Race-Ethnicity and Sex Disparities in the Use of Pregnancy Prevention Methods Among U.S. High School Students.

Objective: To examine race-ethnicity and sex differences in the reported use of pregnancy prevention methods at the last sexual encounter among sexually active high school students.

Study design: Three waves of cross-sectional data from the nationally representative Youth Risk Behavior Survey (2015-2019) were used to analyze sexually active students who exclusively had sex with opposite-sex partners. R, with its survey package, was used to estimate average marginal percentages, risk differences, and confidence intervals.

Results: Results showed significant sex differences in the use of contraceptives. Females (52.4%) were significantly less likely to report condom use than males (61.4%). Females were significantly more likely than males to report the use of oral contraceptive pills (23.2% vs 19.1%) or long-acting reversible contraception (11.8% vs 5.4%). Black (23.2%), Hispanic (21.0%), and Asian (23.0%) females were significantly less likely than White (45.6%) females to use oral contraceptive pills or long-acting reversible contraception. There were significant race-ethnicity differences in not using pregnancy prevention or a reliable pregnancy prevention method. About 37% of Asian female students did not use condoms or any reliable form of contraception.

Conclusions: Overall, the use of contraceptives among U.S. female high school students was low. Except for condom use, male high school students underreported the use of contraceptives. Black, Hispanic, and Asian female students are significantly less likely to use reliable contraception compared to White students.

Implications for policy and practice: Efforts are needed to close the race-ethnicity gap in contraceptive use and increase contraceptive use among all sexually active students.