Sex education and contraceptive use of adolescent and young adult females in the United States: an analysis of the National Survey of Family Growth 2011–2017()()

OBJECTIVES: The effects of the comprehensiveness of sex education on sexual health measures have not been well-studied. We compared trends in comprehensive sex education and its relation to contraceptive use at first intercourse and current contraceptive use for women ages 15–24 in the United States between 2011 and 2017. STUDY DESIGN: Analyses included females ages 15–24 from the 2011–2017 National Survey of Family Growth. We defined comprehensive sex education as including 6 topics queried in the NSFG (how to say no to sex, birth control methods, where to get birth control, how to use condoms, sexually transmitted infections, HIV/AIDS), and non-comprehensive sex education as including less than 6 topics. Multivariable regression models investigated associations with contraceptive indicators. RESULTS: Among 5445 respondents, percentages of women receiving comprehensive sex education in 2011–2013, 2013–2015, and 2015–2017 were 35%, 40%, and 34%. Across all periods, respondents reporting comprehensive sex education before first sex were less likely to report first sexual intercourse before age 15 (aOR 0.55; 95% CI: 0.40–0.74) and non-volitional first intercourse (aOR 0.42, 95% CI: 0.26–0.72) compared to those with non-comprehensive sex education. At first intercourse, those with comprehensive sex education were more likely to have used any (aOR = 1.63; 95% CI: 1.18–2.25) and very effective (aOR = 1.35; 95% CI: 1.04–1.75) contraception. Comprehensive sex education was unrelated to current contraceptive use (aOR = 0.87; 95% CI: 0.63–1.21). CONCLUSIONS: Comprehensive sex education was associated with increased odds of contraceptive use at first intercourse, but not current contraceptive use. IMPLICATIONS: Programs that promote comprehensive sex education may have a positive impact on preventive behaviors at sexual debut.