Teen Years Old Sex

Teen Years Old Sex

Douglas J. Besharov

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At least until the last few years, the proportion of teenagers who have had sex rose steadily, and they are more likely to use contraceptives than their earlier counterparts. Underlying this general trend has been an increase in sexual activity among young teens—ages 15 and under—as well as middle-class and white teenagers. Contraceptive use has risen also, probably because of the fear of AIDS and the increased sexual activity among white and middle-class teenagers. Because more teenagers were using contraceptives, the pregnancy rate per 1,000 sexually active teenagers actually declined during the 1980s, even as more teenagers were having sex. Nevertheless, contraceptive use is far from perfect, leading to high levels of abortion, sexually transmitted diseases, and nonmarital births. The challenge for school-based programs is to pursue two simultaneous goals: lower the level of sexual activity and raise the rate of contraceptive use among those who have sex.
When President Clinton appointed his first surgeon general, the controversial and outspoken Joycelyn Elders, he signaled his intention to make an issue of teenage pregnancy and parenthood. Dr. Elders left Washington, but the issue has remained. The past year, for example, witnessed the creation of a multimillion dollar national campaign to reduce teenage pregnancy and welfare reform legislation that earmarked one-quarter billion dollars for abstinence education.
There is nothing new about teenage sex. In the past, however, it was largely confined to married teenagers, or those soon to be married, and thus was not considered a problem. But today, teenagers are much less likely than in the past to get married. In 1993, for example, the average age at first marriage for women was 24.5 years and 26.5 years for men.
The decline in teenage marriages, however, has not led to a corresponding drop in teenage sexual activity. During the 1970s and 1980s at least, more teenagers became sexually active, and they had sex more frequently, with more partners, and at younger ages. Newly-released data, however, indicate that there may have been a decline in teenage sexual activity. According to the 1995 National Survey of Family Growth, the proportion of sexually active females ages 15 to 19 fell 8 percent between 1988 and 1995 (Abma et al., 1997). The 1995 National Survey of Adolescent Males also found an 8 percent decline in sexual activity among teenage males since 1988 (Sonenstein & Ku, 1997). This is welcome news after the rate of sexual activity seemed to rise inexorably over the past two decades. The new data contained another positive finding: The proportion of sexually active teenagers using contraception rose dramatically.
These data may signal the start of a trend towards less sex and more contraceptive use among teenagers. Further analysis of the data, as well as additional studies, will be needed to draw a definitive conclusion. But even if these early suggestions of a turnaround in teenage sexual activity are valid, there is still much room for improvement. About half of male and female teenagers have had sex, including about 20 percent of 15-year-old females. And contraceptive use is far from perfect. As a result, each year there are about 1 million pregnancies resulting in approximately 400,000 abortions, 500,000 births, and 100,000 miscarriages. Of the births, over 70 percent are out of wedlock, putting those young mothers at risk of long-term welfare dependency. And about 3 million teenagers contract a sexually transmitted disease (STD) such as chlamydia, gonorrhea, and even AIDS.
Most people are unhappy about sexual activity among younger adolescents, but disagreement is more widespread about sexual activity among older teenagers. (We will not try to draw the age line.) Some believe that sex outside of marriage undermines traditional moral values or can be psychologically damaging to adolescents. Others are concerned that teenagers are relatively poor contraceptors.
Most agree that teenagers tend to be reckless in their behavior, and unprotected sex is just one of a host of risky behaviors in which they engage. But even for those who are always careful, accidents can happen and contraceptives can fail. Moreover, some teenagers are exploited or coerced into having sex and thus have little control over contraception.
Today, several major policy issues surround teenage sexual activity: (1) how can the level of such activity be reduced, especially among younger teenagers? and (2) how can sexually active teenagers be better contraceptors? To provide a context for considering these two questions, this paper presents an overview of major trends.
