Are Young People Abandoning Condoms?
A report by the World Health Organization’s Regional Office for Europe shows an alarming decrease in condom use among young people. A third of sexually active adolescents in the region did not use either a condom or birth control pills the last time they had sex. The authors blame a lack of sexuality education and also warn that if this trend continues it will have “far-reaching consequences.” These include a rise of unintended pregnancies, unsafe abortions, and sexually transmitted infections (STIs) across the continent. In the United States, the Youth Risk Behavior Surveillance System (YRBS) suggest the same issues in this country.
The WHO data comes from the Health Behaviour in School-aged Children (HBSC) study. The HBSC study surveyed over 242,000 15-year-olds across 42 countries and regions between 2014 and 2022. Among other things, the survey found:
- The proportion of sexually active adolescents who used a condom at last intercourse dropped from 70% to 61% among boys and from 63% to 57% among girls between 2014 and 2022.
- Condom use varied widely between counties. Among girls, it was lowest in Albania (24%) and highest in Serbia (81%). For boys, it was lowest in Sweden (43%) and highest in Switzerland (77%).
- The proportion of sexually active adolescents using the contraceptive pill remained steady (26%).
- Almost a third of adolescents (30%) reported using neither a condom nor the contraceptive pill at last intercourse. This proportion has been unchanged since 2018.
The survey also found that condom use varied by socioeconomic status. Adolescents from low-affluence families (33%) were more likely to report not using a condom or the contraceptive pill at last sexual intercourse than their peers from more affluent families (25%).
Trends in the U.S. are similar. The latest edition of the YRBS, a survey of high school students which has been conducted since the 1990s, was released this summer. In 2023, 46% of sexually active females and 58% of sexually active males reported using condoms at last sex. This is a significant drop from 2013. In that year, 58% of females and 66% of males used condoms the last time they had sex.
WHO leaders blamed the worsening statistics in Europe on political forces that have gutted sexuality education in recent years. Dr Hans Henri P. Kluge, WHO Regional Director for Europe, said:
“While the report’s findings are dismaying, they are not surprising. Age-appropriate comprehensive sexuality education remains neglected in many countries, and where it is available, it has increasingly come under attack in recent years on the false premise that it encourages sexual behaviour, when the truth is that equipping young persons with the right knowledge at the right time leads to optimal health outcomes linked to responsible behaviour and choices. We are reaping the bitter fruit of these reactionary efforts.”
We’ve seen similar political issue play out in the U.S. Efforts to prevent sexuality education in schools and ban books on the topic continue to intensify. Just recently, Florida’s Department of Education forced a dozen school districts to rewrite sexuality lessons. Districts were made to emphasize that abstinence is the “expected standard of behavior” for young people. Broward County was told to remove pictures of the reproductive system and demonstrations of correct contraceptive use from its curriculum.
This is exactly the opposite of what schools should be doing to increase the use of condoms and contraceptives among adolescents. The WHO report offers a roadmap for progress. This includes:
- investing in comprehensive sexuality education
- enhancing access to youth-friendly sexual health services
- promoting open dialogues about sex in families, schools, and communities
- training educators
- conducting more research on best practices in sex education
"Comprehensive sexuality education is key to closing these gaps and empowering all young people to make informed decisions about sex at a particularly vulnerable moment in their lives… But education must go beyond just providing information. Young people need safe spaces to discuss issues like consent, intimate relationships, gender identity and sexual orientation, and we – governments, health and education authorities, and civil society organizations – should help them develop crucial life skills."
AHSA believes these are all important steps that we need to take in the U.S. as well. New public health interventions, such as PrEP and Doxy PEP, have been getting a lot of attention because they are so effective in preventing HIV and some other STIs. Still, these interventions are only appropriate for certain segments of the population. When talking about—and to—all adolescents, it’s important to continue to promote sexuality education and condom use.
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