Trends in Sexual Activity, Condom Use, and Use of Pregnancy Prevention Methods Among Female Adolescents: United States, 2007-2023.

Abstract

<b>Objectives.</b> To examine trends in sexual behaviors, condom use, and pregnancy prevention methods among female adolescents. <b>Methods.</b> We analyzed national and state Youth Risk Behavior Surveillance System data (2007-2023) among US female high school students (≥ 14 years). Outcomes included current sexual activity, condom use, and use of pregnancy prevention methods. We estimated weighted prevalence and trends overall and by region, age, and race/ethnicity and examined adolescent birthrates using Centers for Disease Control and Prevention data. <b>Results.</b> The proportion of respondents who were currently sexually active declined (2007-2011: 35.1%; 2019-2023: 23.8%; <i>P</i> < .01). Among those sexually active, nonuse of condoms increased (45.8% to 52.4%; <i>P</i> < .01), whereas nonuse of moderately or highly effective pregnancy prevention decreased (73.0% to 63.0%; <i>P</i> < .01), reflecting increased uptake of effective methods. The proportion using no pregnancy prevention method remained stable. Declines in sexual activity reduced population-level sexual risk indicators. Racial/ethnic disparities persisted. Birthrates declined substantially. <b>Conclusions.</b> Declines in adolescent birthrates are driven largely by reduced sexual activity, whereas condom use has declined and disparities in contraceptive use persist, indicating uneven improvements in sexual health behaviors. <b>Public Health Implications.</b> Efforts should strengthen comprehensive sexual health education and access to effective contraception and condoms, with targeted strategies for younger adolescents, the South, and non-Hispanic Black and Hispanic populations. (<i>Am J Public Health</i>. Published online ahead of print July 2, 2026:e1-e10. https://doi.org/10.2105/AJPH.2026.308511).