Condom Use at First Vaginal Intercourse Among Adolescents and Young Adults in the United States, 2002-2017

Sources of condom information among adolescents in the United States

OBJECTIVE

To describe receipt of condom information from formal sources and parents among sexually experienced and sexually inexperienced adolescents in the United States.

STUDY DESIGN

Data come from the 2015-2019 National Survey of Family Growth and a sample of 15-to-19-year-olds.

RESULTS

Most adolescent females and males reported receipt of condom information from any source, with sexually experienced adolescents more likely to do so. Close to one-third of adolescents, regardless of sexual experience, reported sex education about condoms from only formal sources, with small proportions reporting receipt of this information from only parents. Receiving condom information from both formal sources and parents was more common among sexually experienced adolescents, whereas not receiving this information from either source was more frequently reported among sexually inexperienced adolescents.

CONCLUSIONS

This study highlights disparities in condom information receipt based on sexual experience and underscores the need to provide both sexually experienced and sexually inexperienced youth with condom knowledge and information to protect their sexual health.

Changes in Oral and Anal Sex With Opposite-Sex Partners Among Sexually Active Females and Males Aged 15 to 44 Years in the United States: National Survey of Family Growth, 2011-2019

BACKGROUND

Oral and anal sex with opposite-sex partners is common and associated with sexually transmitted infection (STI) transmission. Trends in these behaviors over the last decade, during which bacterial STI diagnoses have reached historic highs while HIV diagnoses have decreased, are not well understood. We examined recent trends in oral and anal sex and associated condom use with opposite-sex partners among females and males.

METHODS

We analyzed data from 16,926 female and 13,533 male respondents aged 15 to 44 years who reported sex with an opposite-sex partner in the past 12 months from the National Survey of Family Growth, 2011-2019. We used survey-weighted linear or logistic regression to evaluate linear temporal trends in oral and anal sex behaviors.

RESULTS

From 2011-2013 to 2017-2019, reports of oral sex and number of oral sex partners in the past 12 months increased among females (85.4% in 2011-2013 to 89.4% in 2017-2019; odds ratio [OR], 1.05 [95% confidence interval {CI}, 1.02-1.09], and β = 0.014 [95% CI, 0.005-0.023]; respectively) but not males (ranges, 87.9%-89.1%; 1.27-1.31). Condom use at last oral sex decreased among both females and males (6.3%-4.3%: OR, 0.93 [95% CI, 0.88-0.99]; 5.9%-4.4%: OR, 0.95 [95% CI, 0.91-1.00]). Anal sex (ranges, 21.0%-23.3% [females] and 23.3%-24.6% [males]), number of anal sex partners (females, 0.22-0.25; males, 0.26-0.30), and condom use at last anal sex (females, 15.3%-18.2%; males, 27.0%-28.7%) remained stable.

CONCLUSIONS

The frequency of oral and anal sex with opposite-sex partners among U.S. 15- to 44-year-olds, paired with limited and-for oral sex-decreasing condom use, demonstrates the need to understand the role of these behaviors in increasing STI diagnosis rates and the potential role of extragenital screening and condoms in reducing STI transmission.

Factors affecting the safe sexual behaviors of Korean young adults by gender: a structural equation model

PURPOSE

The aim of this study was to determine the factors that influence safe sexual behaviors of Korean young adults and identify differences by gender.

METHODS

This study aimed to determine which factors affected safe sexual behaviors based on the Theory of Planned Behavior. Data from 437 Korean young adults (in their 20s and 30s) were collected via online survey between January 3 and January 28, 2022. The questionnaire included items on sexual body image, sexual role perception, sexual attitudes, sexual socialization, sexual communication, and safe sexual behaviors. Structural equation modeling was performed.

RESULTS

According to the overall model fit of the hypothetical model, the final model was acceptable and explained 49% of safe sexual behaviors. Sexual attitudes (β=-.70, p<.001) and sexual communication (β=.53, p<.001) directly affected safe sexual behaviors, and sexual role perception (β=.42, p<.001) indirectly affected safe sexual behaviors in a combined model. There were gender differences in the path from sexual attitudes (β=-.94, p<.001) and sexual communication (β=.66, p<.001) to safe sexual behaviors and from sexual body image (β=.27, p<.001) to sexual communication.

CONCLUSION

Sexual attitudes and sexual communication were predictors of safe sexual behaviors, which differed by gender. Strategies that consider sexual attitudes, sexual communication, sexual role perception, and differences between men and women should be developed to improve the safe sexual behaviors of young adults.

Motivations for Maintaining Virginity Among US Adolescents

PURPOSE

This study describes trends in virginity and the motivations for maintaining virginity between 2006 and 2019 among 15- to 19-year-old adolescents in the United States.

METHODS

We used logistic regression and the margins command in Stata to estimate the proportion reporting virginity and the primary motivation for virginity during each survey period and the lincom command to facilitate statistical comparisons across time.

RESULTS

The proportion of males reporting virginity increased (from 56% to 61%), and the distribution of reasons for maintaining virginity shifted over time. Most females and males reported not having "found the right person" (16%-25% for females; 26%-35% for males), and a small percentage of females reported religion and morality (39%-27%) as motivations for abstinence.

