Sound Body

Love, American style

When it comes to sex and health, recent studies show that teens may have something to teach their parents

By Stephen Smith
Globe Staff / February 7, 2011

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It is the age of invincibility: adolescence, when the thrill of the moment is unperturbed by the consequences of the future.

Except, maybe, when it comes to sex. Two recent studies — one, a national survey; the other, a report from Boston health trackers — found widespread use of condoms among the nearly one-third of adolescents who had intercourse, belying the portrayals of wanton recklessness that are the coin of the cable realm.

This is a generation whose entire lifetime has been framed by the presence of the AIDS virus. So, some sex researchers aver, teens today are keenly aware of the importance of condoms (although there’s also evidence that certain sexually transmitted diseases are rising among youths, complicating the analysis).

And, it turns out, they might have a thing or two they could teach their parents or grandparents. The same national survey found that adults in their 40s, 50s, and 60s who were still playing on the field of love — they described their intimates as “casual partners’’ as opposed to “relationship partners’’ — used protection at substantially lower levels than youngsters.

Maybe they should listen to Anastasia Walker, a take-no-prisoners 17-year-old who starred a couple of years back in an online video touting the virtues of safe sex.

“A lot of people know someone who got something on the down low,’’ said Walker, a junior at TechBoston Academy. “So you’re like, ‘Wow, I don’t want to be like that.’ So I know a lot of teenagers who always do use condoms.’’

The countrywide data documenting condom use — the participants spanned the ages, as young as 14, as old as 94 — are part of a series of studies depicting love, American style, circa the 21st century. The lead authors of the research, published in the Journal of Sexual Medicine, are the intellectual progeny of Alfred Kinsey, the bow-tied biologist who began his academic life studying wasps and concluded it exploring the sexual proclivities of humans.

The National Survey of Sexual Health and Behavior, underwritten by the maker of Trojan brand condoms, depicts the vibrant, varied sexual life of Americans — and its durability, even deep into life, with people in their 70s and beyond craving physical connection.

“The easiest thing you could conclude from this is that sex is practiced at all ages, from very young to very, very old,’’ said Dr. Irwin Goldstein, director of San Diego Sexual Medicine, who was not involved in the study. “It’s a reality of human life at all levels, at all times of life.

“As I personally start to age and get into my 60s,’’ he said, “it’s nice to see they have data showing sex is widely practiced in both men and women at older ages.’’

It is the findings about condom use that sparked the most interest among researchers in human sexuality — both because they suggest what’s working and what more needs to be done.

Condom use among adolescents has been rising in recent years, and the rates reported in the national study from researchers at Indiana University — they surveyed nearly 6,000 adults and adolescents — stand as some of the highest ever recorded.

About 79 percent of sexually active males between 14 and 17 said they used condoms during their most recent sexual encounter; that compares with 65 percent of 15- to 19-year-olds in a 2001 federal study.

A Boston Public Health Commission study reported similar patterns: Among sexually active Boston high school students, 73 percent said they used protection during their most recent sex act.

And just last week, a federal health agency reported that the nation’s teen birth rate had fallen to a historic low — another potential piece of evidence that adolescents are using protection.

“We often as a country make the assumption that adolescents are sort of being risky and irresponsible and promiscuous,’’ said a leader of the national survey on sexuality, Michael Reece, director of the Center for Sexual Health Promotion at Indiana University. “To be at a point where adolescents are using condoms at a high rate, that’s a monumental change in how we think about sexuality.’’

It would be incorrect, though, to conclude that the majority of adolescents are having sex with abandon. In fact, the study found that not even a third of adolescents had engaged in intercourse by the time they reached 17.

Still, those findings emerge at a time when disease detectives are sounding alarms about rising diagnoses of chlamydia, among the most common sexually transmitted diseases. In Boston, for example, teen chlamydia cases climbed 70 percent from 1999 to 2008, with about 24 cases per 1,000 youths.

Further complicating the story, it’s unclear how much of that increase is actually attributable to improved testing techniques and expanded screening campaigns for a disease that often lingers silently before, in rare cases, causing infertility.

Cindy Engler, director of child and adolescent health services at Boston’s health agency, said it’s clear to her that some students may hear the admonishments to use condoms but fail to do so. What’s less clear, she said, is why. One possible reason: “When you’re talking about adolescents,’’ Engler said, “it’s a lot more challenging to negotiate with your partner about the use of a condom.’’

Walker, the Boston teen, said that while condom use appears to be standard practice among her peers, she suspects some youths shade the truth when answering surveys.

“I do know people who lie about using a condom so they won’t be embarrassed,’’ she said, “and so that people won’t look at them like they’re nasty.’’

There’s no denying this: Condom use plummets as adolescence fades into young adulthood. The national study found that 18- to 24-year-old men who engaged in casual encounters were about half as likely to use condoms as adolescent males. The authors of the study called for reinvigorated education measures emphasizing the importance of protection as youths enter adulthood — and beyond.

By the time people reach their 50s, protection practices decline even further, with both men and women who are in casual relationships reporting they use condoms far less than one-third of the time.

That should serve as a cautionary tale, said Kevin Fenton, director of the US Centers for Disease Control and Prevention branch that oversees efforts to slow sexually transmitted infections, known as STIs. “Although the majority of STIs and HIV are seen in individuals under age 40,’’ Fenton said, “increasingly we’re seeing STI and HIV among older populations.’’

Persuading the middle-aged to discuss their sexual practices — and even be tested for infections — proves daunting, said another author of the national study, Debby Herbenick.

“For many people in their 50s, 60s, 70s, and beyond, the idea of asking about STI testing may make you feel like you’ve done something wrong or you’ve been promiscuous or that people will think you picked a partner who’s been unfaithful to you — all that shame and stigma,’’ Herbenick said.

In his practice at Boston Medical Center, certified sex therapist Stanley Ducharme sees patients from 18 to 80. To his older patients, condoms are a latex method to prevent pregnancy, not stanch infectious diseases.

“Whether they’re a widower or divorced, I don’t think they see the importance or the necessity of using a condom,’’ Ducharme said. “So I think we could say young people have something to teach in terms of protecting themselves.’’

Stephen Smith can be reached at