Condom use among sexually active teenagers has declined significantly over the past decade.

A new report from the World Health Organization (WHO) suggests that 30% of teenage boys and girls in Europe, Central Asia and Canada didn't use any form of contraception, including condoms, the last time they had sex.

Hans Henri Kluge, the WHO Regional Director for Europe, said the report's findings were "dismaying, [but] not surprising."

The data suggest rates of unprotected sex are at their highest levels since 2014. That's putting young people at significant risk of sexually transmitted infections (STIs) and unintended pregnancies.

"Age-appropriate comprehensive sexuality education remains neglected in many countries, and where it is available, it has increasingly come under attack on the false premise that sex education encourages sexual behavior," Kluge said in a media statement.

The study's authors call for new reproductive health services and sex education without any so-called "gatekeeping measures" so that teenagers get unhindered access to available support.

Up to 61% of teenagers not using contraception

The study surveyed over 242,000 15-year-old teenagers in 42 countries and regions in Europe, Central Asia and Canada.

Across Europe, an average of one in five boys and one in seven girls reported having had sex.

Almost a third (30%) of those teenagers said they used no contraception at all the last time they had had sex. That figure has been constant since 2018.

There were big differences between regions, though, with teenagers from some countries engaging in more unprotected sex than others.

In Denmark, including Greenland, 61% of teenage girls and 50% of boys said they used no form of contraception the last time they had sex.

Rates of unprotected sex were also high in some eastern European countries, including Slovakia, Bulgaria and Poland, as well as in the United Kingdom and Ireland.

Swiss, Austrian, German and French teenagers used contraceptives the most, but between 12-25% of teenagers in those countries didn't use contraception. 

Concern over STIs and unwanted pregnancies

"This trend is concerning as not using a condom exposes young people to the risk of sexually transmitted infections and, especially if no other forms of contraception are used, unintended pregnancy," the study authors write.

Rises in unprotected sex have been linked with increased syphilis rates.

STIs are on the rise in Europe, with the number of reported cases significantly increasing in 2022 compared to 2021.

In a separate report published by the European Centre for Disease Prevention and Control (ECDC), cases of gonorrhea were shown to have risen by 48%, syphilis cases by 34% and chlamydia cases by 16%.

The report also found that 6% of girls and 18% of boys did not know whether their partner had used contraception during their last intercourse.

While alcohol-induced memory loss might be at play, according to the study authors, the figures indicate that many teenagers experience sexual assault, including from stealthing, when the condom is removed without consent, or unwanted or nonconsensual sex.

Call for more sex education

Some European countries, such as France and the UK, offer free and easy access to condoms for people under the age of 25.

But making condoms freely available isn't seen as the only solution. Even with free access to condoms in the UK, teenagers in Wales and Scotland continued to report high levels of unprotected sex (between 30-42% of the respondents).

Experts are therefore calling for more and better sex education. In France, President Emmanuel Macron said the country wasn't doing a good job at sex education.

"The reality is very, very far from the theory. We have to train our teachers better in this area, we have to sensitize them again," said Macron in 2022 when France's free condom scheme was launched. 

The WHO report gives credence to Macron's words and extends their relevance across Europe and Central Asia. The United Nations body calls for comprehensive sex education in schools so that teenagers can openly discuss topics around sexuality and sex health.

The study findings show the "vital importance of age-appropriate, youth-friendly sexuality education that allows young people to learn about and explore sexual feelings, relationships and behaviors," the report says.

No services should have gatekeeping measures imposed on them, such as requiring parental permission or a referral from a clinician, the report says.

Edited by: Zulfikar Abbany

Sources: 

A focus on adolescent sexual health in Europe, Central Asia and Canada Health Behaviour in School-aged Children international report from the 2021/2022 survey (World Health Organization, August 2024) https://iris.who.int/handle/10665/378547

Annual Epidemiological Reports on the state of sexually transmitted infections (STIs) in the European Union/European Economic Area (EU/EEA) (European Centre for Disease Prevention and Control, March 2024) https://www.ecdc.europa.eu/en/news-events/sti-cases-rise-across-europe