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South Dakota 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
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
70.8% - 80.8%
80.9% - 82.2%
82.3% - 85.8%
85.9% - 90.6%
90.7% - 94.1%
No Data
US Value: 85.6 %
Top State(s): Wisconsin: 70.8 %
Bottom State(s): Mississippi: 94.1 %
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(s): U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Adolescent and School Health, Youth Risk Behavior Surveillance System, 2023
Suggested Citation: America's Health Rankings analysis of U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Adolescent and School Health, Youth Risk Behavior Surveillance System, United Health Foundation, AmericasHealthRankings.org, accessed 2026.
For teenagers engaging in sexual activities that could result in pregnancy, the ideal safe sex practice is dual contraceptive use — the use of a condom to prevent sexually transmitted infections (STIs) in addition to a more effective method at preventing unwanted pregnancies. The American College of Obstetricians and Gynecologists recommends long-acting reversible contraceptive (LARC) methods, such as intrauterine devices and hormonal implants, which have higher rates of efficacy and continued use compared with short-acting options. Condoms are not ideal as a sole contraceptive due to their high typical-use failure rate compared with other contraceptives such as LARCs.
Based on data from a survey of sexually active high school students, dual contraceptive use is higher among:
Studies show that adolescents are more likely to access contraceptive services via pharmacies or general health services than youth-centered programs. Effective strategies should, therefore, focus on equipping these existing venues to better respond to the contraceptive needs of adolescents.
County Health Rankings & Roadmaps lists several proven approaches for increasing condom use and reducing risky sexual behavior, including condom availability programs and behavioral interventions to prevent HIV and other sexually transmitted infections. The American Academy of Pediatrics recommends that pediatricians provide all adolescents with access to contraceptive information and counseling.
Healthy People 2030 has multiple objectives related to youth contraceptive use, including increasing the proportion of adolescent males who used a condom the last time they had sex and increasing the proportion of adolescent females who used effective birth control the last time they had sex.
“ACOG Committee Opinion No. 710: Counseling Adolescents About Contraception.” Obstetrics & Gynecology 130, no. 2 (August 2017): e74–80. https://doi.org/10.1097/AOG.0000000000002234.
Centers for Disease Control and Prevention. Youth Risk Behavior Survey Data Summary & Trends Report: 2011-2021. Centers for Disease Control and Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Division of Adolescent and School Health, February 2023. https://www.cdc.gov/yrbs/dstr/pdf/YRBS_Data-Summary-Trends_Report2023_508.pdf.
Ott, Mary A., Andrea J. Hoopes, Gina S. Sucato, Maayan Leroy-Melamed, Committee on Adolescence, Elizabeth M. Alderman, Elise Berlan, et al. “Contraception for Adolescents: Policy Statement.” Pediatrics 156, no. 1 (July 1, 2025): e2025072217.https://doi.org/10.1542/peds.2025-072217.
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