Individual, familial, friends-related and contextual predictors of early sexual intercourse

Sexual health knowledge acquisition processes among very young adolescent girls in rural Malawi: Implications for sexual and reproductive health programs

Early adolescence is a period characterized by enormous biological, cognitive, sexual, emotional, and social changes. Sexual curiosity and the desire to acquire sexual health (SH) information are part of these developments. Understanding the SH knowledge acquisition process is critical for designing interventions that can best support very young adolescents (VYAs). This study explored the SH knowledge acquisition processes among VYA girls aged 10 to 14 years who attended the DREAMs Girl Only Clubs (GOCs) and those who did not. The GOCs were a part of a larger comprehensive HIV prevention project called DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe) which provided an evidence-based core package of interventions to VYAs to prevent HIV. In-depth interviews were conducted with 43 VYA girls aged 10-14 years in two rural southern districts of Zomba and Machinga in Malawi. Twenty-three VYA girls were GOC participants and 20 VYAs were not. Guided by the Social Ecological Model, a thematic analysis approach was used to analyze the data with the assistance of Nvivo 12 software. The SH knowledge acquisition processes were the interaction of various factors at the microsystem (self-efficacy, attitudes, trust and the beginning of menstruation), mesosystem (communication of SH issues between VYAs and their immediate family and peers), and exosystem levels (availability of life skills programs and mother-groups in schools and availability of GOCs). Compared to Non-GOC participants, GOC participants demonstrated an in-depth knowledge of SH issues and positive sexual behaviors such as HIV testing. Limitations to SH knowledge acquisition were adult messages' focus on sexual relationship avoidance and on girls who have started menstruation; the perception of adults not being knowledgeable about SH and school teachers hiding some SH information. VYAs' SH interventions that provide VYAs with accurate, consistent, and age-appropriate SH information such as the GOCs have the potential to address the limitations that other sources have in reaching VYAs. Integrating such interventions with programs that empower parents, other adults, and teachers with comprehensive SH information and with skills on how to deliver SH information to VYAs can enhance VYAs' SH knowledge acquisition and influence positive behavior change.

Motivations, Behaviors and Expectancies of Sexting: The Role of Defensive Strategies and Social Media Addiction in a Sample of Adolescents

Adolescents and young adults engage in sexting behaviors. Research has mainly emphasized the relationship between motivations and sexting behaviors, with little attention paid to sexting expectations and the potential role of coping strategies. This study aims to explore the measure of emotional-behavioral functioning with the Youth/Adult Self Report (based on the subject's age), the use of defensive strategies measured with the Response Evaluation Measure (REM-71), social media addiction with the Bergen Social Media Addiction Scale (BSMAS) and all dimensions of sexting: motivations, behavior and expectations measured with the Sexting Motivation Questionnaire (SMQ), Sexting Behavior Questionnaire (SBQ) and Sexpectancies Questionnaire (SQ), respectively. N = 209 adolescents and young adults were recruited from high schools and universities in Rome to complete the self-report questionnaires. Results show that males tend to have higher expectations of sexting than females. We also found that expectations play a role in determining sexting behaviors and motivations. Our hypotheses on social media addiction and sexting were confirmed, while the relationship between the defensive strategies and sexting was not significant as expected. Further studies on this topic are desirable in the future.

The relation of perceived social support to compulsive sexual behavior

We conducted two studies to investigate the links between perceived social support, problematic pornography use (PPU) and compulsive sexual behavior disorder (CSBD). In Study 1 (n=807, convenience sample recruited via social media) we collected preliminary data and in Study 2 (n=1526) we checked whether the results replicate in a sample representative of the Polish adult population. In both studies participants completed the Brief Pornography Screen, Compulsive Sexual Behavior Disorder Scale and Multidimensional Scale of Perceived Social Support. In Study 1 and 2, general social support was a weak protective factor against CSBD (β = -0.15 and β = -0.10) and PPU (β = -0.12 and β = -0.09 respectively, all p values ≤ .001) adjusting for gender, age, sexual orientation and relationship status. The results for three domains of social support (from friends, significant other and family), however, largely differed between the two studies. In Study 1, perceived friends' support weakly protected against PPU and CSBD symptoms. In Study 2 higher support from friends weakly predicted lower CSBD symptoms among men; and stronger family support predicted lower PPU. Support from a significant other was weakly related to lower CSBD for women in Study 1. The conducted studies provided evidence that perceived social support is a protective factor against problematic sexual behavior; however, its predictive power is limited and further studies are needed to assess the importance of various domains of social support in the development of CSBD and PPU symptoms.

Mapping HIV risk trajectories from adolescence to young adulthood: a life-course study among unmarried urban Indian youth

The study explores trajectories of HIV risks from adolescence to adulthood among unmarried, educated (12+ years of formal education), 20-29 year old youth. Retrospective time event data (n=517) was used to build HIV risk trajectories (age 10 onwards), employing group-based trajectory technique and multinomial logistic regression in SAS v9.4. Among men (n=271), 10% had "Declining risk - high to low", and 15% had "consistent high risk". Among women (n=246), 11% had "late-rising risk", and 15% had "consistent high risk". Among women, childhood experience of sexual abuse, having self-income, father education until 12th standard, frequent alcohol use predicted higher risk trajectories. Among men, it was an early sexual debut, alcohol dependency in parent/s, non-heterosexual orientation, early sexual debut, and frequent alcohol use. The HIV risk behaviors of unmarried Indian youth are diverse. A subsection engages in high-risk behaviors that change over time and have linkages to developmental factors.

Life expectations in early adolescence and the timing of first sex and marriage: evidence from a longitudinal survey in Ethiopia

BACKGROUND

Raising the median age at first sexual intercourse and first marriage among females is a policy goal of the Ethiopian government. Education figures prominently in the government's plans for achieving its goals, including primary and secondary schools; higher education; and out-of-school interventions such as youth centers, peer clubs, and youth associations In this study, we tested whether adolescents and youth who had high educational and occupational expectations at younger ages were at a lower risk of first sexual intercourse and marriage during adolescence and early adulthood.

METHODS

Data came from multiple waves of a longitudinal survey of households and adolescents conducted in southwestern Ethiopia. A measure of career expectations was created from educational and occupational expectations measured at baseline when the adolescents were ages 13-17. The occurrence and timing of first sexual intercourse (called first sex) and marriage were measured four years later in a wave 3 survey. Discrete-time logistic hazard regression models were applied to a person-year file to predict first sex for males and females separately and first marriage for females.

RESULTS

Male and female adolescents who had high career expectations at young ages were at a significantly lower risk of first sex during adolescence and early adulthood. Unlike the delaying effect of being in school, the effect of high career expectations did not wear off as adolescents aged. Among female adolescents, delaying first sex, staying in school, and having parents who desired them to marry at older ages were all associated with a significantly lower risk of marriage during adolescence and early adulthood.

CONCLUSIONS

The educational and occupational expectations and family plans that youth develop early in adolescence influence the timing of the transition into sexual activity and marriage. Ethiopian youth who develop high career expectations delay first sex, which for female youth is a key predictor of age at first marriage. Adolescents' perceptions of parents' expectations for them are strongly associated with their own expectations and behavior.

Is Adolescent Risk Behavior Associated With Cross-Household Family Complexity? An Analysis of Post-separation Families in 42 Countries

We examine whether complex cross-household structures of post-separation families are associated with higher risk-taking behavior in adolescence (substance use, bullying, early sexual onset) and whether the proportion, and thus statistical normality, of complex family types in a certain country is a potential moderator of this association. Drawing on representative data from 42 countries and regions from the Health Behavior in School-aged Children (HBSC) study in 2001, 2006, and 2010 (N = 506,977), we provide detailed analyses on adolescent risk behavior even for very rare family types, thereby accounting for the complex cross-household structure present in many post-separation families. We combine logistic and count regression models to analyze risk incidence and intensity. Controlling for relevant child and family characteristics, our results reveal a gradient along which adolescent risk-taking increases with family complexity: The incidence and intensity of risk-taking among adolescents is lowest in two-biological-parent and highest in two-household families with stepparents in both households. The association decreases with a higher proportion of the respective family type in a country. However, the differences between family types, other than the two-biological parent family, are not as pronounced as expected.

Opportunity and the sexual abuse of adolescents

OBJECTIVES

The risk of sexual abuse victimization was examined from a routine activity perspective. For comparison, predictors of sexual encounters with same-age peers were also examined.

METHODS

Analyses were based on a nationally representative sample of 24,823 Finnish youth who responded to questions about their sexual encounters with peers and with someone outside their family who was at least five years older.

RESULTS

Adolescents who had older friends and parents who did not monitor their social relationships were at greater risk of sexual abuse and peer encounters. In addition, delinquent youth had a higher risk of abuse than non-delinquents, controlling for exposure. Delinquent youth were also more likely to have favorable attitudes toward the abuse, to initiate the sexual encounter, and to experience repeat victimizations. Physical attractiveness, but not sexual maturity, was related to abuse.

CONCLUSIONS

Risk of sexual abuse is positively related to exposure to older people, susceptibility to deviant influence, and the target's value to the offender. A full understanding of risk factors requires a consideration of the victims' characteristics and their compliant behavior.

Association Between Timing of Sexual Initiation and Suicidal Ideation Among Adolescents in South Korea: A Cross-Sectional Study

BACKGROUND

The age of adolescents' sexual initiation is decreasing worldwide. Early sexual initiation has been reported to affect social, physical, and mental health, but little is known about the relationship between the timing of sexual initiation and suicidal ideation.

PURPOSE

This study was designed to identify the association between the timing of sexual initiation and suicidal ideation by gender.

METHODS

This cross-sectional study used data from South Korea's Youth Health Behavior Online Survey for 2016. Data on first- to 12th-grade students (N = 10,810) were analyzed using descriptive statistics, χ2 tests, and hierarchical logistic regression.

RESULTS

The results revealed a significant relationship between early sexual initiation and suicidal ideation among both boys and girls. This relationship remained significant after controlling for confounding variables that are known to affect suicidal ideation, including perceived stress, hopelessness, school grades, and sociodemographic characteristics. The risk of suicidal ideation was higher among students who first experienced sex in earlier grades (before the ninth grade) and was also higher in girls than in boys.

CONCLUSIONS/IMPLICATIONS FOR PRACTICE

Health providers should be aware of the potentially higher risk of suicidal behavior among adolescents after early sexual initiation. Given the extreme sensitivity and vulnerability of this target population, a multidisciplinary school- or community-based intervention program to promote the mental health of affected individuals and the general student population is warranted.

A Longitudinal Investigation of Observed Adolescent Text-Based Sexting and Adjustment

Despite strong concerns that sexting poses risks for adolescents' well-being, previous research finds mixed results. Moreover, these studies rely heavily on self-report measures and cross-sectional designs. This study utilizes observational methods to examine longitudinal relations between text-based sexting and both negative and positive indicators of psychosocial adjustment. An ethnically diverse sample of 197 adolescents was provided smartphones that captured their text messages across high school, from 2008-2012. Two, two-day samples of text messages from grades 9-12 were content-coded (468,201 total observations). Sexting was defined as sending and receiving text-based statements about past, present, or hypothetical sexual behaviors occurring between dyadic texting partners. Each year, adolescents reported on negative (internalizing, externalizing, and social problems; borderline personality features) and positive (life satisfaction, group belongingness, and positive self-perceptions) indicators of their psychosocial adjustment. Using concurrent and longitudinal multilevel models, greater sexting at one time point than one's average (within-person) was only associated with lower levels of group belongingness within the same year. For girls only, text-based sexting more than others on average (between-person) was related to increased externalizing symptoms and borderline personality disorder features, as well as decreased life satisfaction, group belongingness, self-perceived social competence, and global self-worth. No within-person differences by gender emerged, nor did longitudinal associations. Future studies and intervention efforts should examine when and why higher sexting might be related to psychosocial problems among girls.

Girl-only clubs' influence on SRH knowledge, HIV risk reduction, and negative SRH outcomes among very young adolescent girls in rural Malawi

BACKGROUND

Early adolescence is an important period to lay the foundation for positive sexual health development that can overcome sexual and reproductive health (SRH) challenges faced by very young adolescents (VYAs) as they reach puberty and sexual debut. In this study, we explored the following questions: first, what are the experiences of VYA girls on DREAMS' Go Girl club participation? Second, how does club participation influence the VYAs SRH knowledge to reduce their risk for HIV and negative sexual health outcomes?

METHODS

This was a qualitative study in which twenty-three in-depth interviews were conducted with VYA girls aged 12-14 years. These girls were enrolled in girl-only clubs in two rural southern districts in Malawi. The clubs were a part of larger comprehensive HIV prevention project called DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe) which provided an evidence-based core package of interventions to VYAs to prevent HIV. Interventions included improved access to key health services, education support, social skills, asset building, and economic strengthening. Narrative inquiry was used to generate first-hand accounts of the girls' experiences with club participation. Thematic analysis was used to generate themes from the transcribed stories.

RESULTS

Six main themes were generated: 1) reasons for joining the clubs with desire to learn about SRH as a motivation for joining the clubs.; 2) influence on gender norms and roles whereby participants described a change of gender roles and norms at home; 3) influence on child abuse practices whereby participants reported a decline in child abusive practices at home;4) influence on life skills and social networks whereby participants described learning about networking; 5) support to go back to school whereby out-of-school girls described how economic empowerment of their guardians facilitated their return to school; and 6) influence of clubs on SRH knowledge acquisition and behaviours whereby participants described acquiring knowledge on sexual health issues.

CONCLUSION

Girls-only HIV and SRH programs coupled with economic empowerment for their families can be effective in keeping VYA girls in school and improving SRH knowledge and health seeking behavior.

Attitudes, knowledge and sexual behavior among Finnish adolescents before and after an intervention

Adolescents are an important target group for sexual health promotion, and there are numerous programs and interventions carried out in this field. The aim of this study is to describe adolescents' attitudes, knowledge and sexual behavior before and after a sexual health promotion intervention. The intervention was developed in the study and consisted of three elements: (i) class-room session, (ii) information materials and (iii) free condom distribution. The study was carried out in eight randomly selected vocational schools in Finland. The participants were first year students aged 15-19 years. The data were collected using an electronic questionnaire before intervention (intervention baseline n = 500, control baseline n = 183) and two times after the intervention (intervention first follow-up n = 173/second follow-up n = 202, control first follow-up n = 115/second follow-up n = 46). There were significant differences before and after the intervention concerning better knowledge and more frequent testing for sexually transmitted infections (STIs). Schools are an important environment to reach adolescents during the phase where their sexual health is developing and there is an increased risk of STI transmission. More school-based interventions are therefore needed, and the results of this study can be utilized when developing sexual health promotion interventions among adolescents.

Why Do Socially Withdrawn Children Tend to Become Heterosexually Active Later than Their Peers? A Mediation Model

Socially withdrawn children are more likely to be heterosexually inactive in early adulthood. This study aimed to test a three-mediator model. We hypothesized that social withdrawal during childhood would hinder a sense of social competence in early adolescence, limiting other-gender friendships in mid-adolescence, in turn limiting involvement in romantic relationships in late adolescence, and thus favoring a later transition into sexual activity. This mediation model was tested on a sample of 332 participants assessed annually between the ages of 12 and 22. Structural equation modeling revealed a significant indirect effect of social withdrawal on late transition into heterosexual activity through the three tested mediators. The direct effect of social withdrawal on late transition into heterosexual activity was also significant, suggesting a partial mediation.

Early Life Exposures and Risky Sexual Behaviors among Adolescents: A Cross-sectional Study in Ghana

BACKGROUND

Risky sexual behaviors (RSBs) are behaviors that could result in unwanted pregnancies and sexually transmitted infections. These behaviors are often initiated during adolescence, and the frequency of engagement in such behaviors rises with increasing age during the teenage years. It has been asserted that exposures to sexual materials early in life could lead to early sex debut among adolescents.

OBJECTIVE

The objective of this study was to determine the early life exposures contributing to RSBs among basic school pupils in the Twifo Praso District of Ghana.

MATERIALS AND METHODS

A descriptive cross-sectional study was conducted using a structured questionnaire. Three hundred and sixty basic school pupils were selected by simple random sampling technique. Data were analyzed using SPSS version 20.

RESULTS

The study found that 64.4% of the respondents have had sexual intercourse at a mean age of 13.7 years. Respondents from polygamous homes were more likely to engage in earlier sexual debut than those from monogamous home (r = 0.0343, P = 0.003). Furthermore, having a high number of friends who have had sex was associated with an early sexual debut (r = 0.720, P = 0.000).

CONCLUSION

Adolescents are initiating sexual intercourse very early in life and this calls for customized reproductive health promotion activities aimed at minimizing risky sexual behaviors. Further studies on how parent-child sexual communication could delay sexual debut are recommended.

Mental health problems in adolescence, first births, and union formation: Evidence from the Young HUNT Study

While a large literature documents how mental health problems in adolescence have long-term consequences for adult socioeconomic outcomes, less is known about the relation with family-formation behavior. In this paper, we use data from a population based Norwegian health survey (the Young-HUNT study) linked to administrative registry data (N = 8,113) to examine the long-term consequences of symptoms of internalizing and externalizing problems, the two most common forms of mental health problems, on family-formation outcomes: the likelihood of a first birth, the union status of a first birth, and entering first marriage. For men, externalizing problems are associated with earlier parenthood, especially becoming a father without having a coresidential relationship with the child's mother. Internalizing problems, on the other hand, are associated with lower first-birth rates and the association grows progressively stronger with age. We also find that the associations are more pronounced among men with low childhood socioeconomic status. In contrast, women's family-formation appears for the most part unrelated to their mental health.

The Association Between African American Parent-Child Sex Communication and Adolescent Condomless Sex

African American adolescents are at elevated risk for HIV and sexually transmitted infections. Risk reduction efforts have focused on parent-child communications, despite inconsistent findings regarding their association with adolescent sexual risk behaviors. The present study included sexually active African American adolescents and their parents/guardians (N = 125 dyads). All participants reported on frequency of sexual health conversations and adolescents reported recent occasions of protected and condomless sex. Analyses examined the congruence between parent-child communication reports and the association between this congruence and adolescent condomless sex. Parents and adolescents disagreed on the frequency of sexual health communication: 30% of parents reported such conversations as frequent, whereas only 2% of adolescents did. Parent-reported sex communication was negatively associated with adolescent condomless sex, while adolescent-reported communication was not. The moderation hypothesis was supported in that adolescent-reported sex communication was negatively associated with adolescent condomless sex only among parent-child dyads high in agreement on sexual health communication. Promoting parent-child conversations regarding sexual health, with attention to relational characteristics of the conversations, offers a promising approach to sexual health promotion and disease prevention for African American youth.

Interaction Between Smoking Cigarettes and Alcohol Consumption on Sexual Experience in High School Students

Objectives

This study aimed to analyze nationwide representative data from the 11^th Korean Youth Health Risk Behavior Web-Based Survey to determine whether factors including socio-demographics, smoking and alcohol consumption, were factors related to high school students that had experienced sexual intercourse.

Methods

A total of 33,744 students (17,346 boys and 16,398 girls) in 1^st, 2^nd, and 3^rd grade at high school were analyzed. SPSS complex samples methods were used for analyses. Socio-demographic and health risk behaviors (type of region of residence, family structure, and economic status, student academic achievement, gender, high school grade, pocket money, student smoking, alcohol consumption, and having engaged in sexual intercourse) were considered as independent variables.

Results

There were 3.6% of girls and 9.9% of boys in high school that were sexually active. This behavior and the average number of cigarettes smoked daily, and alcohol consumed weekly, represented a dose-response relationship, after considering confounding factors. Compared with students that did not smoke or consume alcohol, smoking 1–9 cigarettes per day and consuming 1–6 cups of alcohol and group “smoking more than 10 cigarettes per day and consuming more than 7 cups of alcohol, had a 5.94 and 22.25 higher risk of having had sexual intercourse, respectively.

Conclusion

Cigarette smoking and alcohol consumption were associated with an increased likelihood of high school students engaging in sexual intercourse.

Social Misfit or Normal Development? Students Who Do Not Date

OBJECTIVE

Prior research identified 4 distinct dating trajectories from 6th to 12th grade: Low, Increasing, High Middle School, and Frequent. The purpose of this study was to examine whether 10th graders in the Low dating group differed on emotional, interpersonal, and adaptive skills from youth in the other trajectories.

METHODS

The sample consisted of 594 10th graders. We compared the 4 dating groups using teacher ratings (social skills, leadership, depression) and student self-reports (positive relationships with friends, at home, and at school; depression, suicidal ideation). To compare scores by dating trajectory, we used chi-square test and analysis of variance.

RESULTS

Students in the Low dating group had significantly higher teacher ratings of social skills and leadership, and lower ratings of depression compared to the other groups. Self-reports of positive relationships did not differ by dating groups. Self-reported depression was significantly lower in the Low dating group, but suicidal ideations did not differ.

CONCLUSION

Adolescents who were not in a romantic relationship had good social skills and low depression, and fared better or equal to peers who dated. These results refute the notion that non-daters are maladjusted. Health promotion interventions in schools should include non-dating as one option of healthy development.

“You’re a virgin? Really!?”: A qualitative study of emerging adult female virgins’ experiences of disclosure

Recent research has highlighted that off-time sexual transitions such as maintaining virginity into adulthood are often experienced as a stigma. Based on stigma and identity theories, adult virginity is conceptualized as a concealable and stigmatized identity. The literature on concealable stigmatized identities emphasizes the significance of their disclosure and the personal and interpersonal consequences of their concealment. Little is known about the subjective experience of adult virginity as an identity and about adult virgins’ experiences of disclosing this identity to others. The present study explored personal and social experiences of adult virginity (i.e., perceptions, motives, identity) and its disclosure (i.e., confidants’ reactions and their impact) through in-depth semi-structured interviews with 11 heterosexual women aged 24–29 who identified as virgins and had never engaged in penile-vaginal intercourse. Data was analysed using directed content analysis and two main conceptual categories were identified: a) Framing virginity: Making sense of not having sex, and b) Disclosure and concealment: Managing virginity stigma. Participants perceived the meaning of their virginity as likely to endure despite its anticipated temporary nature and described the risk of losing a relationship opportunity as present whether they disclosed or concealed their virginity. The results of this study highlight the need to challenge virginity stigma by increasing awareness and the visibility of adult virginity as an identity. Implications for sexuality educators, clinicians and researchers are discussed and focus on interventions that frame adult virginity as a form of sexual diversity.

Sexual Minority Youth at Risk of Early and Persistent Alcohol, Tobacco, and Marijuana Use

The current study sought to examine substance use disparities among sexual minority youth. The current subsample of 348,175 students participated in the Youth Risk Behavior Surveillance System (YRBSS) study from years 2005 to 2015 (biennially) in jurisdictions that asked at least one question about sexual minority status. Latent class analysis was used to identify implicit classes of sexual minority youth, based on respondents' sexual identity and sexual behavior. Sex-stratified regression models were run to determine the association between class membership and age of onset and persistent use of alcohol, tobacco, and marijuana. Findings showed that sexual minority female subgroups were primarily distinguished by sexual identity (e.g., "lesbian," "bisexual"), whereas sexual minority male subgroups were primarily distinguished by sexual behavior. Female lesbian and bisexual youth were at risk of initiating substance use at younger ages and, among lifetime users, were more likely to persist in their tobacco and marijuana use over time, relative to sexually active female heterosexual youth. Among lifetime users, male youth with partners of both sexes were at greater risk of persistent use of alcohol, tobacco, and marijuana over time and earlier ages of first use. Recommendations for intervention and prevention programs geared toward reducing sexual minority youth substance use are provided.

The Influence of Parent and Parent-Adolescent Relationship Characteristics on Sexual Trajectories into Adulthood

To examine sexual partner acquisition into young adulthood and to explore what characteristics of the adolescent family context might predict this change, we used growth curve modeling to examine data from a nationally representative sample of adolescents followed longitudinally over 13 years through young adulthood (N = 5385). Growth curve modeling allowed us to treat the outcome as a dynamic variable and to examine 10 potential predictors of change while accounting for the nested nature of the data. Six family characteristics emerged as predictors of mean number of partners and rate of partner acquisition, while accounting for three significant adolescent predictors. Living in a single-parent or blended family and general communication about sex predicted higher lifetime number of sexual partners in young adulthood. Parent religiosity, parent disapproval of adolescent engagement in sex, and parent-adolescent connectedness were predictive of lower lifetime number of sexual partners. By following participants into their late twenties and early thirties, we were able to detect changes in the impact of early family factors that are not apparent in studies restricted to adolescents and emerging adults. For example, parent education, parent disapproval, and parent-adolescent connectedness were associated with higher rates of partner acquisition at age 23, but faster deceleration in partner acquisition as time progressed. Communication about negative consequences of sex was not predictive, regardless of whether it was "on time" (before sexual intercourse) or not. These results reveal that parents have significant, and sometimes unexpected, influence on their children's sexual behavior that persists well into adulthood.

Associations between Parental Psychopathology and Sexual Behavior in an Outpatient Psychiatric Sample

Early age of sexual debut is associated with an increase in negative outcomes, including higher incidence of nonconsensual sexual experiences, higher rates of sexually transmitted infections, and risky sexual practices. Little research has examined the role of parental psychopathology as a predictor of adolescent sexual activity, however. The current study aims to close this gap by examining the relationship between parental psychopathology and sexual activity in a longitudinal sample of youth. Participants were 685 adolescents from the Longitudinal Assessment of Manic Symptoms study, the majority of whom were male (67%) and White (65%). Analyses considering likelihood of sexual initiation included the full sample, whereas analyses considering predictors of the age of sexual debut included the 162 participants who reported ever having sexual intercourse (62% male, 51% White) via the Youth Risk Behavior Surveillance-High School version. Cox regression analyses suggested that maternal generalized anxiety disorder predicted decreased likelihood of initiating sex during the 8-year follow-up period, whereas paternal conduct disorder predicted increased likelihood of initiating sex. Multivariate linear regressions also showed that maternal conduct disorder predicted earlier age of sexual debut among those who had initiated, whereas paternal antisocial personality disorder predicted later age of sexual debut. These associations were observed in both male and female adolescents. Furthermore, these effects were largely not explained by the established relationship between youth psychopathology and sexual behavior. Results have implications for interventions aimed at decreasing sexual risk taking in vulnerable youth.

Factors associated with early sexual intercourse among teenagers and young adults in rural south of Benin

Early initiation to sexual intercourse increases the risk of sexually transmitted infections including HIV/AIDS and early or unwanted pregnancies. This study aimed identifying the factors associated with the early initiation to sexual intercourse among teenagers and young adults aged 10-24, in the south of Benin. A cross-sectional study was conducted in the south of Benin where 360 respondents were selected by random cluster sampling. Multiple logistic regressions was used to find related factors to early sexual intercourse. The significance level for the tests was of 5%. The average reported age of initiation to sexual intercourse was 14.75±2.18. Among the male teenagers and young adults, 41.11% had an early sexual intercourse against 20.24% for the female gender (P<10-3). The lack of communication between parents-teenagers (P=0.003), level of education of the father (P=0.021), exposure to pornographic movies (P=0.025), an adverse opinion on premarital sexual abstinence (P=0.026) were significantly associated with early sexual intercourse. Communication about health promotion for behavioural change may contribute to delay the age of sexual initiation.

Observed Normativity and Deviance in Friendship Dyads' Conversations About Sex and the Relations With Youths' Perceived Sexual Peer Norms

The current study examined the relations between observed normativity and deviance during adolescents' and young adults' conversations about sex with their friends and their individual perceptions of sexual peer norms. Participants were 16-21-year-old same-sex friendship dyads (31 male and 30 female dyads) who performed a peer interaction task that consisted of five discussion assignments focusing on party planning, sexual double standards, condom use, homosexuality, and consensual sex. Videotaped discussions were coded to capture the amounts of normative talk (e.g., consistent with notions of healthy sexuality) and deviant talk (e.g., consistent with notions of risky sexuality), and the verbal or nonverbal reinforcement thereof. Participants also completed individual questionnaires to assess their perceived sexual descriptive norms, injunctive norms, pressure, and risk norms among their peers. Actor-partner interdependence model (APIM) results revealed that youths' perceived descriptive, injunctive, and risk norms, but not their experienced peer pressure, were related to both their own (actor effects) and their friends' (partner effects) normativity and deviance. Overall, more deviance was related to perceiving friends to be more sexually active, more approving of having sex, and engaging in more risky sex, whereas more normativity was related to these perceptions in the opposite direction. Gender differences in the APIMs indicated that interactive normativity and deviance was related to perceived descriptive, injunctive, and risk norms for boys, but only to perceived injunctive norms for girls. These findings demonstrate the importance of assessing the dyadic nature of youths' sexual communication with friends, their relation to individual sexual peer norm perceptions, and gender differences therein.

Mother- and Father-Adolescent Relationships and Early Sexual Intercourse

OBJECTIVES

To assess the prospective associations between mother-adolescent and father-adolescent relationship quality and early sexual intercourse initiation (ie, ≤16 years) among a large sample of Dutch adolescents.

METHODS

Two waves of data from the Rotterdam Youth Monitor, a longitudinal study in the Netherlands, were used. The analysis sample consisted of 2931 adolescents aged 12 to 16 years (Mean_age@T1 = 12.5 years, SD = 0.61; Mean_age@T2 = 14.3 years, SD = 0.60). Variables were assessed by means of self-report questionnaires. Prospective associations between mother-adolescent and father-adolescent relationships and early sexual initiation were assessed by logistic regression analyses, stratified by gender, controlling for various potential confounders.

RESULTS

We found that only girls (not boys) having a higher-quality relationship with mothers were significantly less likely to have initiated early sexual intercourse between T1 and T2. Bivariate findings showed that both girls and boys having a higher-quality relationship with their father at T1 were significantly less likely to have engaged in early sexual intercourse between T1 and T2, but when assessed multivariately, these associations were no longer significant, neither for boys nor for girls.

CONCLUSIONS

Our findings suggest that a higher-quality relationship between adolescents and their parents, especially between mothers and daughters, may help to protect against early sexual initiation. Pediatricians and other health care professionals should be able to explain to parents that early sexual intercourse initiation can be associated with negative health outcomes, but that parents can play an important role in promoting healthy sexual behaviors.

Who Delays Childbearing? The Associations Between Time to First Birth, Personality Traits and Education

Using data from a large-scale survey, the British Household Panel Survey, this paper assesses the influence of personality traits on the timing of first childbirth and investigates whether, and in what way, personality traits explain the differences in maternity timing across educational groups. We estimate a log-logistic model of the time to first childbirth and show that there is a statistically significant relationship between the Big Five personality traits and the timing of motherhood. The results also show that highly qualified women who are 'open-minded' have the lowest hazards of childbirth, lower than similar less educated counterparts.

Trajectories of Annual Number of Sexual Partners from Adolescence to Emerging Adulthood: Individual and Family Predictors

Adolescent sexual development is not the same across the board, and can be seen as both normative as well as risky behavior, depending on factors such as age of onset and number of partners. This longitudinal study identified developmental trajectories of annual number of sexual partners from adolescence to emerging adulthood and their antecedents. From the ages of 16-22, 332 participants (60.8 % females) annually reported their number of sexual partners. Measures of adolescent and family characteristics taken at ages 13-15 were used as predictors. Group-based modeling identified four trajectory groups: the abstainers group (9.1 %), low-increasing group (30.6 %), medium-increasing group (53.0 %), and multiple-partners group (7.3 %). Multinomial logistical regressions indicated that better social competence increased chances of belonging to the multiple-partners group as compared to the abstainers and low-increasing groups, and more substance use predicted membership in the multiple-partners group as compared to the abstainers group. Moreover, females were overrepresented in the low-increasing and medium-increasing groups. These results imply a greater diversity in sexual development than proposed in the literature and highlight the importance of identifying the strengths and competencies associated with healthy sexual development along with the early risk factors.

Community social capital on the timing of sexual debut and teen birth in Nicaragua: a multilevel approach

Background

Community attributes have been gradually recognized as critical determinants shaping sexual behaviors in young population; nevertheless, most of the published studies were conducted in high income countries. The study aims to examine the association between community social capital with the time to sexual onset and to first birth in Central America.

Methods

Building upon the 2011/12 Demographic and Health Survey conducted in Nicaragua, we identified a sample of 2766 community-dwelling female adolescents aged 15 to 19 years. Multilevel survival analyses were performed to estimate the risks linked with three domains of community social capital (i.e., norms, resource and social network).

Results

Higher prevalence of female sexual debut (norms) and higher proportion of secondary school or higher education (resource) in the community are associated with an earlier age of sexual debut by 47 % (p < 0.05) and 16 %, respectively (p < 0.001). Living in a community with a high proportion of females having a child increases the hazard of teen birth (p < 0.001) and resource is negatively associated with teen childbearing (p < 0.05). Residential stability and community religious composition (social network) were not linked with teen-onset sex and birth.

Conclusions

The norm and resource aspects of social capital appeared differentially associated with adolescent sexual and reproductive behaviors. Interventions aiming to tackle unfavorable sexual and reproductive outcomes in young people should be devised and implemented with integration of social process.

Early Sexual Intercourse: Prospective Associations with Adolescents Physical Activity and Screen Time

Objectives

To assess the prospective associations of physical activity behaviors and screen time with early sexual intercourse initiation (i.e., before 15 years) in a large sample of adolescents.

Methods

We used two waves of data from the Rotterdam Youth Monitor, a longitudinal study conducted in the Netherlands. The analysis sample consisted of 2,141 adolescents aged 12 to 14 years (mean age at baseline = 12.2 years, SD = 0.43). Physical activity (e.g., sports outside school), screen time (e.g., computer use), and early sexual intercourse initiation were assessed by means of self-report questionnaires. Logistic regression models were tested to assess the associations of physical activity behaviors and screen time (separately and simultaneously) with early sexual intercourse initiation, controlling for confounders (i.e., socio-demographics and substance use). Interaction effects with gender were tested to assess whether these associations differed significantly between boys and girls.

Results

The only physical activity behavior that was a significant predictor of early sexual intercourse initiation was sports club membership. Adolescent boys and girls who were members of a sports club) were more likely to have had early sex (OR = 2.17; 95% CI = 1.33, 3.56. Significant gender interaction effects indicated that boys who watched TV ≥2 hours/day (OR = 2.00; 95% CI = 1.08, 3.68) and girls who used the computer ≥2 hours/day (OR = 3.92; 95% CI = 1.76, 8.69) were also significantly more likely to have engaged in early sex.

Conclusion

These findings have implications for professionals in general pediatric healthcare, sexual health educators, policy makers, and parents, who should be aware of these possible prospective links between sports club membership, TV watching (for boys), and computer use (for girls), and early sexual intercourse initiation. However, continued research on determinants of adolescents’ early sexual initiation is needed to further contribute to the strategies for improving adolescents’ healthy sexual development and behaviors.

Recalled Explanations for Adolescent Girls' Engagement in Age-Discordant Sexual Relationships

Age-discordant sexual relationships are associated with negative sexual health outcomes for adolescent females. We were particularly interested in females' motivations for engaging in these relationships, and in contextual factors that increase receptivity to age-discordant relationships in the United States (U.S.). However, recent research addressing this topic in the U.S. has been sparse. To address this gap in the literature, we recruited 15 women (Mdn age = 26 years; 93 % African American) from an urban, publicly funded sexually transmitted disease clinic to qualitative interviews. Reasons given by women for their involvement in age-discordant sexual relationships as adolescents included: (a) desire for an actively engaged father figure, (b) to obtain material support, (c) to escape from a troubled home life, and (d) to express independence and maturity. Thus, familial, economic, and developmental factors motivate socioeconomically disadvantaged adolescent females to enter into age-discordant sexual relationships. Efforts to reduce females' participation in these relationships will need to address socioeconomic vulnerability and family relationships.

Intimate partner violence, sexual assault, and reproductive health among university women

Relationships between victimization, termination of pregnancy (ToP), diagnosis of sexually transmitted infection (STI), and emergency contraceptive use were examined using data from a survey of university students in Montreal, Canada. Female students who had been sexually active in the past two years with at least one male partner were included (n=1,812). Victimization experiences were assessed, and logistic regressions were performed to predict the correlates of lifetime use of emergency contraception, ToP, and ever having been diagnosed with an STI. In this sample, 36.1% reported intimate partner violence (IPV), 8.5% reported sexual assault (SA) and 18.9% reported both SA and IPV. Factors statistically associated with emergency contraceptive use, ToP and STI diagnosis were older age, financial hardship, migratory trajectory, early sexual initiation, and dual victimization. These data indicate that the reproductive health needs of female university students experiencing victimization are unmet. Interventions should focus on victimization screening and enhancing reproductive autonomy.

Sexuality (and Lack Thereof) in Adolescence and Early Adulthood: A Review of the Literature

Youth sexuality has been primarily studied with a focus on its potential public health issues, such as sexually transmitted infections and unwanted pregnancies, and its comorbidity with other risky behaviors. More recently, it has been studied as a normative step in romantic partnerships, either pre- or post-marital, as well as outside the context of romantic involvement. In this paper, we review the extensive literature on sexuality in adolescence and early adulthood both within and outside romantic relationships (i.e., casual sexual relationships and experiences; CSREs). Furthermore, the recent recognition of youth sexuality as a developmental task has led to a renewed interest from scholars in youth who abstain from sexual encounters, whether deliberately or not. A brief overview of the literature on cultural differences in sexuality, and sexual-minority youth sexual development is also provided. This paper concludes by suggesting future directions to bring the field of youth sexuality and romantic relationships forward.

A Six-Year Longitudinal Study of Consumption of Pornographic Materials in Chinese Adolescents in Hong Kong

STUDY OBJECTIVE

Using longitudinal data collected over 6 years, consumption of pornographic materials in adolescents in Hong Kong and the related demographic and psychosocial correlates were examined in this study. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: A longitudinal research design with 6 waves of data was used to examine consumption of pornographic materials in high school students. A total of 3291 high school students from 28 schools responded to the questionnaire at wave 1.

RESULTS

Consumption of online pornography was higher than traditional pornography. There was an increase in consumption of pornographic materials in the high school years. Gender, family functioning, and positive youth development were related to the initial status of pornography consumption. Besides, gender, family intactness and positive youth development predicted rates of change in consumption of pornographic material over time.

CONCLUSION

The present findings showed that gender, family functioning, and positive youth development are significant predictors for pornography consumption in Chinese adolescents.

Prenatal substance exposure: What predicts behavioral resilience by early adolescence?

Understanding behavioral resilience among at-risk adolescents may guide public policy decisions and future programs. We examined factors predicting behavioral resilience following intrauterine substance exposure in a prospective longitudinal birth-cohort study of 136 early adolescents (ages 12.4-15.9 years) at risk for poor behavioral outcomes. We defined behavioral resilience as a composite measure of lack of early substance use initiation (before age 14), lack of risky sexual behavior, or lack of delinquency. Intrauterine substance exposures included in this analysis were cocaine, tobacco, alcohol, and marijuana. We recruited participants from Boston Medical Center as mother-infant dyads between 1990 and 1993. The majority of the sample was African American/Caribbean (88%) and 49% female. In bivariate analyses, none and lower intrauterine cocaine exposure level predicted resilience compared with higher cocaine exposure, but this effect was not found in an adjusted model. Instead, strict caregiver supervision (adjusted odds ratio [AOR] = 6.02, 95% confidence interval (CI) [1.90, 19.00], p = .002), lower violence exposure (AOR = 4.07, 95% CI [1.77, 9.38], p < .001), and absence of intrauterine tobacco exposure (AOR = 3.71, 95% CI [1.28, 10.74], p = .02) predicted behavioral resilience. In conclusion, caregiver supervision in early adolescence, lower violence exposure in childhood, and lack of intrauterine tobacco exposure predicted behavioral resilience among a cohort of early adolescents with significant social and environmental risk. Future interventions should work to enhance parental supervision as a way to mitigate the effects of adversity on high-risk groups of adolescents. (PsycINFO Database Record

Social factors associated with readiness for sexual activity in adolescents: a population-based cohort study

Various factors are associated with sexual activity in adolescence and it is important to identify those that promote healthy and adaptive romantic and sexual development. The objectives of this study were to describe rates of early sexual intercourse (before 16 years) and sexual readiness in adolescence and to assess the extent to which these were social patterned. We prospectively studied nearly 5,000 15-year-olds from the Avon Longitudinal Study of Parents and Children, a UK birth cohort. Between 2006 and 2008, female and male participants answered a computer assisted interview about romantic and sexual behaviors in the last year. Predictors of sexual intercourse and readiness for sexual intercourse were examined across a range of sociodemographic measures. Overall, 17.7% (95% CI 16.7%, 18.9%) of participants reported having had sexual intercourse in the last year, with more girls than boys reporting sexual experience (risk ratio 1.30, 95% CI 1.15, 1.47). Of these, one-third of both male and female were classed as unready because they were unwilling, lacking in autonomy, felt regret or had not used contraception. There was strong evidence of social patterning for sexual activity with higher rates for young people from poorer homes, with lower social class, and with younger, less educated mothers. In contrast, among 860 young people who had had sexual intercourse, there was no clear evidence of associations between social factors and sexual readiness. The lack of social patterning in sexual readiness supports the provision of comprehensive education to develop life skills for adolescents across all social groups.

Risky sexual behaviours: The role of substance use, psychopathic traits, and attachment insecurity among adolescents and young adults in Quebec

The purpose of this study was to examine how substance use, psychopathic traits, and attachment representations explain sexual risk-taking in adolescence. Variables used to define risky sexual behaviours were age at first sexual intercourse and number of lifetime sexual partners. A sample of 1,553 adolescents and young adults completed a battery of questionnaires including measures of substance use, psychopathic traits, attachment representations, and sexual behaviours. Structural equation modelling demonstrated that, in the present sample, risky sexual behaviours were best modelled through both direct effects of avoidant attachment representations and indirect effects of psychopathic traits and abandonment anxiety through increases in substance use. This model was gender-invariant and may represent a contemporary trend toward homogenization of sexual practices among young people in Quebec.

Do family factors protect against sexual risk behaviour and teenage pregnancy among multiply disadvantaged young people? Findings from an English longitudinal study

Background Structure and parenting within family of origin have been found to be determinants of sexual risk and teenage pregnancy in the general youth population. Few studies have examined determinants of sexual risk among disadvantaged young people; those that do have not examined teenage pregnancy outcomes.

METHODS

Longitudinal data from a cohort of multiply disadvantaged at-risk young people aged 13-15 years living in deprived neighbourhoods in England (n=1285) were analysed to examine how family structure, communication with parents and parental interest in education were associated with heterosexual debut, contraception use, expectation of teenage pregnancy and teenage pregnancy.

RESULTS

At follow-up, young women living with both biological parents were less likely than other young women to become pregnant (odds ratio (OR)=0.21, 95% confidence interval (CI): 0.04-0.97). Young women who could talk to their mothers about private things were less likely to expect to become a teenage parent (OR=0.61, 95% CI: 0.37-0.99). Those whose parents cared very much how they did at school were less likely to report contraception nonuse (OR=0.44, 95% CI: 0.21-0.93). After adjustment, no associations between any family factors and sexual health outcomes were found for young men.

CONCLUSIONS

We found limited evidence for family-related effects on sexual health risk or teenage pregnancy among disadvantaged young women in England and no evidence of risk factors within the home environment for young men's outcomes. This suggests that targeted family-based interventions may not be appropriate for addressing these outcomes.

The developmental progression of age 14 behavioral disinhibition, early age of sexual initiation, and subsequent sexual risk-taking behavior

BACKGROUND

Research has demonstrated a consistent relationship between early sexual experience and subsequent sexual risk-taking behaviors. We hypothesized that this relationship is due to a general predisposition toward behavioral disinhibition (BD), and that relationships among BD, early sex, and subsequent risky sexual behavior may be influenced by common genetic influences for males and common environmental influences for females.

METHODS

A prospective sample of 1,512 same-sex adolescent twins (50.2% female) was used. Adolescent BD was measured by clinical symptom counts of conduct disorder, oppositional defiant disorder, and self-reported delinquent behavior (age 14). Age of sexual initiation was defined as first age of consensual oral or penetrative sex (mean age ~17). Adult risky sexual behavior was defined by sexual behaviors under the influence of drugs and alcohol and number of casual sexual partners in the past year (age 24).

RESULTS

Multivariate analyses showed evidence for substantial common genetic variance among age 14 BD, age at sexual initiation, and adult risky sexual behavior for males, but not females. There was no significant difference in the degree of common environmental influence on these variables for females compared to males. Notably, age of sexual initiation was not significantly correlated with age 24 risky sexual behavior for females.

CONCLUSION

The relationship between early sex and later risky sex can be better understood through a general liability toward BD, which is influenced primarily by genetic factors for males. The association between age 14 BD and age of sexual initiation was influenced through a combination of genetic and environmental factors for females; however, age of sexual initiation does not appear to be a salient predictor of adult women’s sexual risk-taking behavior. Findings suggest that prevention programs aimed at reducing sexual risk behavior might target youth exhibiting BD by age 14, particularly males. More research is needed on what predicts adult sexual risk-taking behavior for females.

Early sexual initiation and risk factors in Serbian adolescents: data from the National Health Survey

OBJECTIVES

To identify factors associated with sexual initiation before the age of 17 among Serbian adolescents and to assess whether the latter is associated with other risky behaviours, such as tobacco, alcohol and illicit drug use, and fighting.

METHODS

The study was an analysis of data gathered by the 2006 Serbian National Population Health Survey in which information concerning adolescents was obtained by means of questionnaires. Data were analysed using descriptive statistics and a logistic regression model.

RESULTS

A total of 474 adolescents aged 15 and 16 completed the survey. Multivariate logistic regression analysis showed that male respondents reporting sexual initiation were significantly more likely to smoke daily and to have experienced two or more episodes of drunkenness in the past. Female respondents reporting sexual initiation were significantly more likely to live with both parents, to feel insecure in school, to smoke daily and to drink more than once a week.

CONCLUSIONS

A strong association was found between adolescent sexual initiation and substance abuse. Although a causal relationship is evidently not established, one might contemplate including measures lowering the frequency and intensity of substance abuse in health prevention programmes and interventions aiming at reducing the risks associated with sexual initiation.

Associations between life contexts and early sexual initiation among young women in France

CONTEXT

Early sexual initiation (before age 16) has been linked to an increased risk of teenage pregnancy and STDs. Most research on correlates of early sexual initiation is from the United States; no similar work has been conducted in France, where the sociocultural environment differs.

METHODS

Cross-sectional data from the 2010 Health Behaviour in School-Aged Children survey were used to examine the relationships of personal, family, peer, school and neighborhood characteristics with early sexual initiation among 1,094 French females in grades 8-10. Two-level logistic regressions were used to identify associations.

RESULTS

Twenty-five percent of respondents had had sex before age 16. Early sexual initiation was primarily -associated with individual-level characteristics. Young women had an elevated likelihood of having initiated sex early if they went out after school at least four times a week (odds ratio, 2.0), had repeated a grade (1.8), lived with a single parent or in a stepfamily (1.8 and 1.5, respectively), perceived a low level of parental monitoring (1.6) or had two or more male friends (2.8). At the environmental level, respondents who attended school in areas with a high proportion of residents who were foreigners had a reduced likelihood of having initiated sex early (0.5-0.6).

CONCLUSIONS

Although early sexual initiation in France was essentially linked to individual-level variables, further research is needed to understand its relationship with neighborhood characteristics. Such studies should include additional environmental variables, test new hypotheses and employ a longitudinal approach.