by Michelle Rotermann
Sexual behaviour is a major determinant of sexual and reproductive health.1,2 Early sexual intercourse, unprotected sex, and having multiple sexual partners put youth at risk of Human Immunodeficiency Virus (HIV) and other sexually transmitted infections (STIs)3-6 and of unplanned pregnancy.7,8 Individuals aged 15 to 24 experience some of the highest rates of STIs.9-11
Based on results of the 2003 and 2009/2010 Canadian Community Health Survey (CCHS), this article examines whether the sexual behaviour and condom use of 15- to 24-year-olds has changed since 2003 (the earliest years for which comparable national data are available). (See The data )
In 2009/2010, 66% of 15- to 24-year-olds reported having had sexual intercourse at least once, which was not significantly different from 2003 (data not shown). The likelihood of being sexually active rose with age. At ages 15 to 17, 30% reported having had sex, compared with 68% of 18- to 19-year-olds and 86% of 20- to 24-year-olds. The 2003 figures were 30%, 68%, and 85%, respectively (data not shown).
In 2009/2010, 9% of 15- to 24-year-olds reported that they first had sexual intercourse when they were younger than 15, and about 25% had had intercourse for the first time at age 15 or 16 (Table 1). These results were not significantly different from 2003. However, in 2003, similar percentages of males and females reported having had intercourse before age 15, but in 2009/2010, this was less common among females (8%) than males (10%).
In 2009/2010, about one-third of sexually active 15- to 24-year-olds reported having had sexual intercourse with more than one partner in the previous 12 months, unchanged from 2003 (Table 2). A larger percentage of sexually active males than females had had intercourse with more than one partner: 39% compared with 25%. The percentage reporting more than one sexual partner was higher among 15- to 17-year-olds than among 20- to 24-year-olds (35% versus 30%).
The percentages reporting multiple sexual partners were fairly consistent across the country. The exception was Yukon, where 54% of 15- to 24-year-olds reported having had intercourse with more than one partner in the past year, compared with the Canadian average of 32%. In Alberta, the percentage reporting multiple partners had been below the national figure in 2003, but by 2009/2010, the percentages were not significantly different.
In 2009/10, 68% of sexually active 15- to 24-year olds reported using condoms the last time they had intercourse, compared with 62% in 2003 (Table 2). As in 2003, condom use was more common among males than females—in 2009/2010, 73% of males, compared with 63% of females, reported using condoms the last time they had intercourse.
As was the case in 2003, the 2009/2010 results indicate that condom use declined with age from 80% among 15- to 17-year-olds to 63% among 20- to 24-year-olds (Table 2). This pattern prevailed among both sexes (data not shown). It may reflect the tendency to use other forms of birth control, such as oral contraceptives, at older ages.1,2,21 Furthermore, older individuals are more likely to be in longer-term, monogamous relationships in which partners perceive less risk of contracting HIV/STI and the use of condoms to be less important.22-24
In 2003, 15- to 24-year-olds with one sexual partner in the past year were less likely than those with more than one partner to report using a condom: 59% versus 68% (Table 3). By 2009/2010, the prevalence of condom use did not differ by the number of sexual partners: 67% (one partner) and 69% (more than one partner) (Table 3).
Table 3 Number and percentage of sexually active 15- to 24-year-olds who used condom at last sexual intercourse, by number of sexual partners in past year and age group, household population, Canada, 2003 and 2009/20100
In 2009/2010, the prevalence of condom use was above the national average in Ontario (73%), Alberta (73%), Northwest Territories (78%) and Nunavut (79%), and below the average in Quebec (60%) and Manitoba (65%) (Table 3). In New Brunswick, Ontario and Alberta, the percentages reporting condom use increased significantly between 2003 and 2009/2010. Condom use did not decline in any province or territory.
Geographic variations in condom use may reflect differences in the effectiveness of campaigns to promote their use25 and in the accessibility and/or affordability of other contraceptives.23,25,26 In Quebec, for example, the province’s drug insurance plan27 reimburses the cost of some contraceptives, such as birth control pills.