Five principal sources supply information about the sexual practices of teenagers: the National Survey of Family Growth (NSFG), a national in-person survey of women ages 15 to 44 conducted in 1982, 1988, and 1995 (Forrest & Singh, 1990; CDC, 1991; Abma et al., 1997); the National Survey of Adolescent Males (NSAM), a longitudinal survey of males ages 15 to 19 conducted in 1988, 1991, and 1995 (Sonenstein, Pleck, & Ku, 1989 & 1991; Sonenstein & Ku, 1997); the National Survey of Young Men (NSYM), a 1979 survey of 17- to-19-year-olds (Sonenstein, Pleck, & Ku, 1989); and the Youth Risk Behavior Survey (YRBS), a 1990 questionnaire-based survey of 11,631 males and females in grades 9 to 12 conducted by the Centers for Disease Control (CDC, 1992). Additional data are provided by the 1991 National Survey of Men (NSM), a nationally representative sample of 3,300 males ages 20 to 39 (Billy et al., 1993).
All these surveys are based on self-reports and must be interpreted with caution. Recall bias, for example, can be a problem. A 44-year-old may not remember the exact circumstances surrounding her first sexual experience. Moreover, because many interviews are conducted in person, the teenager or adult being interviewed may give the answer that he thinks is socially correct. Thus, the following statistics should be viewed as indicative of trends rather than as precise measures of current behavior.
Since 1970, nonmarital sexual activity among teenagers has increased sharply. The NSFG asked women ages 15 to 44 to recall their first premarital sexual experience. About 40 percent of the females who were 18 years old in 1970 said that they had had sex by that age. But 56 percent of the females who were 18 years old in 1980 said they had had sex by that age. For those who were 18 in 1988, the proportion had risen to 70 percent (CDC, 1991). Premarital teenage sex has always been more prevalent among males. According to the NSM, 55 percent of males who were 18 years old in 1968–1970 had had sex, compared with 64 percent in 1977–1979 and 73 percent in 1986–1988 (Alan Guttmacher Institute, 1994) (see chart 1).
As mentioned above, the 1995 NSFG reports a reversal in this trend. According to the 1995 NSFG, the proportion of 18-year-old females who reported having had sex fell 10 percent, to 63 percent (Abma et al., 1997).
Teenagers were not only more likely to become sexually active in the 1970s and 1980s, but they were experiencing sex at younger ages. As mentioned above, the percentage of 18-year-old females who had had sex increased about 75 percent between 1970 and 1988. The percentage of sexually experienced 15-year-old females, however, multiplied more than fivefold during the same period, from less than 5 percent to 26 percent. (See chart 2).
The 1995 data, however, show that the proportion of teenage females who reported that they have had sex fell or levelled off among all age groups (except 16-year-olds). As noted above, sexual activity decreased about 10 percent among 18-year-olds (from 69 percent to 63 percent), stayed virtually the same among 17-year-olds (51 percent vs. 50 percent), and declined almost 20 percent among 15-year-olds (from 26 percent to 21 percent) (Abma et al., 1997).
Partly because they were beginning sex at earlier ages, the majority of teenagers in the late 1980s reported having had sex with more than one partner (see chart 3). According to the 1988 NSFG, the proportion of sexually active 15- to-19-year-old females who had more than one lifetime partner increased from 38 percent in 1971 to 61 percent in 1988 (Smith, 1994). The 1990 YRBS found that about 7 percent of 9th-grade females and 19 percent of males the same age had had intercourse with four or more different partners. By the 12th grade, 17 percent of females and 38 percent of males reported having had four or more sexual partners.
The overall figures, however, tend to overstate teenage sexual activity because they include all youngsters who have ever had sex, even once. Analyzing data from the NSAM, for example, Sonenstein and her colleagues found that the average 15-to-19-year-old male was abstinent for six months each year. Fifteen-year-old males spent an average of eight months abstinent (Sonenstein, Pleck, & Ku, 1991).
Moreover, these are aggregate rates, and they mask important differences among various groups in our society. Low-income and African-American teenagers have always had higher rates of sexual activity than nonpoor and white ones, and still do. But the gap is narrowing—at least among older teenagers.
Rates of sexual activity of poor and nonpoor females are converging, because sexual activity has become more prevalent among middle-class and older teenagers. According to the NSFG, between 1982 and 1988 the proportion of sexually active 15-to 19-year-old females in families with incomes equal to or greater than 200 percent of the poverty line increased from 39 percent to 50 percent. At the same time, the proportion of females from poorer families (those earning less than 200 percent of the poverty line) who had ever had sex remained stable at 56 percent (Forrest & Singh, 1990) (see chart 4).
