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Teens must use condoms first time, every time


THE GOOD NEWS is, the teen birth rate is down and teen pregnancies are down. More teens report delaying sex, and more teens report using some kind of contraceptive the first time they do.

The bad news is, if you ask teens if they used contraceptives the last time they had sex, more of them will tell you no.

Something is happening between a teen-ager's first sexual experience and his most recent sexual experience, and it isn't good.

According to a study released by the National Campaign to Prevent Teen Pregnancy, the number of teens who reported using any kind of birth control the first time they had sex increased dramatically from 1982 (48 percent) to 1995 (76 percent), primarily due to increased condom use.

But contraceptive use during the most recent sex decreased from 77 percent in 1988 to 69 percent in 1995.

In other words, kids in the 1980s were less likely to use contraceptives the first time. But they got smart, and they were using it the next time you asked. By 1995, the situation had reversed itself.

It is clear that, for at least one moment in time, teens understood they needed to protect themselves against pregnancy and sexually transmitted diseases.

What happened next? Why did they stop? Did they forget? Change their minds? What are these kids thinking?

"The best we can make out is that they start trusting their partner more," says Sarah Brown, executive director of the National Campaign to Prevent Teen Pregnancy.

"At first intercourse, they don't know each other very well and they do what everyone is telling them to do, which is use protection. As they become more committed, they get a little more relaxed and their vigilance decreases."

Susan Bankowski, associate director of Baltimore's Campaign for Our Children, agrees.

"There is this trust thing," she says. "You are in a committed relationship, and your partner wants you to believe he is clean."

"The girls tell us they will use it for their 'side dishes,' but not for their steady," says Patti Flowers-Coulson, director of the Maryland's Council on Adolescent Pregnancy. "They assume their regular boyfriend is clean, but they use a condom with a guy they aren't sure about.

"With her boyfriend, she starts to think that if there is a pregnancy, he will take care of her because he loves her."

"There might be coercion involved, too," Bankowski says. "He will tell her that he can't feel anything when he wears a condom."

The irony is that in a committed relationship, there should be shared decision-making about contraception, but most teens can barely bring themselves to talk to each other about it.

"They should get tested together, make choices together. Instead, they are just being stupid together," Bankowski says.

"We have to find a way to make them understand that this has nothing to do with trust and everything to do with protecting their bodies and their futures," said Flowers-Coulson.

Teens also say that drinking and drug use are reasons they fail to use contraceptives. It is also true that teens often switch from condom use to birth control pills and are vulnerable to unprotected sex during that transition. The list of reasons teens aren't using contraceptives is a long one.

"Frankly, this isn't a phenomenon that is unique to teens, says Monica Rodriguez of the Sexuality Information and Education Council of the United States. "Correct and consistent contraceptive use is something people across the life span struggle with. Teens aren't the only ones with high rates of unintended pregnancy or STDs."

But teens, she says, have many more reasons to be inconsistent contraceptive users. Access to birth control is a big one. They need a doctor or a clinic or a ride to the drugstore or the money to pay for it. And they need to be taught how to use it and why it has to be used every, single time.

"In this country, young people have the right to birth control without parental permission, but the reality is that without the permission and support of a parent or an adult, it becomes very complicated," says Rodriguez. "Too complicated for most teens."

But parents fear that a candid message about protection carries unspoken permission. We are saying, "Don't have sex, but if you do, protect yourself." But we fear they are hearing, "It is OK to have sex if you protect yourself."

"There is voluminous research that shows that, if anything, this kind of conversation delays first sex and increases contraceptive use for those who go on to become sexually active and about half of high school kids do," says Brown. "It doesn't stimulate sexual activity, it is a protection against it."

The fact that teens are not consistent contraceptive users should not surprise us. Teens aren't consistent about much. Their decision-making is as fluid as their emotions and negotiating contraception use is awkward at best. Their lives are spontaneous and their opportunities for sex unpredictable. "Sexually active" might mean four times a year.

That makes this research that much more alarming. We didn't want teens to have sex in the first place. But if they are going to do it, we want them to be safe. When it looks like they were using protection, we were grateful because their well-being means more to us than their virginity. When we learn that they are casually abandoning this protection, we are devastated and defeated by their carelessness.

But this glimpse inside the confused thinking of a teen-ager is squandered if we don't realize that there must be no confusion about our message to them.

"We have to tell them: 'All of us adults feel very strongly that you should not have sex while you are in school. We have many reasons to feel that way, from pregnancy to broken hearts,' " says Brown.

" 'But if you have sex, you must use protection every single time. Now let me tell you what that means.' "

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