A new study by a pair of Notre Dame economists received some media attention this week. It found that school districts that instituted condom distribution programs in the early 1990s saw significant increases in the teen-fertility rate. This study fills an important gap in the existing research on contraceptive programs. There has been a considerable amount of academic research on Long Acting Reversible Contraceptives (LARCs) and oral contraceptives. However, there has been almost no academic research on high-school condom-distribution programs.
The study is very rigorous. The authors identified 22 school districts in twelve states that launched condom-distribution programs during the 1990s. Some of these school districts are among the largest in the country including New York City, Los Angeles, and San Francisco. Overall, the study analyzes teen-fertility data from 396 high-population counties over a span of 19 years. A range of demographic and economic factors are held constant. It finds that if 100 percent of high-school students attended a school with a condom-distribution program, the teen-fertility rate would increase anywhere from 10 to 12 percent. Furthermore, this finding was fairly consistent across school districts with condom-distribution programs.
The researchers were unable to determine how exactly the condom-distribution program increased teen-fertility rates. There is a possibility that these programs reduced the usage of oral contraceptives which tend to be more reliable. There is a possibility that after condom-distribution programs were instituted, there was less emphasis on programs encouraging teens to delay sexual activity. Finally, there is a possibility that condom-distribution programs resulted in more teen sexual activity. Interestingly, the study finds sexually transmitted diseases (STDs) increased in counties with condom-distribution programs. While this provides evidence that condom-distribution programs encouraged sexual risk taking — the authors warn that this finding has to be interpreted cautiously.
Thus study has received some coverage from some mainstream-media outlets such as Vox and Slate. However, their spin is that condom-distribution programs need to be coupled with either counseling programs or sex-education curricula in order to be effective. The study does find that counseling programs result in reductions in the teen-fertility rate. However, most of the regressions find these reductions fail to offset the increase in teen fertility associated with the condom-distribution program.
Overall, the study adds to an impressive body of research which shows that efforts to encourage contraceptive use either through mandates, subsidies, or distribution are ineffective at best or counterproductive at worst. In many countries, increases in contraception use are correlated with increase in the abortion rate. Additionally, this study is very similar to a recent University of Michigan study which showed that increases in the price of oral contraceptives on college campuses resulted in less sexual activity among college-age women. Unfortunately, such research typically receives scant attention from the mainstream media.