Fewer U.S. High School Students Having Sex, Using Drugs

Cross-posted from NCHHSTP Newsroom

Too Many Still at Risk for HIV & Sexually Transmitted Diseases 

The 2017 National Youth Risk Behavior Survey (YRBS) paints a promising picture about the drug and sexual behaviors U.S. high school students report, but the findings leave room for concern – especially among groups of young people who report multiple health risks.

"The health of our youth reflects the nation's wellbeing," said CDC Director Robert R. Redfield, M.D. "In the past decade, there have been substantial improvements in the behaviors that put students most at risk for HIV and sexually transmitted diseases. However, we can't yet declare success when so many young people are getting HIV and STDs, and experiencing disturbingly high rates of substance use, violence, and suicide."

Student Sexual Behavior

In 2017, there was another decline in the percentage of high school students who report that they have ever had sex and those who have had four or more sexual partners — the lowest levels since CDC began conducting the survey in 1991.

Unfortunately, a lower percentage of students who engage in sex report using condoms. The correct use of condoms helps to prevent the transmission of HIV and sexually transmitted diseases (STDs), and 15-24 year-olds account for half of all new STD infections in the U.S.

The self-reported data shows that students who:

• Ever had sex: Declined from 47.8% in 2007 to 39.5% in 2017.
• Had four or more sexual partners: Declined from 14.9% in 2007 to 9.7% in 2017.
• Used a condom during last sex: Declined from 61.5% in 2007 to 53.8% in 2017.

Student reports of other factors that have been shown to increase the risk for HIV and STDs – like drug-use, experiences of violence, and poor mental health – remain troubling.

Illicit Drug Use and New Findings on Prescription Opioids

While the percentage of students who reported ever using select illicit drugs (defined here as cocaine, heroin, methamphetamines, inhalants, hallucinogens, or ecstasy) was down, the survey found that 14 percent of U.S. high school students (1 in 7) reported misusing prescription opioids. The misuse of prescription opioids can lead to overdose as well as injection drug use, which increases the risk for HIV.

The percentage of students who:

• Ever used select illicit drugs: Declined from 22.6% in 2007 to 14.0% in 2017.
• Ever misused prescription opioids: Was 14.0% in 2017 (first year for data).

Substantial Levels of Violence and Persistent Feelings of Sadness or Hopelessness

Nationally, 1 in 5 students reported being bullied at school, and 1 in 10 female students and 1 in 28 male students reported having been physically forced to have sex. Also in 2017, the proportion of students reporting persistent feelings of sadness or hopelessness increased to 1 in 3. The percentage of students who:

• Were bullied at school: Has not significantly decreased from 19.9% in 2009 to 19.0% in 2017.
• Were forced to have sex: Has not significantly improved from 7.8% in 2007 to 7.4% in 2017.
  • Females: Has not significantly decreased from 11.3% in 2007 to 11.3% in 2017.
  • Males: Has decreased from 4.5% in 2007 to 3.5% in 2017.
• Felt sad or hopeless: Has increased from 28.5% in 2007 to 31.5% in 2017.

"Today's youth are making better decisions about their health than just a decade ago," said Jonathan Mermin, M.D., director of CDC's National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. "But, some experiences, such as physical and sexual violence, are outside their control and continue at painfully high levels. Their experiences today have powerful implications for their lives tomorrow."

In addition to national trends, the 2017 YRBS data highlight the health disparities that exist among students based upon sex, race/ethnicity, and sexual identity/same-sex sexual contact. The national YRBS data on sexual minority youth (defined here as students who identify as gay, lesbian, or bisexual; or who are not sure of their sexual identity) revealed stark differences between the risks experienced by these students and their heterosexual peers, especially in regard to violence, substance use, and suicide-related behaviors.

Student Health: Schools Central But Can't Do It Alone

Schools, families, and communities must work together to make sure the nation's youth stay healthy now and into their adulthood. Research shows that schools and families can protect against these risks by working to increase the connections youth have to schools and adults. Families can do this by providing strong family support, modeling healthy behaviors, engaging in meaningful conversations early and often, and staying engaged in their adolescents' daily lives. Schools can do this by building environments that provide safety and connectedness for all students, delivering evidence-based health education with a focus on building skills for healthy decision-making, and connecting students to necessary health services. These groups can work together to provide more intentional messages, skills, and mental health support for teens, so that encouraging trends can continue and the troubling trends can be reversed.

"We know that being connected to schools and safe adults is key to protecting the health of adolescents," said Kathleen Ethier, PhD, director of CDC's Division of Adolescent and School Health. "Students are more likely to thrive if they feel safe and have a sense of belonging – and if they have parents, adults, teachers, and friends who they know care about their success."

The CDC and its partners work on multiple levels to address strategies that protect and improve young people's lives – including funding, implementing, and evaluating programs that address many of these risks and protective factors.