Data and Statistics on Adolescent Sexual and Reproductive Health

Adolescent Sexual Behavior and Contraceptive Use

As adolescents develop, they begin to explore romantic and sexual expression and may become sexually active. Decisions about their sexual activity, including decisions to remain abstinent or to use condoms and contraceptives if sexually active, shape adolescent experiences in relationships as well as their exposure to and risk of sexually transmitted infections (STIs) and pregnancy. 

According to the 2023 Youth Risk Behavior Survey (YRBS), adolescent sexual activity has declined since 2013. We have also observed declines in condom use and the number of adolescents getting tested for STIs (referred to in the YRBS as sexually transmitted diseases, or STDs) and human immunodeficiency virus (HIV).

Figure 1: Trends in the percentage of high school students’ sexual behavior, 2013-2023

Source: Centers for Disease Control and Prevention Youth Risk Behavior Survey Data Summary & Trends Report: 2013–2023 U.S. Department of Health and Human Services; 2024. https://www.cdc.gov/yrbs/dstr/index.html 

There are disparities in these experiences and behaviors across adolescents’ sex and gender, sexual orientation, race and ethnicity, age and other factors. For example, in 2023:

• Reports of being currently sexually active varied by race and ethnicity, from 11% among Asian students to 35% among American Indian or Alaska Native students, and 20-25% across all other groups.
• High school students who identified as lesbian, gay, bisexual, transgender, questioning, or another non-heterosexual identity (LGBTQ+) were less likely than their cisgender and heterosexual peers to use a condom the last time they had sex.
• Female high school students were more likely to be tested for STIs than male students.

Figure 2: Trends in the percentage of high school students who were currently sexually active, 2013-2023

Source: Centers for Disease Control and Prevention Youth Risk Behavior Survey Data Summary & Trends Report: 2013–2023 U.S. Department of Health and Human Services; 2024. https://www.cdc.gov/yrbs/dstr/index.html 

Adolescent Sexually Transmitted Infections (STIs) and HIV

Unprotected sexual activity among adolescents can result in unintended pregnancy or STIs that affect young people’s reproductive and overall health. For example, some STIs, like gonorrhea and chlamydia, not only require care and are transmissible to others but can cause pelvic inflammatory disease (PID). The human papillomavirus (HPV) is the most common STI in the United States and is thought to cause most vaginal, vulvar, cervical, anal, and penile cancers, as well as oropharyngeal (back of the throat) cancers. Adolescents and young adults are overrepresented in the prevalence and risk of STIs. 

According to recent data:

• Despite making up 13% of the U.S. population—and about 25% of the sexually active population—young people ages 15–24 accounted for nearly half (48%) of reported cases of chlamydia, gonorrhea, and syphilis (all stages) in 2023.
• Reported rates of certain STIs, such as chlamydia and gonorrhea, are highest among females during adolescence and young adulthood.
• Adolescent females may be more susceptible to infection with some STIs, such as chlamydia, due to differences in the cervix age at that age.
• Prior to the introduction of the HPV vaccine, nearly half of the 14 million new HPV cases each year were among people ages 15–24. In 2023, only 61% of adolescents ages 13–17 were up to date on their HPV vaccine.
• People ages 13–24 accounted for 20% of new HIV diagnoses in 2022.
• Among people ages 13–24 living with HIV in 2022, 44% did not know their HIV status.

In addition to being disproportionately affected by STIs compared to other age groups, there are disparities in STIs among young people. For example, Hispanic, American Indian/Alaska Native, and Black adolescents have higher STI rates than their White peers. Adolescent males who have sex with other males, transgender youth, youth with disabilities, youth with lower socioeconomic status, and other groups face greater risks of STIs. While most people who acquire HIV as adolescents or young adults acquire it through sexual transmission, youth who engage in injection drug use face a higher risk of HIV.

Adolescent Pregnancies and Births

Since 2009, the birth rate for females ages 15–19 in the United States has fallen to a new low every year.¹ Still, the U.S. teen birth rate remains higher than that of other high-income countries. Adolescent pregnancies can carry more health risks for the mother and baby, and adolescent parents often face economic and social costs, particularly the mothers. 

The Centers for Disease Control (CDC) National Center for Health Statistics tracks births and birth rates of all age groups and periodically publishes data on adolescent pregnancies. According to recent data:

• The 2019 teen pregnancy rate was 29.4 pregnancies per 1,000 females ages 15–19, down from 60.8 in 2010.
• The teen birth rate in 2022 was 13.6 births for every 1,000 females ages 15-19, down 2% from 2021 (13.9) and down 78% from the 1991 peak (61.8).¹
  • The 2022 birth rate for adolescents ages 15–17 was 5.6.¹
  • The 2022 birth rate for adolescents ages 18–19 was 25.8.¹
• Most adolescents who give birth are in their older teens. Of the 143,789 births to females ages 15-19 in 2022, 75% were to mothers ages 18-19.¹
• Roughly 14% of live births to 15- to 19-year-olds were the second birth or higher born to the mother.¹

Figure 3: Teen Birth Rate, 1950-2022
Number of live births per 1,000 females aged 15 to 19

Source: Mickler, K. M., & Tollestrup, J. (2024). Teen Birth Trends: In Brief. CRS Report R45184, Version 8. Updated August 28, 2024. Congressional Research Service. https://crsreports.congress.gov/product/pdf/R/R45184

Adolescent pregnancies and births differ substantially across different groups, such as race and ethnicity, socioeconomic status, geography (regions and states as well as rural versus urban areas), LGBTQ+ youth, and youth involved in the child welfare system. For example:

• In 2022, teen birth rates of American Indian/Alaska Native, Native Hawaiian/Other Pacific Islander, Black, and Hispanic adolescents were more than double the rate for White adolescents, and more than 10 times higher than the rate among Asian adolescents.¹
• While rates are declining for all adolescents, the magnitude of the decline in teen birth rates varies by race and Hispanic origin.¹
• U.S. teen birth rates vary by state, with the highest rates in southern states. 
• Adolescent birth rates are higher in rural areas than in urban areas.
• Women who had been in foster care were more likely to have had an adolescent birth than those who had not.
• Adolescent bisexual and lesbian females are more likely to have been pregnant than heterosexual females.

Figure 4: Birth rates for females ages 15-19, by race and Hispanic origin of mother, 1990-2022

Note: Race categories shown are from published National Center for Health Statistics (NCHS) reports. The categorization method has changed over time. Estimates from before 2016 use different categories consistent with the 1977 Office of Management and Budget (OMB) standards and only present estimates separated by Hispanic origin for Black and White racial groups. Beginning with the 2016 report, the NCHS reports race consistent with the 1997 OMB standards. 

Sources:

• For 1990-2015: Centers for Disease Control and Prevention. (2017). Births: Final data for 2015. National Vital Statistics Reports, 66(1). https://www.cdc.gov/nchs/data/nvsr/nvsr66/nvsr66_01.pdf
• For 2016-2020: Centers for Disease Control and Prevention. (2022). Births: Final data for 2020. National Vital Statistics Reports, 70(17). https://www.cdc.gov/nchs/data/nvsr/nvsr70/nvsr70-17.pdf
• For 2021-2022: Centers for Disease Control and Prevention. (2024). Births: Final data for 2021. National Vital Statistics Reports, 73(2). https://www.cdc.gov/nchs/data/nvsr/nvsr73/nvsr73-02.pdf 

Despite the declines, some adolescents will get pregnant. It is essential that they have support and access to care. Find resources and services to support expectant and parenting teens.

How OPA’s Grant Programs Support Adolescent Sexual and Reproductive Health

Footnotes