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United States Value:
Percentage of sexually active high school students who reported not using both: a condom during last sexual intercourse; and either birth control pills, an intrauterine device or implant, or a shot, patch or birth control ring before last sexual intercourse
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Percentage of sexually active high school students who reported not using both: a condom during last sexual intercourse; and either birth control pills, an intrauterine device or implant, or a shot, patch or birth control ring before last sexual intercourse
Percentage of sexually active high school students who reported not using both: a condom during last sexual intercourse; and either birth control pills, an intrauterine device or implant, or a shot, patch or birth control ring before last sexual intercourse
Percentage of sexually active high school students who reported not using both: a condom during last sexual intercourse; and either birth control pills, an intrauterine device or implant, or a shot, patch or birth control ring before last sexual intercourse
CDC, Youth Risk Behavior Surveillance System
Percentage of sexually active high school students who reported not using both: a condom during last sexual intercourse; and either birth control pills, an intrauterine device or implant, or a shot, patch or birth control ring before last sexual intercourse
CDC, Youth Risk Behavior Surveillance System
US Value: 90.9%
Top State(s): Vermont: 79.2%
Bottom State(s): Florida: 93.6%
Definition: Percentage of sexually active high school students who reported not using both: a condom during last sexual intercourse; and either birth control pills, an intrauterine device or implant, or a shot, patch or birth control ring before last sexual intercourse
Data Source and Years: CDC, Youth Risk Behavior Surveillance System, 2019
Suggested Citation: America's Health Rankings analysis of CDC, Youth Risk Behavior Surveillance System, United Health Foundation, AmericasHealthRankings.org, accessed 2023.
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:
Strategies to increase contraceptive use among youth include:
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:
“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.
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