Rate of condom use among sexually active adolescents: a nationwide cross-sectional study in Taiwan from 2012 to 2016

OBJECTIVE: Adolescents’ sexual behaviours are associated with sexually transmitted infections and unwanted pregnancies. This study aimed to estimate the sexual intercourse and condom use rates at first and last sex among Taiwanese adolescents in grades 7–12. DESIGN: A secondary data analysis of the Taiwan Global School-Based Student Health Survey’s 2012–2016 data. The survey was anonymous, cross-sectional and nationwide. SETTING: Taiwan high school students (grades 7–12). PARTICIPANTS: The sample comprised 27 525 students from junior high schools (grades 7–9), and senior high schools, comprehensive schools, vocational high schools and night schools (grades 10–12). MAIN OUTCOME MEASURES: The rate of ever having had sexual intercourse; the rates and factors of condom use at first and last sex. RESULTS: The sexual intercourse rate in each school type (in ascending order) was junior high school (1.62%), senior high school (4.14%), comprehensive school (9.08%), vocational high school (14.03%) and night school (41.09%). Condom use rate decreased from 57.07% (95% CI=54.31% to 59.83%) at first sex to 25.72% (95% CI=23.34% to 28.10%) at last sex (p<0.0001). The condom use rate (in ascending order) was junior high school (first sex: 37.67%, last sex: 19.76%), night school (55.83%, 22.62%), vocational high school (61.13%, 25.78%), comprehensive school (62.83%, 28.61%) and senior high school (68.38%, 34.96%). Older age at sexual debut was associated with condom use at first and last sex, and having one sexual partner was associated with condom use at last sex, as revealed by logistic regression analysis. CONCLUSIONS: This study highlights an urgent need to instil a proper understanding of protected sex while adolescents are still in their formative years. Despite the low sexual intercourse rate (4.95%), there is lower condom use at last sex than at first sex, which indicates that many sexually active adolescents are not practising protected sex, especially among junior high school students.