QuickStats: Percentage of Women Who Missed Taking Oral Contraceptive Pills Among Women Aged 15–44 Years Who Used Oral Contraceptive Pills and Had Sexual Intercourse, Overall and by Age and Number of Pills Missed

September 18, 2017

Among women aged 15–44 years who used oral contraceptive pills in the last 4 weeks and had sexual intercourse in the past 12 months, 69% of women reported missing no pills, 15% missed one pill, and 16% missed two or more pills.

Across the two age groups (15–24 years and 25–44 years), similar percentages of women aged 15–24 years reported missing no pills (67%) compared with women aged 25–44 years (70%).

Similar percentages of women aged 15–24 years reported missing one pill (12%) compared with women aged 25–44 years (17%).

A higher percentage of women aged 15–24 years (21%) reported missing two or more pills compared with women aged 25–44 years (13%).

Source: National Survey of Family Growth, 2013–2015. https://www.cdc.gov/nchs/nsfg/index.htm



Unmarried Men’s Contraceptive Use at Recent Sexual Intercourse, United States 2011-2015

August 31, 2017

Questions for Kimberly Daniels, Ph.D., Statistician and Lead Author of “Unmarried Men’s Contraceptive Use at Recent Sexual Intercourse, United States 2011-2015

Q: Why did you decide to examine contraceptive use among unmarried men?

KD: There were a number of motivations to conduct this study on contraceptive use among unmarried men. Most, but not all, of the reports published at NCHS on contraceptive use are based on data from women.  We wanted to use the data from men to showcase their first-hand reports, especially for the male methods (condoms, withdrawal and vasectomy). We wanted to focus on men who are not married given the role of contraception in preventing unintended pregnancies and the higher risk for unintended pregnancy among unmarried men. Also, about half of new sexually transmitted infections (STI) occur among people ages 15-24.  Most people in that age range are unmarried. Contraception is also used to help prevent STIs.

Q: What were the main findings of your report?

KD: There are a few key findings in this study on contraception.The report describes contraceptive method use at last recent sexual intercourse (within 3 months before the interview). A lot of the focus in this report is on describing variation in use of “male methods” of contraception, those that require action on the part of the male partner. These include condoms, withdrawal, and vasectomy. In 2011-2015, about 60% of unmarried men reported using a male method of contraception at last recent sexual intercourse. Higher percentages of men in younger age groups reported using any method of contraception, any male method of contraception, condoms, and withdrawal compared with older unmarried men.

We also presented differences based on marital or cohabiting status at the time of interview among unmarried men. The categories presented include currently cohabiting (regardless of former marital experience), formerly married, and never married. The percentage of men using any method, any male method, and the male condom was highest for never-married men, followed by formerly married, and currently cohabiting men. Use of withdrawal was higher among never-married men (23.0%) compared with formerly married (16.3%) and cohabiting (13.0%) men.

Q: Was there a finding in your new study that surprised you? If so, why?

KD: I was surprised to see the change over time in the use of withdrawal as a contraception method among unmarried men.  A lot of recent discussion about contraception focuses on contraceptive implants and intrauterine devices (referred to together as long-acting reversible contraception).  Withdrawal is not the focus of as much current research as those methods are. In this report, use of withdrawal at last recent sexual intercourse among unmarried men nearly doubled from 9.8% in 2002 to 18.8% in 2011-2015. That means that in the most recent data, about 1 in 5 unmarried men aged 15-44 reported using withdrawal at last sex.

Q: What differences did you see among race and ethnic groups, and between different ages?

KD: We observed a few differences among various groups of unmarried men and their use of contraception. One of the differences by both age and Hispanic origin and race was in the use of condoms at last recent sexual intercourse. Among unmarried men, higher percentages of younger men used condoms compared to older men. A higher percentage of non-Hispanic Black men (54.3%) used condoms at last sexual intercourse compared with non-Hispanic white (44.2%) and Hispanic (42.1%) men.