DISCUSSION

The calculus of adolescents' sexual decision-making is changing, pointing to a need for new, longitudinal data aimed at clarifying the role of sexual (in)activity in teens' lives.

A Trend Analysis of Condom use in Spanish Young People over the Two Past Decades, 1999-2020

HIV exposure is one of the greatest sexual risks in young people, and condom use is the best protective measure. Despite the preventive efforts, trend in condom use is still unclear. This study examines the trend of condom use by gender in Spanish young people, in different sexual practices (vaginal, oral and anal), relationships (regular and casual) and having sex after drugs consumption during the two past decades (from 1999 to 2020). For this, 14,472 people who ranged from 17 to 40 years old (63.5% women) filled the AIDS Prevention Questionnaire in each year. In general, low condom use remains stable and even gets worse regardless of the type of sexual practice, relationship and the substance consumption. Regarding gender, this trend is worse in women who have been less likely to report condom use than men have. Moreover, older people have reported a minor frequency of condom use than the youngest people have done, except for anal sex. Therefore, it is necessary to analyze why, despite preventive efforts, condom use seems to decrease over time.

Rate of condom use among sexually active adolescents: a nationwide cross-sectional study in Taiwan from 2012 to 2016

OBJECTIVE

Adolescents' sexual behaviours are associated with sexually transmitted infections and unwanted pregnancies. This study aimed to estimate the sexual intercourse and condom use rates at first and last sex among Taiwanese adolescents in grades 7-12.

DESIGN

A secondary data analysis of the Taiwan Global School-Based Student Health Survey's 2012-2016 data. The survey was anonymous, cross-sectional and nationwide.

SETTING

Taiwan high school students (grades 7-12).

PARTICIPANTS

The sample comprised 27 525 students from junior high schools (grades 7-9), and senior high schools, comprehensive schools, vocational high schools and night schools (grades 10-12).

MAIN OUTCOME MEASURES

The rate of ever having had sexual intercourse; the rates and factors of condom use at first and last sex.

RESULTS

The sexual intercourse rate in each school type (in ascending order) was junior high school (1.62%), senior high school (4.14%), comprehensive school (9.08%), vocational high school (14.03%) and night school (41.09%). Condom use rate decreased from 57.07% (95% CI=54.31% to 59.83%) at first sex to 25.72% (95% CI=23.34% to 28.10%) at last sex (p<0.0001). The condom use rate (in ascending order) was junior high school (first sex: 37.67%, last sex: 19.76%), night school (55.83%, 22.62%), vocational high school (61.13%, 25.78%), comprehensive school (62.83%, 28.61%) and senior high school (68.38%, 34.96%). Older age at sexual debut was associated with condom use at first and last sex, and having one sexual partner was associated with condom use at last sex, as revealed by logistic regression analysis.

CONCLUSIONS

This study highlights an urgent need to instil a proper understanding of protected sex while adolescents are still in their formative years. Despite the low sexual intercourse rate (4.95%), there is lower condom use at last sex than at first sex, which indicates that many sexually active adolescents are not practising protected sex, especially among junior high school students.

Trends in U.S. adolescent sexual behavior and contraceptive use, 2006-2019

OBJECTIVE

This study examines changes over time in the prevalence of select sexual behaviors and contraceptive use measures in a national sample of U.S. adolescents.

STUDY DESIGN

We used data on adolescents aged 15-19 from the 2006-2010 (n=4,662), 2011-2015 (n=4,134), and 2015-2019 (n=3,182) National Surveys of Family Growth. We used logistic regression to identify changes between periods in sexual behaviors and contraceptive use by gender, and for some measures by age. We estimated probabilities of age at first penile-vaginal intercourse with Kaplan-Meier failure analysis.

RESULTS

Over half of adolescents have engaged in at least one of the sexual behaviors measured. Males reported declines in sexual behaviors with a partner of a different sex. Adolescent males reported delays in the timing of first penile-vaginal intercourse. Adolescent females reported increases from 2006-2010 to 2015-2019 in use at last intercourse of any contraceptive method (86%, 95%CI 83-89; 91%, 95%CI 88-94), multiple methods (26%, 95%CI 22-31; 36%, 95%CI 30-43), and IUDs or implants (3%, 95%CI 1-4; 15%, 95%CI 11-20). Adolescent males reported increases in partners' use of IUDs or implants use from <1% to 5% and recent declines in condom use at last intercourse (78%, 95%CI 75-82, 2011-2015; 72%, 95%CI 67-77, 2015-2019). Condom consistency declined over time. Males were more likely than females to report condom use at last intercourse and consistent condom use in the last 12 months.

CONCLUSIONS

These findings identify declines in male adolescent sexual experience, increased contraceptive use overall, and declines in consistent condom use from 2006 to 2019.

IMPLICATIONS

This analysis contributes a timely update on adolescent sexual behavior trends and contraceptive use, showing that adolescent behaviors are complex and evolving. Sexual health information and services must be available so that young people have the resources to make healthy and responsible choices for themselves and their partners.