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Healthy People 2010 – Women's and Men's Health: A Comparison of Select Indicators

Responsible Sexual Behavior

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Responsible sexual behaviors reduce the risk of sexually transmitted diseases (STDs) — including HIV infection — and unintended pregnancies. Irresponsible sexual behaviors can result in high costs for females, including increased high school dropout rates and poverty (single mothers with limited education and job skills). The four objectives in this section address responsible sexual behaviors among adults and adolescents.

Two objectives cover condom use. The correct and consistent use of a male latex condom can reduce the risk of STD transmission, including HIV infection.³³ A limited number of clinical studies have evaluated the effectiveness of the female condom in reducing the risk of STDs, including HIV. According to STD treatment guidelines issued in 2006, "If used consistently and correctly, the female condom might substantially reduce the risk for STDs."³³

Adult Condom Use

In 2006, women and adolescent girls accounted for 26 percent of reported AIDS cases.³⁴ AIDS is the leading cause of death for black women aged 25 to 34 years.¹⁴ In 2001 — 2005, black women accounted for two-thirds of newly diagnosed HIV/AIDS cases among U.S. women. Black men accounted for 44 percent of new diagnoses among U.S. men.³⁵

Having sex with a man who has HIV is the most common way that women are infected with HIV. Women of color, especially African American women, are at highest risk. Younger women are more likely than older women to get HIV.³⁶

Women have special challenges in protecting themselves against HIV infection.³⁶ For example, women are particularly vulnerable to HIV transmission through heterosexual intercourse because the vagina's lining provides a large potential exposure area. Furthermore, women may lack the power or skills to negotiate condom use in their relationships.³⁶

Increased condom use is one of the recommended strategies for reducing the risk of HIV infection in both women and men. When used consistently and correctly, male latex condoms are highly effective in preventing HIV transmission.³³

For condom use by unmarried adults, only two data points are available for women and one for men. Men were more likely to have used a condom at last intercourse in 2002 — 42 percent, compared with 31 percent of women or their male partners.

Condom use by the partners of unmarried females aged 18 to 44 years increased from 23 percent to 31 percent between 1995 and 2002. Data are expected by the end of the decade to measure progress for males. Neither gender is close to achieving the 2010 targets — 54 percent for men and 50 percent for women (figure 22).

Figure 22. Unmarried, Sexually Active Persons Aged 18 to 44 Years Who Used a Condom at Last Intercourse, by Gender (1995 and 2002)

Healthy People 2010 Targets (Women: 50%, Men: 54%)*

Percent	1995	2002
Women	23	31
Men		42

95% confidence interval

* The Healthy People 2010 target calls for an increase in this measure.
Source: Centers for Disease Control and Prevention, National Center for Health Statistics, National Survey of Family Growth.

Adolescent Sexual Behavior

In recent years, progress has been made in preventing, diagnosing, and treating STDs. However, in 2000, an estimated 19 million new infections occurred, almost half of them among young persons aged 15 to 24 years.³⁷ Some 5,000 young persons in that age group became infected with HIV/AIDS.³⁷ More than 1 of every 10 live births occurs among adolescents aged 15 to 19 years. In 2005, the total for that age group was 421,315 births.³⁸

Young persons in the United States use alcohol and other drugs at rates well above the Healthy People 2010 targets (see page 21). Adolescents are more likely to engage in high-risk behaviors, such as unprotected sex, when they are under the influence of drugs or alcohol.³⁹ In 2007, 23 percent of high school students who had sexual intercourse during the past 3 months drank alcohol or used drugs before their last sexual intercourse.⁴⁰

Healthy People 2010 measures three types of responsible adolescent sexual behavior: never had sexual intercourse; not currently sexually active; and, if currently sexually active, used a condom at last sexual intercourse.

Never had sexual intercourse. Between 1991 and 2007, there were no appreciable differences in the proportions of girls in grades 9 through 12 who have never had sexual intercourse. For boys, the rate in 1991 was lower than the rates observed in 2001 through 2007. The trend data show no differences between boys and girls (figure 23).

