Contraception Use Higher in Older Teens

The authors noted prior studies that showed an association between using contraception at first sex and using contraception consistently later. Contraception included hormonal and barrier methods, withdrawal, and periodic abstinence.

Of girls age 12 or younger, only 52% used contraception at sexual initiation. Among 13- and 14-year-olds, contraceptive use remained scant as well.

But by age 15, the authors wrote, contraceptive use reflected that of females who put off sex until later teenage years: 80% reported using contraception the same month they first had sex, as did 85% of 17- to 18-year-olds.

Pregnancy Rare in Younger Teens

Pregnancies among 12-year-olds is “minuscule” and among 11-year-olds it is “exceedingly rare,” they said. Only one in about 7,000 of 12-year-olds gets pregnant each year. Most pregnancies (excluding miscarriages) among girls 13 and younger end in abortion, while in girls 14 and older, more pregnancies result in birth. For girls 17 and older, twice as many pregnancies end in birth as abortion, they wrote.

Because first-time sex among younger teens is “frequently nonconsensual,” the authors said, “individual pregnancies to girls this young are significant events, [and] they arguably represent a different public health concern than the broader issue of pregnancies to older teens.”

Among those young teens, they said, “lower rates of contraceptive use at first sex are probably due to their lower likelihood of having information about and access to contraceptive methods.”

But it is older teens, the substantial proportions of 15- and 16-year-old girls “who are most at risk for experiencing an unwanted teenage pregnancy, and who are therefore most affected by restrictions, legal or practical, to using contraception.”

The study was limited by retrospective reporting by respondents, the authors said, but memory of the “highly salient events” should be accurate. The proportion of young adolescents whose first sexual experience was coerced might be higher than the author’s data, they said. The survey method that asked if first sexual intercourse was nonconsensual has been susceptible to underreporting, they said.

Of greater concern, they said, was the underreporting of current sexual behavior, influenced by respondents’ bias for social desirability. Also, measures of sexual activity and contraception were limited to the first instance of each.

The researchers said pediatricians and health professionals should screen for unwanted sexual activity among patients of all ages, particularly younger adolescents. Healthcare providers should also inform young adolescents about contraception, as well.

“Teaching young adolescents about contraceptive methods and prescribing or offering methods before they are likely to become sexually active is prudent,” they said. “No study of sex education programs to date has found evidence that providing young people with sexual and reproductive health information and education results in increased sexual risk-taking.”

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Primary source: Pediatrics
Source reference: Finer L and Philbin J, “Sexual initiation, contraceptive use, and pregnancy among young adolescents” Pediatrics 2013; 131: 1–6