Why Do Young People Have Unprotected Sex? Study Finds They Have Multiple Reasons

WASHINGTON, DC (May 23, 2023)—Past research has indicated that young people are more likely than adults to have unprotected sex, but hasn’t sufficiently explored why. In a study selected as the Editor's Choice for the May/June issue of Women's Health Issues, authors report what they learned from 212 young people about why they have had unprotected sex and might do so again in the future.
 
Women’s Health Issues is the official journal of the Jacobs Institute of Women’s Health, which is based at the Milken Institute School of Public Health (Milken Institute SPH) at the George Washington University.
 
Sarah F. Nathan of the University of California, San Francisco School of Nursing and her colleagues surveyed young people (ages 14-25) assigned female at birth who sought family planning services at San Francisco Bay Area community and school-based clinics that offer comprehensive, no-cost contraception. The setting, they note, means that participants weren’t facing the cost barrier that often inhibits contraceptive use. The questionnaire asked participants if they’d had “sex without using condoms, pills, or any other type of birth control” over the past three months and asked them to select from a list of 22 reasons for doing so. The survey also asked participants if they would be willing to have unprotected sex in the next three months. 
 
The authors found that 69 percent of participants had recently engaged in unprotected sex, and the most common reasons for doing so were not planning to have sex, a preference for unprotected sex, and difficulty using contraception. Forty-one percent of the young people reported a willingness to have unprotected sex in the future. 
 
For 18 percent of participants, the authors found that barriers to accessing contraception — including running out of contraception and having a hard time getting to a clinic — were a reason for having unprotected sex. “For hormonal methods such as the pill, patch, or ring, providing a 1-year supply instead of 1–3 months at a time, telehealth provision, and removing the prescription requirement are likely to decrease barriers related to running out of birth control and clinic access,” Nathan and colleagues write. They also emphasize the importance of “recognizing emergency contraception as a viable option for pregnancy prevention,” given that many study participants (23 percent) hadn’t been planning to have sex when they did so without protection. 
 
“Understanding the reasons why young people have unprotected sex can help identify steps to improve access for those who wish to use contraception,” said Karen McDonnell, Editor-in-Chief of Women's Health Issues and associate professor of prevention and community health at Milken Institute SPH. “The fact that many young people who have access to no-cost contraception still encounter barriers shows the need for more options, such as the over-the-counter birth control pill FDA is now considering.”
 
“Reasons for Having Unprotected Sex Among Adolescents and Young Adults Accessing Reproductive Health Services” has been published in the May/June 2023 issue of Women’s Health Issues.