Figure 23. Students in Grades 9 Through 12 Who Have Never Had Sexual Intercourse, by Gender (1991 — 2007, Selected Years)

Healthy People 2010 Target (56%)*

Percent	1991	1993	1995	1997	1999	2001	2003	2005	2007
Girls	49	50	48	52	52	57	55	54	54
Boys	43	44	46	51	48	52	52	52	50

* The Healthy People 2010 target calls for an increase in this measure.
Source: Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Youth Risk Behavior Surveillance System.

Among racial and ethnic population groups, white non-Hispanic girls and boys achieved the Healthy People 2010 target of 56 percent in 2007. Black non-Hispanic boys had the lowest rate of never having had sexual intercourse (figure 24).

Figure 24. Students in Grades 9 Through 12 Who Have Never Had Sexual Intercourse, by Race/Ethnicity and Gender (2007)

Healthy People 2010 Target (56%)*

Race/ethnicity	White non-Hispanic	Black non-Hispanic	Hispanic	Other*
Boys	56	27	42	66
Girls	56	39	54	61

95% confidence interval

* The Healthy People 2010 target calls for an increase in this measure.
Source: Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Youth Risk Behavior Surveillance System.

Ninth- and tenth-grade girls achieved the target in 2007, as did ninth-grade boys. Ninth-grade girls were more likely never to have had sexual intercourse than ninth-grade boys and students in higher grades.

If sexually experienced, not currently sexually active. The proportion of sexually experienced boys who have not had sexual intercourse in the past 3 months has been at or above the Healthy People 2010 target of 30 percent for all but 1 data year during the period 1991 through 2007. During the same period, the proportion for girls fluctuated between 22 percent and 25 percent (figure 25).

Figure 25. Students in Grades 9 Through 12 Who Are Sexually Experienced but Not Currently Sexually Active, by Gender (1991 — 2007, Selected Years)

Healthy People 2010 Target (30%)*

Percent	1991	1993	1995	1997	1999	2001	2003	2005	2007
Girls	25	25	22	23	24	22	23	24	22
Boys	36	33	34	32	30	31	29	30	31

* The Healthy People 2010 target calls for an increase in this measure.
Source: Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Youth Risk Behavior Surveillance System.

White non-Hispanic, black non-Hispanic, and Hispanic boys achieved the Healthy People 2010 target of 30 percent not currently sexually active in 2007. Girls in grade 9 and boys in grades 9 and 10 also achieved the Healthy People 2010 target of 30 percent.

If currently sexually active, used a condom at last intercourse. Condom use increased for both boys and girls between 1991 and 2007 (figure 26). Boys were more likely than girls to report using a condom at last intercourse. Boys achieved the Healthy People 2010 target of 65 percent in 1999 and have remained above the target.

Figure 26. Students in Grades 9 Through 12 Who Are Currently Sexually Active and Who Used a Condom at Last Intercourse, by Gender (1991 — 2007, Selected Years)

Healthy People 2010 Target (65%)*

Percent	1991	1993	1995	1997	1999	2001	2003	2005	2007
Girls	38	46	49	51	51	51	57	56	55
Boys	55	59	61	63	66	65	69	70	69

* The Healthy People 2010 target calls for an increase in this measure.
Source: Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Youth Risk Behavior Surveillance System.

White non-Hispanic, black non-Hispanic, and Hispanic boys achieved the Healthy People 2010 target for condom use in 2007. Boys had higher rates of condom use than girls in all of these racial and ethnic population groups.

Boys in grades 9, 10, and 11 achieved the target in 2007 (figure 27). Boys in all grades had higher rates of condom use than girls in the same grade.

Figure 27. Students in Grades 9 Through 12 Who Are Currently Sexually Active and Who Used a Condom at Last Intercourse, by Grade and Gender (2007)

Healthy People 2010 Target (65%)*

Grade	12	11	10	9
Boys	60	69	73	76
Girls	50	55	60	61

95% confidence interval

* The Healthy People 2010 target calls for an increase in this measure.
Source: Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Youth Risk Behavior Surveillance System.

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Content last updated July 1, 2009.

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