The debate over contraception distribution in schools often focuses on whether districts should only teach abstinence. In the schools included in this study, “counseling often included the message that abstinence is the safest method of protection against STIs,” wrote the researchers, Kasey Buckles and Daniel Hungerman of Notre Dame, in an email. But the programs weren’t necessarily geared toward abstinence—“in some cases, a counselor might be required to show how a condom is put on, and in other cases a counselor might be forbidden from doing that.” Opponents worry that this kind of show-and-tell, paired with easy access to condoms, encourages kids to have sex or engage in risky sexual behavior. The researchers speculated that the ’90s-era condom programs might have done exactly that.
But a lot has changed over the last couple of decades, suggesting that alternative policies might have different outcomes. Since 1990, teen birth rates have fallen dramatically, declining from roughly 62 births per 1,000 girls aged 15 to 19 to roughly 24 among the same group in 2014. Teen abortions have also decreased significantly: In 2011, roughly 14 out of every 1,000 adolescent girls had an abortion, compared to 44 out of 1,000 in 1988. Teens are also waiting longer to have sex, and when they do, they’re doing it more safely.
The way young women use birth control is also changing. According to the CDC, condom use decreased by about half among women aged 15 to 19 between 1995 and 2010, while reliance on hormonal birth control has gone up, especially among women under 30. While women in their late 20s and 30s are more likely than teens to get IUDs, the greatest decrease in condom use as the only method of birth control was among teens.
These trends have likely been driven by a number of factors, including new public-health policies. Recently, a number of programs have shifted their emphasis away from condoms and toward hormonal birth control. While condoms are still the most common kind of contraception used by teens, they have higher failure rates for preventing pregnancy than hormonal birth control. As the researchers in this study point out, girls also have less control over condom use than they do over something like the pill; they can make a long-term decision to get on birth control, rather than deciding whether or not to use a condom when they’re about to have sex.
That’s why some states and localities are pushing for wider distribution of other kinds of birth control, including long-acting reversible contraceptives, or LARCs. An initial study of one such program—Colorado’s Family Planning Initiative, founded in 2009—suggests it has reduced teen birth rates in the state by about 5 percent.
Then again, as the researchers point out, some public-health organizations, including the American Academy of Pediatrics, have recently advocated condom-distribution programs in schools. Because of this, “many school districts (including Boston and Chicago) have recently considered the role of condoms in schools,” Buckles and Hungerman wrote in an email. In some areas of the country, alternative programs, including those that provide students with free IUDs, have had trouble catching on. This is especially true in conservative states like Texas, as my colleague Olga Khazan reported earlier this month.