The differences in rates of sexual activity between white and black female teenagers also narrowed during the 1980s. Analysis of the NSFG found that between 1970 and 1988, the percentage of 15- to 19-year-old black females who reported having had sex rose from 49 percent to 59 percent. Among white females, the rate almost doubled between 1970 and 1988, from 27 percent to 51 percent (CDC, 1991). But these rates converged mostly because older black and white females (ages 18 and 19) were having sex in similar proportions: 76 percent and 73 percent, respectively (see chart 5).
Although more analyses will be needed to reach a definitive conclusion, it appears that the black/white differential among females grew in the 1990s. According to the 1995 data, the proportion of black 15- to 19-year-old females who reported having had sex stayed at the 1988 level. The proportion of sexually active white females, however, fell slightly, to 47 percent (Abma et al., 1997). Even among older black and white females (ages 18 and 19), the gap in sexual experience widened slightly. The proportion of blacks who had had sex dropped one percentage point (to 75 percent), while the white rate fell 5 percentage points (to 68 percent).
Moreover, even before these recent data, it appeared that there were substantial racial differences in sexual experience among younger teenagers (both boys and girls). According to the 1988 NSFG, one-third of black 15-year-old females reported that they had had sex, compared with 24 percent of their white counterparts (Moore, 1992).
Among males, the proportion of black 17-to-19-year-olds who had had sex increased from 71 percent in 1979 to 88 percent in 1988, while the rate for white males increased from 64 percent to 73 percent (Sonenstein, Pleck, & Ku, 1989). Again, rates of sexual activity are closer for older teenagers. The 1988 NSAM found that 96 percent of black males reported that they had had sex by age 19 compared with 85 percent of white males. The gap was wider among 15-year-olds: 64 percent of blacks versus 33 percent of whites reported already having had sex (Moore, 1992). The foregoing data measure the proportion of teenagers who have ever had sex. Black teenager males, however, tend to report having had more partners and more frequent sex. These racial differences also are highly associated with income differences, so they should be interpreted with care.
Contrary to conventional wisdom, it appears that teenagers have become more careful about contraception. The proportion of teenage females who reported using a method of contraception at first intercourse, for example, increased from 48 percent in 1982 to 65 percent in 1988 to 77 percent in 1995 (Forrest & Singh, 1990; Abma et al., 1997). This is important because studies indicate that half of premarital first pregnancies to teenagers occur within six months of initiating sex, and one-sixth occur within a month of first sex (Zabin et al., 1979).
Moreover, use of contraceptives at first sex increased among both white and black teenagers. Although whites were still more likely to report having used a contraceptive, the rate of increase since 1988 was greater among blacks. (see chart 6). The proportion of white females who reported using a method of contraception at first intercourse increased from 55 percent in 1982 to 69 percent in 1988. By 1995, use rose to 83 percent, a 20 percent increase. Among black females, the proportion using contraception at first intercourse increased from 36 percent to 54 percent between 1982 and 1988. By 1995, 72 percent of black females reported using a method at first sex, a 33 percent increase from 1988 (Forrest & Singh, 1990; Abma et al., 1997).
Contraceptive use at first intercourse has also increased among males since the late 1980s. The 1995 NSAM found that proportion of 15- to 19-year-old males who said they relied on an “effective” method of contraception (such as a condom or oral contraceptives) increased from 62 percent in 1988 to 73 percent in 1995 (Sonenstein & Ku, 1997).
Much of the increase in contraceptive use at first intercourse was apparently driven by condom use. The 1995 NSFG reported that 60 percent of females used a condom at first intercourse, an increase from 47 percent in 1988. By way of comparison, the proportion of females who relied on oral contraceptives increased from 8 percent to 11 percent (Forrest & Singh, 1990; Abma et al., 1997). Among males, condom use at first intercourse rose from 55 percent in 1988 to 69 percent in 1995 (Sonenstein & Ku, 1997).
