{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T02:23:27Z","timestamp":1792290207511,"version":"4.4.0"},"reference-count":21,"publisher":"American Public Health Association","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Public Health"],"published-print":{"date-parts":[[2007,1]]},"abstract":"<jats:p> Objectives. We explored the relative contributions of declining sexual activity and improved contraceptive use to the recent decline in adolescent pregnancy rates in the United States. <\/jats:p><jats:p> Methods. We used data from 1995 and 2002 for women 15 to 19 years of age to develop 2 indexes: the contraceptive risk index, summarizing the overall effectiveness of contraceptive use among sexually active adolescents (including nonuse), and the overall pregnancy risk index, calculated according to the contraceptive risk index score and the percentage of individuals reporting sexual activity. <\/jats:p><jats:p> Results. The contraceptive risk index declined 34% overall and 46% among adolescents aged 15 to 17 years. Improvements in contraceptive use included increases in the use of condoms, birth control pills, withdrawal, and multiple methods and a decline in nonuse. The overall pregnancy risk index declined 38%, with 86% of the decline attributable to improved contraceptive use. Among adolescents aged 15 to 17 years, 77% of the decline in pregnancy risk was attributable to improved contraceptive use. <\/jats:p><jats:p> Conclusions. The decline in US adolescent pregnancy rates appears to be following the patterns observed in other developed countries, where improved contraceptive use has been the primary determinant of declining rates. <\/jats:p>","DOI":"10.2105\/ajph.2006.089169","type":"journal-article","created":{"date-parts":[[2006,12,1]],"date-time":"2006-12-01T01:51:35Z","timestamp":1164937895000},"page":"150-156","source":"Crossref","is-referenced-by-count":311,"title":["Explaining Recent Declines in Adolescent Pregnancy in the United States: The Contribution of Abstinence and Improved Contraceptive Use"],"prefix":"10.2105","volume":"97","author":[{"given":"John S.","family":"Santelli","sequence":"first","affiliation":[{"name":"The authors are with the Guttmacher Institute, New York, NY. John S. Santelli is also with the Heilbrunn Department of Population and Family, Mailman School of Public Health, Columbia University, New York, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura Duberstein","family":"Lindberg","sequence":"additional","affiliation":[{"name":"The authors are with the Guttmacher Institute, New York, NY. John S. Santelli is also with the Heilbrunn Department of Population and Family, Mailman School of Public Health, Columbia University, New York, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence B.","family":"Finer","sequence":"additional","affiliation":[{"name":"The authors are with the Guttmacher Institute, New York, NY. John S. Santelli is also with the Heilbrunn Department of Population and Family, Mailman School of Public Health, Columbia University, New York, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susheela","family":"Singh","sequence":"additional","affiliation":[{"name":"The authors are with the Guttmacher Institute, New York, NY. John S. Santelli is also with the Heilbrunn Department of Population and Family, Mailman School of Public Health, Columbia University, New York, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"844","reference":[{"key":"R1","doi-asserted-by":"publisher","DOI":"10.1177\/000271620258000106"},{"key":"R2","doi-asserted-by":"publisher","DOI":"10.2307\/2648144"},{"key":"R3","unstructured":"Ventura SJ, Abma JC, Mosher WD, Henshaw S. Estimated pregnancy rates for the United States, 1990\u20132000: an update. Natl Vital Stat Rep. June 15, 2004;52(23)."},{"key":"R4","unstructured":"Martin JA, Hamilton BE, Sutton PD, Ventura SJ, Menacker F, Munson ML. Births: final data for 2003. Natl Vital Stat Rep. September 8, 2005;54(2)."},{"key":"R6","doi-asserted-by":"publisher","DOI":"10.2307\/3030191"},{"key":"R7","doi-asserted-by":"publisher","DOI":"10.2307\/2134865"},{"key":"R8","doi-asserted-by":"publisher","DOI":"10.2307\/2135494"},{"key":"R9","unstructured":"Premarital sexual experience among adolescent women\u2014United States, 1970\u20131988. MMWR Morb Mortal Wkly Rep. 1991;39:929\u2013932."},{"key":"R10","doi-asserted-by":"crossref","unstructured":"Abma JC, Martinez GM, Mosher WE, Dawson BS. Teenagers in the United States: sexual activity, contraceptive use and childbearing, 2002. Vital Health Stat 23.2004;24.","DOI":"10.1037\/e609162007-001"},{"key":"R11","unstructured":"Brener N, Lowry R, Kann L, et al. Trends in sexual risk behaviors among high school students\u2014United States, 1991\u20132001. MMWR Morb Mortal Wkly Rep. 2002;51:856\u2013859."},{"key":"R12","doi-asserted-by":"crossref","unstructured":"Grunbaum JA, Kann L, Kinchen K, et al. Youth risk behavior surveillance\u2014United States, 2003. MMWR Morb Mortal Wkly Rep. 2004;53(SS-2):1\u201329.","DOI":"10.1037\/e307132005-001"},{"key":"R13","unstructured":"Dailard C. Understanding \u201cabstinence\u201d: implications for individuals, programs and policies. Guttmacher Rep Public Policy. 2003;6:4\u20136."},{"key":"R14","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2005.10.006"},{"key":"R16","doi-asserted-by":"publisher","DOI":"10.1016\/S1054-139X(04)00134-X"},{"key":"R18","doi-asserted-by":"publisher","DOI":"10.2307\/2673738"},{"key":"R23","doi-asserted-by":"publisher","DOI":"10.1177\/109019810102800102"},{"key":"R24","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2005.01.005"},{"key":"R25","doi-asserted-by":"publisher","DOI":"10.2307\/2135889"},{"key":"R26","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2005.05.015"},{"key":"R30","unstructured":"Mohn JK, Tingle LR, Finger R. An analysis of the causes of the decline in non-marital birth and pregnancy rates for teens from 1991 to 1995. Adolesc Fam Health. 2003;3:39\u201347."},{"key":"R31","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a117473"}],"container-title":["American Journal of Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ajph.aphapublications.org\/doi\/pdf\/10.2105\/AJPH.2006.089169","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,9]],"date-time":"2022-05-09T22:19:28Z","timestamp":1652134768000},"score":1,"resource":{"primary":{"URL":"https:\/\/ajph.aphapublications.org\/doi\/full\/10.2105\/AJPH.2006.089169"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2007,1]]},"references-count":21,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2007,1]]}},"alternative-id":["10.2105\/AJPH.2006.089169"],"URL":"https:\/\/doi.org\/10.2105\/ajph.2006.089169","relation":{},"ISSN":["0090-0036","1541-0048"],"issn-type":[{"value":"0090-0036","type":"print"},{"value":"1541-0048","type":"electronic"}],"subject":[],"published":{"date-parts":[[2007,1]]}}}