Teenagers in the United States have the highest rates of pregnancy, childbearing, and abortion among developed countries, and this is primarily because they do not use con­traception as reliably (Alan Guttmacher Institute, 2001a). However, data from the National Survey of Family Growth found that contraceptive use among teenagers in­creased from 1995 to 2002 (Centers for Disease Control and Prevention, 2002b). Over the last decade, condom use among teenagers has increased, whereas use of the birth control pill has decreased (Alan Guttmacher Institute, 1999a). Other data from the National Survey of Family Growth found that 13% of teenagers used long-acting hor­monal contraceptive methods, such as implants and injectables (we will discuss these methods more in Chapter 13).

Several factors have been found to be related to contraceptive use in adolescence. An adolescent who is able to talk to his or her mother about sexuality is more likely to use contraception than an adolescent who cannot (Meschke et al., 2000). High satis­faction between adolescents and their mothers has been found to be associated with a lower probability of sexual intercourse and a higher usage of contraception when sex­ual intercourse does take place (Jaccard & Dittus, 2000). Those who do not use con­traception are more likely to be engaging in early sexual intercourse (U. S. Department of Health and Human Services, 1995), be younger than 17, be in an unstable relation­ship, or engage in infrequent intercourse. Many teens also do not have adequate infor­mation about STI risks. However, there have been studies that have found that a sub­stantial majority of teenagers use contraception without interruption for extended periods (Glei, 1999).

Although gay, lesbian, and bisexual youths may not need contraception for birth control purposes, they do need it for STI protection. Research has found that gays and lesbians are less likely to use condoms than straight youths or those who are unsure about their sexual orientation (Saewyc et al., 1998). Birth control responsibilities among teens, as among adults, often fall on the females. The prevailing attitude seems to be that

females become pregnant; therefore, females must either carry the baby for 9 months or undergo abortion.

It is often difficult to impress on teenage boys the need for shared contraceptive re­sponsibility. Misinformation about contraception is widespread among teens, and par­ents seem to be doing little to correct it. Most studies find relatively low rates of parental communication about sex in general and contraception in particular, with children re­porting far fewer and less involved discussions about it than their parents report (Jaccard et al., 1998; King & Lorusso, 1997). Baker and colleagues (1988) found that parents who communicated to their children about sex did have significant influence on whether or not adolescents used contraception when they had sex. We will discuss contraceptive use in more detail in Chapter 13.