Q:  What is the take-home message of this report?

KD:  With this study, I think the take-home message is found right in its key findings. For example, I think some of the key findings from this report–the increase over roughly the last decade in the use of withdrawal among unmarried men and the higher use of condoms among younger and non-Hispanic, Black men–remind us why updating descriptions of contraceptive use is important. Certainly there is a substantial amount of ongoing research about condoms since they are used to help prevent STIs in addition to their use for contraception (including an NCHS report earlier this month also based on National Survey of Family Growth data, https://www.cdc.gov/nchs/data/nhsr/nhsr105.pdf). This report offers a new look at unmarried mens’ use of contraception, and provides updated descriptions of contraceptive use, mainly of male methods, based on first-hand reports from men.

Condom Use During Sexual Intercourse Among Women and Men Aged 15-44 in the United States: 2011-2015 National Survey of Family Growth

August 10, 2017

Questions for Casey Copen, Ph.D., M.P.H., Statistician and Author of “Condom use during sexual intercourse among women and men aged 15-44 in the United States: 2011-2015 National Survey of Family Growth

Q: Why did you decide to examine condom use in this report?

CC: There are about 20 million new sexually transmitted infections (STI) in the United States each year. These infections can lead to long-term health consequences, such as infertility. Condoms can provide protection against most STIs but are often used incorrectly and inconsistently. Similarly, condoms can reduce the risk of pregnancy but have one of the highest rates of contraceptive failure of any contraceptive method.

The purpose of this report was to examine recent trends in condom use during vaginal (sexual) intercourse and measure the prevalence of condom use, alone or in combination with another contraceptive method. This information can be used to plan health services and educational programs in the U.S.

Q: Has the data in this report been previously published?

CC: Data on condom use has been collected for women since 1973 and for men, since 2002. Starting in 2013, questions on problems with condom use were asked of women aged 15-44 who used a condom during intercourse in the past 4 weeks. Periodically, the National Survey of Family Growth (NSFG) publishes reports on current contraceptive use, which includes condoms, to measure how contraceptive use among women has changed over time.

Last month, NSFG released a report on contraceptive use among female and male teens aged 15-19 that included information on condom use at first and most recent intercourse (https://www.cdc.gov/nchs/data/nhsr/nhsr104.pdf). However, the data on condom use problems have not been previously published.

Q: What do you think were the main findings of your report?

CC: In 2011-2015, 23.8% of women and 33.7% of men aged 15–44 used a condom at last sexual intercourse in the past 12 months. Among condom users aged 15-44, the majority of women and men used only a condom and no other method during last intercourse in the past 12 months (59.9% of women and 56.4% of men); another 25.0% of women and 33.2% of men used condoms plus hormonal methods; and 15.1% of women and 10.5% of men used condoms plus non-hormonal methods. Almost 7% of women aged 15–44 who used a condom in the past four weeks said the condom broke or completely fell off during intercourse or withdrawal and 25.8% said the condom was used for only part of the time during intercourse.

Q: How has the percentage of condom use in the U.S. during sexual intercourse changed since 2002?

CC: The percentages of women aged 15-44 who used condoms at last sexual intercourse in the past 12 months were similar from 2002 to 2011-2015, but for men aged 15–44, the percentages increased from 29.5% in 2002 to 33.7% in 2011–2015. Percentages of female and male condom users aged 15–44 who used condoms only at last intercourse in the past 12 months decreased from 67.9% of women and 63.0% of men in 2002 to 59.9% and 56.4% in 2011-2015. Alongside this decline, percentages of female condom users aged 15–44 who used condoms plus non-hormonal methods at last intercourse increased from 11.9% in 2006–2010 to 15.1% in 2011–2015.

Q: What is the take-home message of your report?

