Comparability of estimates and trends in adolescent sexual and contraceptive behaviors from two national surveys: National Survey of Family Growth and the Youth Risk Behavior Survey

Abstract

Objective: To compare adolescents' reports of sexual and contraceptive behaviors between the National Survey of Family Growth (NSFG) and the Youth Risk Behavior Survey (YRBS).

Methods: For each survey, we estimated the year- and sex-specific prevalence of sexual and contraceptive behaviors among a comparably defined sample of US respondents ages 15-19 currently attending high school. We used logistic regression to test for changes in prevalence from 2007-2019 and conducted sensitivity analyses to investigate between-survey differences.

Results: We found differences in both prevalence and trends between the YRBS and NSFG when limited to a comparably defined sample. Compared to the NSFG, adolescents in the YRBS were more likely to report being sexually experienced, less likely to report use of prescription methods for both sexes, and less likely to report condoms among males. Only the YRBS estimated significant declines in sexual experience for both sexes, and significant increases in prescription methods and declines in condom use among males. Differences between surveys in the prevalence of specific contraceptive methods reflected greater combined use of methods in the NSFG. We identified differences in question-wording and other aspects that may influence these differential patterns.

Conclusions: The NSFG and YRBS produced inconsistent prevalence estimates and trends for sexual and contraceptive behaviors among in-school adolescents. Further efforts to improve these national surveillance systems are critical to inform policy and research efforts that support adolescent sexual and reproductive health and wellbeing.

Fig 1. Prevalence of ever had sex and sex in last 3 months by sex, NSFG and YRBS, 2007–2019.

(A) Ever had sex (B) Sex in last 3 months; Prevalence is plotted for YRBS (blue) and NSFG (green) with 95% confidence intervals (CIs). Significant difference from prevalence in 2007 displayed as solid CI and not-significant as dotted. * p < 0.05, Note: The years displayed for the NSFG are midpoints of data releases 2006–08, 2008–10, 2011–13, 2013–15, 2015–17, and 2017–19.

Fig 2. Prevalence of contraceptive method type at last sex by sex, NSFG and YRBS, 2007–2019.

(A) Any method use (B) Condom use (C) Prescription method use (D) Withdrawal/other method use; Prevalence is plotted for YRBS (blue) and NSFG (green) with 95% confidence intervals (CIs). Significant difference from prevalence in 2007 displayed as solid CI and not-significant as dotted. * p < 0.05, Note: The years displayed for the NSFG are midpoints of data releases 2006–08, 2008–10, 2011–13, 2013–15, 2015–17, and 2017–19.

Fig 3. Overall, combined, and single use of selected contraceptive methods at last sex by survey and sex, 2007–2019.

(A) Prescription methods (B) Withdrawal/other methods (C) Condoms; * Combined use for prescription and withdrawal methods included respondents who reported using these methods and condoms. Combined use for condoms included respondents using this method and either prescription methods or withdrawal.