HIV / STI
Prevalence of Condomless Sex among Sexually Active Adolescents in the United States: Findings from the 2023 Youth Risk Behavior Survey Precious Patrick Edet* Precious Patrick Edet
Background
Adolescents face varying risks of sexually transmitted infections (STIs) influenced by factors such as early initiation of sex, race, sexual identity, etc., and data on condom use among sexually active U.S. adolescents is limited. This study examined the prevalence of not using a condom during last sexual intercourse across several factors, including having multiple partners in the past three months, race, gender, age group, transgender, and sexual identity.
Methods
The 2023 Youth Risk Behavior Survey (YRBS) data for 5,420 sexually active U.S. adolescents was analyzed. YRBS, administered biennially by the CDC, uses complex sampling for national generalizability. Descriptive statistics and chi-square tests were conducted to provide weighted percentages and p-values, respectively, using SAS v. 9.4.
Results
Condomless sex was more prevalent among those with multiple sexual partners in the past three months than their counterpart (57% vs. 44%; p<0.001). Females had a higher prevalence than males (52% vs. 40%; p<0.001), while lesbian or gay adolescents reported the highest rates (67%), followed by queer (53%), bisexual (51%), Other (49%), and heterosexual adolescents (42%) (p=0.003). Transgender adolescents showed higher prevalence than non-transgender peers (52% vs. 45%), though not statistically significant (p=0.389). The prevalence of condomless sex was also highest among Asian and African American adolescents (49%), followed by American Indian (48%), White (46%), Other (43%), and Hispanic adolescents (36%) (p=0.100); and highest among 13-year-olds or younger, followed by those aged 17 years or older, and those aged 14–16 years (53% vs. 47% vs. 44%) (p=0.436), though findings were not statistically significant.
Conclusion
Findings highlight disparities in condom use among sexually active adolescents. Results underscore the need for tailored sexual health education and interventions to address disparities and promote safer sexual practices among adolescents.