Understanding the Decline in Adolescent Fertility in the United States, 2007–2012

The decline in U.S. adolescent fertility has accelerated since 2007. Modeling fertility change using behavioral data can inform adolescent pregnancy prevention efforts. We used data on sexual activity and contraceptive use from National Surveys of Family Growth for young women 15–19 years of age, an...

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Vydáno v:Journal of adolescent health Ročník 59; číslo 5; s. 577 - 583
Hlavní autoři: Lindberg, Laura, Santelli, John, Desai, Sheila
Médium: Journal Article
Jazyk:angličtina
Vydáno: United States Elsevier Inc 01.11.2016
Témata:
Abstinence
Adolescent
Adolescent Behavior
Birth Rate
Contraception
Contraception Behavior - statistics & numerical data
Female
Humans
Pediatrics
Pregnancy
Pregnancy in Adolescence - prevention & control
Risk Factors
Sex Education - statistics & numerical data
Sexual Behavior - statistics & numerical data
Sexual behaviors
Surveys and Questionnaires
Teen pregnancy
United States
Young Adult
Contraception
Teen pregnancy
Abstinence
Sexual behaviors
ISSN:1054-139X, 1879-1972, 1879-1972
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Shrnutí:The decline in U.S. adolescent fertility has accelerated since 2007. Modeling fertility change using behavioral data can inform adolescent pregnancy prevention efforts. We used data on sexual activity and contraceptive use from National Surveys of Family Growth for young women 15–19 years of age, and contraceptive failure rates, to estimate a Pregnancy Risk Index (PRI) for the periods 2007, 2009, and 2012. Logistic regression was used to test for change over time in sexual activity, contraceptive use, and PRI. Statistical decomposition was used to calculate attribution of change in the PRI to changes in sexual activity or contraceptive method use. Sexual activity in the last 3 months did not change significantly from 2007 to 2012. Pregnancy risk declined among sexually active adolescent women (p = .046), with significant increases in the use of any method (78%–86%, p = .046) and multiple methods (26%–37%, p = .046). Use of highly effective methods increased significantly from 2007 to 2009 (38%–51%, p = .010). Overall, the PRI declined at an annual rate of 5.6% (p = .071) from 2007 to 2012 and correlated with birth and pregnancy rate declines. Decomposition estimated that this decline was entirely attributable to improvements in contraceptive use. Improvements in contraceptive use appear to be the primary proximal determinants of declines in adolescent pregnancy and birth rates in the United States from 2007 to 2012. Efforts to further improve access to and use of contraception among adolescents are necessary to ensure they have the means to prevent pregnancy.
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ISSN:1054-139X
1879-1972
1879-1972
DOI:10.1016/j.jadohealth.2016.06.024