BOSTON — By age 15, more than a third of American girls say they are sexually active, according to a Centers for Disease Control and Prevention survey. About 26% have had oral sex, 26% have had vaginal intercourse, and another 8% have had oral sex without intercourse. The proportion that is sexually active grows substantially every year thereafter, according to a presentation at a conference on contraceptive technology sponsored by Contemporary Forums.
Accurate data on teenagers' sexual behavior are important for any clinician concerned about unintended pregnancy and the spread of sexually transmitted infections (as well as the psychological and emotional health of young women). If, as expected, the Food and Drug Administration approves a human papillomavirus vaccine in mid-2006, public health officials will need to accurately predict the age when girls become sexually active in order to recommend an age for vaccination.
Media reports increasingly suggest that as conventional teen dating and romance plunge, oral sex and casual sexual “hookups” among so-called “friends with benefits” have become commonplace. Anecdotal reports of teen promiscuity have seemed to proliferate, after a reporter described teenagers he met through an Internet site where high school and college students post their profiles, chat, and arrange meetings for sex in, “Friends, Friends With Benefits, and the Benefits of the Local Mall” (New York Times, May 30, 2004).
According to the CDC data, the typical teen who is sexually active has one or two partners, though a substantial minority have many more. Among the 15- to 19-year-olds surveyed, girls had a median of 1.4 sexual partners and boys a median of 1.6. Among all 15- to 19-year-olds, 45% had no sexual partner in the last 12 months, 30% had one opposite-sex partner, and 22% had two or more opposite-sex partners. The percentage with same-sex partners was less than 1%.
The results were released in late 2005 and are based on 2002 data (CDC Advance Data from Vital and Health Statistics, Sept. 2005;362:1–56).
The proportion of all young women having oral sex is relatively high, according to the survey—more than doubling from 26% at age 15 to 70% by age 18 (see box). The gender gap on giving and receiving oral sex was small: Among 15- to 19-year-old females, 44% gave oral sex and 50% received. Among males of the same age 39% gave oral sex and 52% received.
Amid all this activity the use of condoms is less than full fledged. Only 44% of female teens said their partners used condoms.
Fortunately, the prevalence of STIs remains relatively low. Among all females aged 15–19 years in the survey, some 3% reported genital herpes, genital warts, syphilis, or pelvic inflammatory disease.
About half of all STIs occur in people aged 15–25—at a cost estimated in 2000 to be $6.5 billion annually. Some 34% of HIV cases are transmitted during heterosexual vaginal intercourse.
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