ATLANTA - Risky behavior among teenagers may be declining, but many teens are engaging in behaviors that put them at risk for chronic diseases as adults, according to the 1999 Youth Risk Behavior Surveillance System.
The survey noted the greatest improvements in sexual behavior. Fifty percent of students reported having had sexual intercourse during their lifetime, down 8% since 1991, according to a recent Centers for Disease Control and Prevention report.
"Bringing sex education into the classroom via a combination of risk reduction programs and abstinence programs has probably begun to have an impact," said Donna Futterman, MD, associate professor of medicine at Albert Einstein College of Medicine and director of the Adolescent AIDS Program at Montefiore Medical Center in the Bronx, N.Y. However, "it is important to not just look at the overall numbers, but also the numbers by grade, where it is apparent that the majority of older teens still in school have engaged in sexual intercourse."
Of those surveyed, black students (71.2%) were more likely than Hispanic (54.1%) and white students (45.1%) to have had sexual intercourse.
Sixteen percent of students reported having at least four sex partners, also a significant decrease from studies in the early 1990s. Boys were more likely than girls (19.3% vs. 13.1%) to have had at least four sex partners, and black students were more likely than white students (34.4% vs. 12.4%) to report this.
More than 8% of students said they first had sexual intercourse before age 13, down from 10.2% in 1991. Boys (12.2%) were more likely to report this than girls (4.4%). Black students (20.5%) were much more likely than Hispanic (9.2%) and white students (5.5%) to have first had sexual intercourse before age 13.
The percentage of students who said they were currently sexually active (36.3%), meaning they had had sex in the last three months, has remained relatively static since 1991 (37.5%). Black students (53%) were more likely than Hispanic (36.3%) and white students (33%) to report this.
These differences may reflect many things, Futterman said, including different resources, such as well-funded prevention programs and the time spent in school to implement these programs, and different cultural norms about the acceptability of sexual intercourse.
Of currently sexually active teens surveyed, 58% reported using a condom the last time they had sex, a 26% increase from 1991. Black students (70%) were more likely than Hispanic (55.2%) and white students (55%) to report condom use.
Futterman said the increase in condom use "may reflect the success of our prevention work and the understanding among increasing numbers of youth that if you are going to be sexually active, you should do it safely."
Sixteen percent of sexually active teens reported using birth control pills, down from 20.8% in 1991. Birth control use was reported more often by white students (21%) than by Hispanic (7.8%) or black students (7.7%).
Reasons for discrepancies in condom and birth control pill use "is [probably] a resource and community norms issue," Futterman said. "White girls are more likely to access health care in private settings where providers are more likely to prescribe birth control pills. Condoms may be more likely to be promoted in the public health settings." Additionally, providers may prejudge who is capable of using birth control pills, and fear of side effects may be more prevalent among black students, she said.
More than 6% of students reported that they had become pregnant or had gotten someone else pregnant. Black students (13.4%) were much more likely than white students (4.3%) to report this.
Almost 25% of teens who were sexually active reported that they used alcohol or drugs the last time they had sex. Boys (31.2%) were more likely to report this than girls (18.5%). White girls were more likely than black girls (21.5% vs. 9.3%) to report using alcohol or drugs the last time they had sex.
Eighty-one percent of students said they had tried alcohol, similar to 1991 figures, when 81.6% reported this. White and Hispanic students (81.8% and 83.4% respectively) were more likely to report this than black students (73.8%).
In addition, 50% of students reported having at least one alcoholic drink in the 30 days preceding the survey. Hispanic (52.8%) and white students (52.5%) were more likely than black students (39.9%) to report current alcohol use, according to the survey.
Almost 32% of students surveyed reported having at least five alcoholic drinks on at least one occasion in the 30 days preceding the survey. Episodic heavy drinking was reported more often by boys than by girls (34.9% vs. 28.1%).
Over 70% of students reported that they had ever tried cigarettes, and 24.7% said they had smoked a whole cigarette before age 13.
Current cigarette use among students increased from 1991 (27.5%) to 1997 (36.4%), with a decrease in 1999 (34.8%). White (38.6%) and Hispanic students (32.7%) were more likely to report current smoking than black students (19.7%). Seventeen percent of students said they had smoked cigarettes on 20 or more days during the previous 30 days.
More than 17% of students reported current cigar use. Boys (25.4%) were much more likely than girls (9.9%) to report smoking cigars, and more white students (18.8%) reported smoking cigars than black students (13.7%).
The percentage of students who have tried marijuana has increased significantly since 1991, when 31.3% of students said they had tried it. In 1999, 47.2% of students said they had tried marijuana. Nearly 27% said they were currently using it. Boys were much more likely than girls to try and currently use marijuana, according to the survey.
More than 14% of students reported that they had used inhalants at some point to get high, down from 20.3% in 1995. White (16.4%) and Hispanic (16.1%) students were more likely to report this than black students (4.5%). More than 4% of students said that they currently use inhalants. This was reported more frequently by Hispanic (4.9%) and white students (4.4%) than by black students (2.3%).
Almost 10% of students reported having tried some form of cocaine, up from 5.9% in 1991. Four percent of students said they were currently using it. Hispanic and white students were more likely than black students to both try and currently use cocaine.
For more information:
- Centers for Disease Control and Prevention. Youth risk behavior surveillance - United States, 1999. MMWR. 2000;49(SS05):1-96.
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