CC: This report showed that the majority of women and men aged 15-44 in each NSFG survey period did not use a condom at all during last sexual intercourse. It is important to note that there are many factors associated with condom nonuse, such as being in a monogamous relationship, using hormonal or other methods to prevent pregnancy or trying to get pregnant. Although this report could not address each of these factors directly, these findings indicate there are differences in condom use by age, education, Hispanic origin and race, relationship at last sexual intercourse and number of sexual partners in the past 12 months. About one-quarter of women aged 15-44 who used a condom during intercourse in the past 4 weeks reported that the condom was used for only part of the time during intercourse (25.8%), suggesting that condoms are often used inconsistently.

Sexual Activity and Contraceptive Use Among Teenagers in the United States: 2011-2015

June 22, 2017

Questions for Joyce Abma, Ph.D., Social Scientist and Lead Author on “Sexual Activity and Contraceptive Use Among Teenagers in the United States: 2011-2015

Q: Is the bottom line here in this study that teens are less sexually active than in the past?

JA: Yes. Although this has changed very gradually, fewer teens have ever had sex than was the case three decades ago. In the late 1980s, just over half of female teens and 61% of male teens had had sex, and the most recent data through 2015 show this percent is well under half: 42% for females and 44% for males.- So males have had a particularly large decrease in the percent who have ever had sex during the teen years.

Over the past 3 decades, since 1988, the percent of teens who had ever had sex has been declining gradually. (decreasing from over half – 51% for females and 60% for males, to under half – 42% for females and 44% for males in 2011-15). Since 2002, however, the decline slowed and there has been no significant change for female or male teens. And this plateau continued through the most recent time period, 2011-2015.

Q: Are the teens of today also more likely to use contraception than past generations?

JA: Yes. Although even about 3 decades ago, in the late 1980s, contraceptive use was common among teens – for example 84% of males used a method at last sex in 1988 – they have become increasingly more likely since then. In the most recent data, 2011-2015, 95% of males used a contraceptive method at last sex. Related to this increase among females is another big change across the time period: the development and availability of a wider variety of contraceptives for females. These include Depo-Provera injectable, implants, emergency contraception, the patch, and more recently, the IUD has been re-designed and recommended for teens. These newer hormonal methods are starting to be used more commonly, but use of the pill remains common as well among female teens.

Q: With such a sensitive topic, do you meet with a lot of resistance in trying to collect this data?

JA Actually, the response rate for the survey is 70%, meaning of the people eligible for the survey, 70% agree to participate and complete it. Generally, people recognize the importance, validity and value of the survey. Those who participate tend to find it an interesting and positive experience. And many topics are covered, including some questions about education, health services, attitudes and opinions, questions about children, and relationships.

Q: Do these findings include teens with same-sex partners?

JA: No, this report covers only sexual intercourse with opposite-sex partners. The purpose of the report is primarily to understand risk behaviors for pregnancy among teens, thus the focus is only on opposite sex sexual activity.

Q: Any other important points of note?

JA: There are several interesting findings in this report, both in terms of sexual activity as well as contraceptive use among teens. For example, teens who had not yet had sex – which is over half of all teens — were asked to identify the main reason they hadn’t yet had sex, from 5 possible reasons. Female and male teens were very similar in the reasons they chose. Female and male teens both chose “against religion or morals”, followed by “don’t want to get (a female) pregnant”, and “haven’t found the right person yet” as the most common reasons. So female and male teens seem to be thinking along the same lines when considering the issue of not being sexually active.

As for contraceptive use, recently the IUD and contraceptive implants have been re-designed and are recommended by reproductive health professionals for teens to reduce the chances of pregnancy. These methods, referred to as “LARC” – for “long-acting reversible contraception”– are important because they offer protection for multiple years, they don’t require regular action on the part of the teen, and their failure rates are extremely low. These methods are still relatively rarely used among teens but are being used more often: 6% of teens had ever used either of these two methods as of the 2011-15 data.

