Objectives: To identify and report cross-national patterns in contraceptive use among sexually active adolescents.
Design: A cross-national cross-sectional survey.
Setting: Data were collected in 2002 by self-report questionnaire from students in school classrooms.
Participants: A cluster sample of 33,943 students aged 15 years from 24 countries.
Main outcome measures: International standardized questions on ever having had sexual intercourse and contraceptive use at last sexual intercourse.
Results: The percentages of students reporting having had sexual intercourse ranged from 14.1% in Croatia to 37.6% in England; 82.3% of those who were sexually active reported that they used condoms and/or birth control pills at last intercourse. Condom use only was most frequent and ranged from 52.7% in Sweden to 89.2% in Greece. Dual use of condoms and contraceptive pills was also relatively frequent, ranging from 2.6% in Croatia to 28.8% in Canada. The use of contraceptive pills was most frequent in northern and western Europe. No contraceptive use at last intercourse was reported by 13.2% of students.
Conclusions: A substantial minority of 15-year-olds have engaged in sexual intercourse. Condom use is the most frequent method of contraception reported by the sexually active respondents, followed by the dual use of condoms and contraceptive pills and contraceptive pills only. The proportions of poorly protected and unprotected youth remain high, and attention to international policy and practice determinants of young sexual behavior and contraceptive use is required.