smith, Chris, Judy Gold, Thoai D. Ngo, Colin Sumpter, and Caroline Free. 2015. “Mobile Phone-Based Interventions for Improving Contraception Use.” Edited by Cochrane Fertility Regulation Group. Cochrane Database of Systematic Reviews, June. https://doi.org/10.1002/14651858.CD011159.pub2.

Szucs, Leigh E., Richard Lowry, Amy M. Fasula, Sanjana Pampati, Casey E. Copen, Khaleel S. Hussaini, Rachel E. Kachur, Emilia H. Koumans, and Riley J. Steiner. 2020. “Condom and Contraceptive Use Among Sexually Active High School Students — Youth Risk Behavior Survey, United States, 2019.” MMWR Supplements 69 (1): 11–18. https://doi.org/10.15585/mmwr.su6901a2.