A new report from the WHO Regional Office for Europe reveals that condom use among sexually active adolescents has declined significantly since 2014, with rates of unprotected sex worryingly high.

The new data were published as part of the Health Behaviour in School-aged Children (HBSC) study, which surveyed over 242,000 15-year-olds across 42 countries and regions in the period 2014 to 2022. The University of Glasgow’s Dr Jo Inchley was the International Coordinator of the HBSC study for the 2021/22 international survey.

Overall, the report highlights that a substantial proportion of sexually active 15-year-olds are engaging in unprotected sexual intercourse, which WHO warns can have far-reaching consequences for young people, including unintended pregnancies, unsafe abortions, and an increased risk of contracting sexually transmitted infections (STIs). The data indicate that the high prevalence of unprotected sex indicates significant gaps in age-appropriate comprehensive sexuality education, including sexual health education, and access to contraceptive methods.

Compared to 2014 levels, the new data show a significant decline in the number of adolescents reporting condom use during last sexual intercourse. From the data, it is clear that the decrease in condom use is pervasive, spanning multiple countries and regions, with some experiencing more dramatic reductions than others. The report underscores the urgent need for targeted interventions to address these concerning trends and promote safer sexual practices among young people within the wider context of equipping them with the foundation they need for optimal health and well-being.

Dr Hans Henri P Kluge, WHO Regional Director for Europe, said: “While the report's findings are dismaying, they are not surprising. Age-appropriate comprehensive sexuality education remains neglected in many countries, and where it is available, it has increasingly come under attack in recent years on the false premise that it encourages sexual behaviour, when the truth is that equipping young persons with the right knowledge at the right time leads to optimal health outcomes linked to responsible behaviour and choices.”

Key findings from the report also include:

  • Decline in condom use: The proportion of sexually active adolescents who used a condom at last intercourse fell from 70% to 61% among boys and 63% to 57% among girls between 2014 and 2022.
  • High rates of unprotected sex: Almost a third of adolescents (30%) reported using neither a condom nor the contraceptive pill at last intercourse, a figure that has barely changed since 2018.
  • Socio-economic differences: Adolescents from low-affluence families were more likely to report not using a condom or the contraceptive pill at last sexual intercourse than their peers from more affluent families (33% compared with 25%).
  • Contraceptive pill use: The report indicates that contraceptive pill use during last sexual intercourse has remained relatively stable between 2014 and 2022, with 26% of 15-year-olds reporting that they or their partners used the contraceptive pill at their last sexual intercourse.

"These findings are deeply concerning and highlight the urgent need for renewed efforts to promote safe sexual practices among adolescents," said Dr Inchley. "The decline in condom use is particularly worrying, as it leaves young people vulnerable to STIs and unintended pregnancies."

"Our research underscores the critical importance of providing comprehensive, age-appropriate sexuality education in schools across the region," Dr Inchley added. "We need to empower young people with the knowledge and skills to make informed decisions about their sexual health and wellbeing."

"The wide variations we see across countries remind us that cultural context matters. We need tailored approaches that take into account local norms and values while ensuring all young people have access to the information and services they need to protect their health."

The report calls for sustainable investments in age-appropriate comprehensive sexuality education, youth-friendly sexual and reproductive health services, and enabling policies and environments that support adolescent health and rights.

Dr Margreet de Looze of Utrecht University, one of the report’s co-authors, said: “The findings of this report should serve as a catalyst for action. Adolescents deserve the knowledge and resources to make informed decisions about their sexual health. We have the evidence, the tools, and the strategies to improve adolescent sexual health outcomes. What we need, though, is the political will and the resources to make it happen.”

First published: 29 August 2024

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