Socioeconomic disadvantage and adolescent women's sexual and reproductive behavior: The case of five developed countries

Data on French 15-18-year-olds' contraceptive use at first intercourse indicate no difference according to educational level; at all three levels of education, 88-90% used a method. However, in the United States, 72% of 15-19-year-olds who have less than a high school education used contraceptives at first intercourse, compared with 80-83% of adolescents who have at least completed high school. In Great Britain, differences by level of educational attainment are even larger: Forty-- nine percent of 20-24-year-olds with low levels of educational attainment used a method at first intercourse, compared with 80% of those with high levels of attainment.

Differences in current or recent contraceptive use within each country according to socioeconomic status are smaller than for use at first intercourse. However, British adolescents at all income levels are much less likely to not use contraceptives than are their American counterparts. In Great Britain, 5% of currently sexually active 16-19-year-old women of the lowest socioeconomic status, 4% of middle status and virtually none of the highest status did not use a method at last intercourse (Figure 4). In the United States, 20% of the poorest sexually active 15-19-- year-old women and 17-23% of those in the two higher-income groups used no method at last intercourse.

In Canada, data are available only on condom use at last intercourse. They indicate that lower-income adolescent women are somewhat more likely than their better-off peers to use condoms. Among lowest-income, single, sexually experienced 15-19-year-old women, 81% used a condom at last intercourse, compared with 76% of those in the highestincome households.28

Great Britain and the United States are the only countries with national data on contraceptive use at last intercourse according to adolescents' school and employment status. In Great Britain, only 2% of all sexually active adolescent women who are in school full-time and 1% of those who are working did not use a contraceptive method at last intercourse, while 12% of those engaged in neither of these activities did not use a method (Figure 4). In the United States, those who are neither working nor in school also are the most likely to have used no method at last intercourse.

Comparable data are not available for Canadian adolescents. However, among single, sexually experienced 15-19-year-- old women participating in a national survey, those who were in school only or were in school and working were more likely to report having used a condom at last intercourse (70-80%) than those who were not in school (a group that included adolescents who were working only as well as neither in school nor working-- 61 %).29

Finally, white and nonwhite adolescents in Great Britain are equally likely to report using no method at last intercourse (4%-- Figure 4). In the United States, black or Hispanic teenagers are more likely than white adolescents to have used no method the last time they had intercourse: Twenty-eight percent of Hispanic teenagers did not use a method at last intercourse, compared with 23% of black teenagers, and 18% of white teenagers.