The 1995 findings concur with data from the 1980s that indicated the increased use of contraception was apparently driven, at least in part, by fear of AIDS and other sexually transmitted diseases. In the mid-1980s, a major public health campaign was waged nationwide that promoted the use of barrier methods of contraception as a way of avoiding STDs. Many teenagers heard this message. According to the NSAM, between 1979 and 1988, the proportion of teenage males who reported using condoms during their last sexual experience almost tripled, from 21 percent to 57 percent (Sonenstein, Pleck, & Ku, 1989).
Increased condom use was also reflected in the NSFG data. The proportion of female teenagers who reported that they relied on condoms (not just at last intercourse) increased almost 75 percent between 1982 and 1988 (from 15 percent to 26 percent).
Increased contraception was also the result of more sexual activity among middle-class and white youths, described above. These groups have traditionally been more careful about their sexual practices. While contraceptive use at first sex increased among all socioeconomic groups, teenagers from middle-class families were more likely to use contraception at first intercourse. According to the NSFG, the proportion of middle-class teenagers who reported using contraception at first sex increased between 1982 and 1988, from 57 percent to 73 percent. During the same period, use at first intercourse among teenagers from poorer families increased from 40 percent to 58 percent (Forrest & Singh, 1990).
Because teenagers are more likely to use birth control, the substantial increase in teenage sexual activity has not been matched with an equivalent increase in the number of teenage conceptions. In fact, the absolute number of pregnancies increased by about 21 percent between 1975 and 1988, even as there was a 39 percent increase in the number of female teenagers who reported engaging in sex. The pregnancy rate among sexually active teenagers (as opposed to the entire population of teenagers) actually declined between 1982 and 1987, from 271 per 1,000 teenagers to 243 per 1,000 (Forrest & Singh, 1990).
In fact, one could construct a crude “teen conception index” that measures the changing rate of conception (composed of abortions, miscarriages, and births) among sexually active but unmarried teenagers. This index stood at 0.87 in 1988, representing a 13 percent decline from 1975. Most of this decline occurred between 1985 and 1988 as contraceptive use increased among all groups and as more middle-class teenagers initiated sex (Besharov & Gardiner, 1993) (see chart 8). If, as the 1995 data indicate, levels of teenage contraceptive use rose, we would expect the index to drop even further.
Despite the improvements in contraceptive use, however, many teenagers still use contraceptives inconsistently, or not at all. Although contraceptive use at first intercourse did increase during the 1980s, the NSFG reports that in 1988, 31 percent of white female teenagers and 41 percent of black ones reported that they did not use any method at that time. Moreover, in that year, 20 percent of sexually active female teenagers reported that they were not using any form of contraception (Forrest & Singh, 1990). Contraceptive use at first intercourse continued to increase during the 1990s. The proportion of teenage females engaging in unprotected first sex fell sharply, to 17 percent of whites and 28 percent of blacks. There is room for substantial progress on this front, however. Almost one in five white females and one in three black females were not using birth control during their first sexual experience, thus putting themselves at risk of pregnancy and disease (Abma et al., 1997).
The more risky the teenager’s general behavior is, the greater the likelihood is of risky—and early—sex (see chart 9). Donald Orr and his colleagues at the University of Indiana studied condom use among inner-city female teenagers in Indianapolis and found that only about 50 percent of them reported that their partners had ever used condoms. Significantly, the figure fell to only 29 percent among “risk-takers,” defined as drug or alcohol users, school dropouts, and those who committed minor delinquencies (Orr et al., 1992).
As chart 10 indicates, sex among young teenagers is also associated with other risk-taking behaviors such as smoking, drinking, and using drugs. The YRBS found, for example, that the proportion of 14- and 15-year-olds who had had sex was 87 percent among those who smoked marijuana regularly, compared with 36 percent of those who never did so (AGI, 1994).
Moreover, many teenagers report that they were using a contraceptive at the time they got pregnant but that it failed. As chart 11 shows, contraceptive failure rates within the first year of use are higher for teenagers, particularly poor ones, than among “typical users” in the general population. Contraceptive failure rates are often presented in two ways: (1) failure rates in clinical trials (usually involving married couples); and (2) the failure rates of “typical users” (based on surveys of the general population). James Truss
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