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Medical News

The Impact of Government Policies and Neighborhood Characteristics on Teenage Sexual Activity and Contraceptive Use

January 6, 2003

The current study examines the effects of government policies and neighborhood characteristics on adolescent female sexual behavior. Using data from the 1995 National Survey of Family Growth (NSFG), Cycle V for unmarried 15- to 19-year-old females, the researchers focused on government programs and laws that might affect the costs of being sexually active and of using contraceptives. They examined such determinants of sexual behavior as parental notification and consent laws, Medicaid funding for abortions, and the availability of family planning and abortion services. They also analyzed state sex education requirements and neighborhood-level variables as they relate to teenage sexual behavior and contraceptive use.

The researchers analyzed data gathered from 1,280 adolescent women. Thirty-eight percent reported being sexually active. Of that group, 70.2 percent reported using contraceptives. "Given current concern about high teenage pregnancy and sexually transmitted disease [STD] rates," they wrote, "this figure suggests the importance of identifying policies and practices that effectively discourage unprotected sex."

The investigators, using a bivariate probit model, found that personal characteristics and family background are generally poor predictors of contraceptive use, but seem to play important roles in the decision to become sexually active. An added year of age, living with one parent and living in a nonreligious household are associated with an increased probability of becoming sexually active.

"Interestingly," Averett and colleagues wrote, "the coefficients of household income, parental education, race, and ethnicity are not statistically significant at conventional levels in either equation." However, such factors relate to neighborhood-level variables, and "neighborhood context is an important determinant of adolescent female sexual behavior." Higher household incomes are associated with lower probability of becoming sexually active, and with higher probability of contraceptive use among sexually active teens. Living in a predominantly African-American neighborhood decreased the probability of becoming sexually active. Controlling for neighborhood effects, neither region of the country nor living in an urban area appeared to have independent effects on sexual behavior.

"Regarding the policy variables," the authors wrote, "our estimates provide little evidence that the cost of obtaining an abortion affects sexual behavior, nor is there evidence that the availability of family planning services is related to sexual activity. There is, however, some support for the hypothesis that female adolescent contraceptive behavior is sensitive to the availability of family planning services. … Our results may suggest that an increase in the supply of family planning services encourages the adoption of contraceptives without leading to increased sexual activity."

The data show no evidence that mandated public school sex, health, or AIDS education programs affect teen sexual activity or contraceptive use. "Estimates of the impact of requiring that sex education be taught in public schools were consistently insignificant. Although these results run counter to claims that the teaching of sex education encourages teens to become sexually active, they suggest that broad state mandates with regard to classroom content are not an effective means by which to encourage the adoption of ‘safe sex’ practices."

Averett and colleagues conclude that neighborhood context is more important in determining adolescent female sexual behavior than government policies. "This pattern of results," they wrote, "suggests that policies that mold communities and neighborhoods will be more successful, or at least more influential, than policies aimed at changing the cost of family planning and abortion services."

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Adapted from:
American Journal of Public Health
Vol. 92; No. 11: P. 1773-1778; 11.2002; Susan L. Averett, Ph.D.; Daniel I. Rees, Ph.D.; Laura M. Argys, Ph.D.

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This article was provided by CDC National Prevention Information Network. It is a part of the publication CDC HIV/Hepatitis/STD/TB Prevention News Update.