Selected behaviors that increase risk for HIV infection, other sexually transmitted diseases, and unintended pregnancy among high school students - United States, 1991

Morbidity and Mortality Weekly Report, Dec 18, 1992

Since the 1970s, sexual activity has increased among adolescents in the United States (1); at the same time, rates of sexually transmitted diseases (STDs) (1), unintended pregnancy (2), and--beginning in the 1980s--human immunodeficiency virus (HIV) infection (3,4) also have increased among adolescents. This report presents 1991 self-reported data from students in grades 9-12 about behaviors that can result in HIV infection, other STDs, or unintended pregnancy.

Data were collected from two school-based components of CDC's Youth Risk Behavior Surveillance System (5): 1) state and local Youth Risk Behavior Surveys (YRBSs) conducted by departments of education in 23 states* and 10 cities during April-May 1991 and 2) the national YRBS conducted during the same period. The 33 state and local sites drew probability samples from well-defined sampling frames of schools and students in grades 9-12. Seventeen sites had adequate school- and student-response rates to allow computation of weighted results of known precision; 16 sites had overall response rates below 60% or unavailable documentation, which precluded making estimates of known precision. The national survey used a three-stage sample design to obtain a sample of 12,272 students representative of students in grades 9-12 in the 50 states and the District of Columbia.

For the state and local surveys, school-response rates ranged from 48% to 100%; student-response rates ranged from 44% to 96% (6); and state and local sample sizes ranged from 369 to 5834 students. The grades and sex of students were distributed evenly for most samples, but the racial/ethnic characteristics of the samples varied. For the national survey, the school-response rate was 75% and the student-response rate was 90%. Risk behaviors addressed in the survey included having sexual intercourse, having sexual intercourse with multiple sex partners, injecting-drug use (IDU)t, not practicing contraception, and not using condoms.

Of students participating in the state and local surveys, 33%-79% (median: 55%; national prevalence: 54%) reported ever having had sexual intercourse (Table 1); 54%-78% (median: 70%; national prevalence: 69%) reported being currently sexually active (i.e., having had sexual intercourse during the 3 months preceding the survey); and 8%-46% (median: 20%; national prevalence: 19%) reported having had sexual intercourse with four or more partners during their lifetime. In 27 of 28 sites, male students were more likely than female students to report ever having had sexual intercourse and having had four or more sex partners during their lifetime while, in 26 of 28 sites, female students were more likely than male students to report being currently sexually active.

Among the state and local surveys, the percentage of students who reported IDU ranged from 1% to 4% (median: 2%; national prevalence: 2%)(Table 1). In all sites, 5% or less of male and female students reported IDU.

Among students participating in the state and local surveys who reported current sexual activity, 58%-87% (median: 77%; national prevalence: 82%) reported they or their partner used contraception [sections] at last sexual intercourse and 28%-53% (median: 48%; national prevalence: 46%) reported they or their partner had used a condom at last sexual intercourse (Table 2). In all sites, male and female students reported similar rates of contraceptive use.

Reported by: J Moore, EdD, Alabama State Dept of Education. J Campana, MA, San Diego Unified School District; M Lain, MSW, San Francisco Unified School District. D Sandau-Christopher, State of Colorado Dept of Education. J Sadier, MPH, District of Columbia Public Schools. D Scalise, MS, School Board of Broward County; N Gay, MSW, School Board of Dade County, Florida. R Stalvey, MS, Georgia Dept of Education. J Schroeder, Hawaii Dept of Education. J Pelton, PhD, Idaho Dept of Education. B Johnson Biehr, MS, Chicago Public Schools. J Harris, MEd, Iowa Dept of Education. N Strunk, MS, Boston Public Schools. R Chiotti, Montana Office of Public Instruction. J Owens-Nausler, PhD, Nebraska Dept of Education. B Grenert, MEd, New Hampshire State Dept of Education. D Chioda, MS, Jersey City Board of Education; D Cole, MEd, New Jersey State Dept of Education. K Meurer, MS, New Mexico State Dept of Education. G Abelson, CSW, New York City Board of Education; A Sheffield, MPH, New York State Education Dept. P Ruzicka, PhD, Oregon Dept of Education. C Balsley, EdD, School District of Philadelphia; M Sutter, PhD, Pennsylvania Dept of Education. M del Pilar Cherneco, MPH, Puerto Rico Dept of Education. J Fraser, EdD, South Carolina State Dept of Education. M Carr, MS, South Dakota Dept of Education and Cultural Affairs. E Word, MA, Tennessee State Dept of Education. P Simpson, PhD, Dallas Independent School District. L Lacy, MS, Utah State Office of Education. S Tye, PhD, Government of the Virgin Islands Dept of Education. B Nehls-Lowe, MPH, Wisconsin Dept of Public Instruction. B Anderson, Wyoming Dept of Education. Div of Epidemiology and Prevention Research; National Institute on Drug Abuse; Substance Abuse and Mental Health Services Administration. Div of Adolescent and School Health, and Div of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC.