Recorded presentation

John S Santelli, MD, MPH¹, Marion Carter², and Brian Morrow². (1) Department of Population and Family Health, Columbia University, Mailman School of Public Health, 60 Haven Avenue, New York, NY 10032, 212-304-5201, jfs8@cdc.gov, (2) Division of Reproductive Health, Centers for Disease Control and Prevention, 4770 Buford Highway, mailstop k22, Atlanta, GA 30341

Background: Teen pregnancy in the United States declined since 1991, the result of delayed initiation of intercourse and improved contraceptive use. Methods: We used national Youth Risk Behavior Surveys to estimate trends in contraceptive use at last sexual intercourse among high school students between 1991 and 2001. We used published, method-specific contraceptive failure rates developed from the NSFG to calculate weighted-average contraceptive failure rates (WACFR), indicators that summarize the effectiveness of overall contraceptive use for populations with different patterns of method use. We examined trends by sex, grade, and race/ethnicity and used weighted least-squares regression to test change. Results: Between 1991 and 2001, contraceptive use improved for girls but not boys, with annual rates of change in the WACFR of -1.5% (95% CI -2.5, -0.6) and -1.0% (95% CI –2.1, 0.2), respectively. The largest improvements occurred among 9th graders and non-Hispanic black girls. Among girls between 1991 and 2001, method change included condom use (38% to 52%), no method (18% to 14%), and withdrawal (19% to 13%),. Use of hormonal methods among girls changed little, with a decline in pill use (25% to 21%) offset by new use of injection (6% in 2001). Dual use among girls was 7% in 2001. Based on the WACFR index, in 2001 almost one quarter of sexually active teens would have been expected to become pregnant with a year. Conclusions: Although contraceptive failure among teens is common, these data demonstrate significant improvement in contraceptive practice among high school-aged teens during the 1990s.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

1. List three trends in contraceptive use among high school students since 199
• 2. Describe differences in trends in contraceptive use by high school students by gender, grade, and race/ethnicity. 3. Identify a way to summarize effectiveness of overall contraceptive use for populations with different patterns of method use.

Keywords: Contraceptives, Adolescent Health

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Recorded presentation