Current Contraceptive Use and Variation by Selected Characteristics Among Women Aged 15–44: United States, 2011–2013

November 10, 2015

A new NCHS report describes current contraceptive use among women of childbearing age (ages 15–44) during 2011–2013. Current contraceptive use is defined as use during the month of interview, not for a specific act of sexual intercourse.

This report’s primary focus is describing patterns of contraceptive use among women who are currently using contraception, by social and demographic characteristics. Data from 2002 and 2006–2010 are presented for comparison.

Key Findings from the Report:

  • Among women currently using contraception, the most commonly used methods were the pill (25.9%, or 9.7 million women), female sterilization (25.1%, or 9.4 million women), the male condom (15.3%, or 5.8 million women), and long-acting reversible contraception (LARC)—intrauterine devices or contraceptive implants (11.6%, or 4.4 million women).
  • Differences in method use were seen across social and demographic characteristics. Comparisons between time points reveal some differences, such as higher use of LARC in 2011–2013 compared with earlier time points.

Trends in Long-acting Reversible Contraception Use Among U.S. Women Aged 15–44

February 24, 2015

Long-acting reversible contraceptives (LARCs), which include intrauterine devices (IUDs) and subdermal hormonal implants, are gaining popularity due to their high efficacy in preventing unintended pregnancies. IUD use was more common among U.S. women in the 1970s before concerns over safety led to a decline in use; however, since approval of a 5-year contraceptive implant in 1990 and redesigned IUDs, there has been growing interest in the use of LARCs for unintended pregnancy prevention.

Using data from the 1982, 1988, 1995, 2002, 2006–2010, and 2011–2013 National Survey of Family Growth, a new NCHS report examines trends in current LARC use among women aged 15–44 and describes patterns of use by age, race and Hispanic origin, and parity.

Key Findings from the Report:

  • Use of LARCs declined between 1982 and 1988, remained stable through 2002, and then increased nearly five-fold in the last decade among women aged 15–44, from 1.5% in 2002 to 7.2% in 2011–2013.
  • The percentage of women using LARCs has remained highest among women aged 25–34, with more than twice as many women aged 25–34 (11.1%) using LARCs in 2011–2013 compared with women aged 15–24 (5.0%) and aged 35–44 (5.3%).
  • After decreasing between 1982 and 1988 and remaining stable from 1988 through 1995, LARC-use patterns diverged among Hispanic, non-Hispanic white, and non-Hispanic black women.
  • Women who have had at least one birth use LARCs at a higher rate compared with women who have had no previous births, and this difference has increased over time.

Current Contraceptive Status Among Women Aged 15–44: United States, 2011–2013

December 15, 2014

Nearly all women use contraception at some point in their lifetimes, although at any given time they may not be using contraception for reasons such as seeking pregnancy, being pregnant, or not being sexually active. Using data from the 2011–2013 National Survey of Family Growth on contraceptive use in the month of the interview, a new NCHS report provides a snapshot of current contraceptive status among women aged 15–44 in the United States.

In addition to describing use of any method by age, Hispanic origin and race, and educational attainment, patterns of use are described for the four most commonly used contraceptive methods: the oral contraceptive pill, female sterilization, the male condom, and long-acting reversible contraceptives, which include contraceptive implants and intrauterine devices.

Key Findings from the Report:

  • In 2011–2013, 61.7% of the 60.9 million women aged 15–44 in the United States were currently using contraception. The most common contraceptive methods currently being used were the pill (16.0%), female sterilization (15.5%), male condoms (9.4%), and long-acting reversible contraceptives (7.2%).
  • Use of long-acting reversible contraceptives was higher among women aged 25–34 (11.1%) compared with women aged 15–24 (5.0%) and aged 35–44 (5.3%).
  • Current condom use was similar across the three Hispanic origin and race groups shown in this report (about 9%).
  • Current use of female sterilization declined, and use of the pill increased with greater educational attainment. Use of long-acting reversible contraceptives was similar across education, about 8%–10%.