Dual Contraceptive Nonuse - Youth in Vermont

Vermont

For teenagers engaging in sexual activities that may result in pregnancy, dual contraceptive use — the use of a condom to prevent sexually transmitted infections in addition to a more effective pregnancy prevention method (intrauterine device, implant, shot, patch, ring or birth control pills) — is the recommended contraceptive practice for adolescents. Approximately 52% of sexually active high school students report using a condom and 33% report using a form of hormonal contraceptive separately, with only 9% reporting dual contraceptive use. 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 have a higher 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:

• White youth compared with Asian, Black and Hispanic youth.
• Heterosexual youth compared with youth who identify as lesbian, gay, bisexual, questioning or another nonheterosexual identity.

Adolescents report a preference to obtain contraceptive services via pharmacies or general health services rather than youth-centered programs. Research indicates that equipping these existing venues may better address 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 dual methods 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.

Chandra-Mouli, Venkatraman, and Elsie Akwara. “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 1, 2020): 107–18. https://doi.org/10.1016/j.bpobgyn.2020.04.003.

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.

Szucs, Leigh E. “Condom and Contraceptive Use Among Sexually Active High School Students — Youth Risk Behavior Survey, United States, 2019.” MMWR Supplements 69 (2020). https://doi.org/10.15585/mmwr.su6901a2.