Association for Public Policy Analysis & Management

This paper provides new evidence on how the diffusion of oral contraceptives to young unmarried women affected the spread of sexually transmitted diseases (STDs) in the United States. From 1960 to 1976, the United States experienced an unprecedented outbreak of STDs. In the same period, all states gradually expanded the access to birth control pills to young single women. Access to the pill substantially reduced the probability of unwanted pregnancy, which has been considered a major cost of sexual activity to young people. It may also have encouraged risky sexual behavior that led to STDs infections such as switching from using condoms to the pill or having multiple partners. Exploiting the variation of access to the pill across time and across states, I find that pill access raised STD incidence in the general population by 2.8 percent each year. The effects were larger on women than on men. The policy was responsible for approximately 10% of the rise of STDs in the period. To understand possible mechanisms through which the pill affected STDs, I also explore the link between the pill access and sexual and contraceptive practice among teenagers in the 1970s. My results suggest that young single women in states with more lenient laws were more sexually active and had more partners in their lives as well as in the past month.