Predictors of initiation of early sex in black and white adolescent females

Prevalence of sexual experience among Korean adolescent: age-period-cohort analysis

OBJECTIVES

Since exposure to sexual content and early sexual initiation among adolescents have become serious social issues in Korea, an in-depth analysis of trends in the prevalence of sexual experience among Korean adolescents is necessary to project the trends and policies required for the next 10 years. The objective of this study was to identify the contributions of age, period, and birth cohort effects on the prevalence of sexual experience in Korean adolescents.

METHODS

We analyzed age-specific, period-specific, and birth cohort–specific trends in the prevalence of sexual experience among 911,502 adolescents (469,593 boys, 51.5%; 441,909 girls, 48.5%) aged 12 years to 17 years from the 2006 to 2017 Korean Youth Risk Behavior Web-based Survey. Joinpoint regression analysis was conducted to examine significant changes in the prevalence of sexual experience and to find the optimal number and location of places where trends changed.

RESULTS

The prevalence of sexual experience generally increased with age in all periods in both boys and girls. In boys, the prevalence of sexual experience increased in recent periods, especially in the age group of 12-13 years, while the prevalence of sexual experience decreased in the age group of 16-17 years. In girls, the age group of 12-13 years showed an increased prevalence of sexual experience in recent periods. However, the prevalence showed a decreasing trend in the age group of 16-17 years.

CONCLUSIONS

In boys and girls, sexual experience increased with age, although this tendency has slowed in recent cohorts. Therefore, early sex education is needed.

HIV prevention among African American youth: how well have evidence-based interventions addressed key theoretical constructs?

Certain constructs are demonstrated in the research literature to be related to HIV risk behaviors among African American adolescents. This study examines how well these constructs are addressed in evidence-based interventions (EBIs) developed for this population. A literature review on variables for sexual risk behaviors among African American adolescents was undertaken. Simultaneously, a review was conducted of the contents of HIV-prevention EBIs. To facilitate comparison, findings from both were organized into constructs from prominent behavior change theories. Analysis showed that environmental conditions and perceived norms were frequently associated with sexual risk behaviors in the literature, while EBIs devoted considerable time to knowledge, skills, and self-efficacy. Findings imply that (a) EBIs might be complemented with activities that focus on important constructs identified in the literature and (b) researchers should better assess the relationship between skill development and HIV risk behaviors. Implications for practice and research are discussed.

Effects of self-esteem and academic performance on adolescent decision-making: an examination of early sexual intercourse and illegal substance use

PURPOSE

To determine whether higher self-esteem and higher academic performance among youth reduce the likelihood of early sexual intercourse and illegal substance use.

METHODS

Using data from waves I-III of the National Longitudinal Study of Adolescent Health, this study used multivariate logistic regression, stratified by gender and controlling for known covariates, to examine relationships between self-esteem and academic performance and youth decision-making, specifically self-reported initiation of sexual intercourse and use of illegal substances. Self-esteem was constructed as an ascending scale of 10 Likert-scaled survey items. Academic performance was assessed using the most recent grades from English, Math, Science, and History.

RESULTS

Among virginal adolescents, higher self-esteem at baseline had no effect on sexual debut 1 year later. However, higher self-esteem at baseline among females corresponded with a significantly lower likelihood of illegal substance use 1 year later (OR, .96; p = .003). In terms of academic performance at baseline, girls averaging "A" grades as compared with girls averaging "C" grades or lower were significantly less likely to initiate sexual intercourse 1 year later (OR, .52; p = .004). Additionally among girls, being an "A" student or a "B" student was associated with lower odds of illegal substance use, compared with students who averaged "C" grades or lower (p < .01). Among young boys, self-esteem and academic performance were not significantly predictive of illegal substance use.

CONCLUSIONS

This study suggests that bolstering self-esteem and improving academic performance among young girls may have specific benefits in sexual decision-making and substance-related risk-taking.

Competence as a predictor of sexual and reproductive health outcomes for youth: a systematic review

To examine the association between "competence" and adolescent sexual and reproductive health (ASRH) outcomes. Competence refers to the development of skills to perform tasks successfully in four areas including social and behavioral, cognitive, emotional, and moral competence. We conducted a systematic review of research published from 1985 through 2007. Inclusion criteria included use of multivariate analyses, a sample size of >or=100, publication in a peer-reviewed journal, and measurement of an ASRH outcome. We coded findings as protective, risk, or no association and as longitudinal or cross-sectional. We considered the presence of two longitudinal studies with consistent findings for at least one outcome to be sufficient evidence for a risk or protective association. We identified 77 studies that examined cognitive competence, 27 studies that examined social and behavioral competence, 12 studies that examined emotional competence, and no studies that met inclusion criteria for moral competence. The evidence indicated that cognitive competence and social and behavioral competence can be protective factors for ASRH, with findings from at least two longitudinal studies demonstrating a protective association with an ASRH outcome. Findings across cognitive, social and behavioral subconstructs and ASRH outcomes were more mixed. There was insufficient evidence to draw conclusions about emotional and moral competence and ASRH. Helping adolescents to achieve cognitive, social, and behavioral competence may reduce the likelihood of sexual activity and teen pregnancy, and increase contraceptive use. Additional research is needed to examine other outcomes and the generalizability of findings.

African-American adolescent girls' initiation of sexual activity: survival analysis

PURPOSE

African-American adolescent females tend to initiate participation in sexual activity at an earlier age than Caucasian adolescent females. Early initial participation in sexual activity is associated with increased risk of HIV infection. However, limited prospective data are available on the rate at which African-American adolescent females delay their initial participation in sexual activity. The purpose is to determine low-income, inner-city, African-American adolescent females' survival or continued nonparticipation in sexual activity over a 20-month period and to determine predictors associated with survival.

METHODS

A longitudinal, quasi-experimental research design with multiple data collection points was used. The convenience sample consisted of 396 African-American females with a mean age of 12.4 years (SD = 1.1 years) and their mothers. The adolescents completed questionnaires assessing perceptions of maternal monitoring, HIV transmission knowledge, self-efficacy to refuse sex, intention to refuse sex, and age. Their mothers completed questionnaires assessing perception of maternal monitoring, safer sex self-efficacy, marital status, and educational level. At baseline, the adolescents reported nonparticipation in sexual activity. Survival analysis was conducted to determine the timing and predictors of sexual activity initiation for these adolescents.

FINDINGS

Of the 396 adolescents, 28.5% did not survive; they participated in sexual activity within the 20-month period. Predictors of non-survival were the adolescents' age, perception of maternal monitoring, and intention to refuse sex.

CONCLUSION

Findings suggest interventions that increase maternal monitoring and adolescents' intentions to refuse sex could be beneficial in delaying sexual activity.

Confidence as a predictor of sexual and reproductive health outcomes for youth

PURPOSE

To assess the association between four positive youth development (PYD) constructs of confidence and adolescent sexual and reproductive health (ASRH) outcomes.

METHODS

We searched nine online databases to locate behavioral research that examined the association between four constructs of confidence (belief in the future, self-determination, clear and positive identity, and self-efficacy) and ASRH outcomes (e.g., ever had sex, condom use, contraception use, number of partners, pregnancy/birth, and sexually transmitted infection). Findings were coded as "protective," "risk," or "no association." The presence of at least two longitudinal studies reporting consistent significant associations for at least one ASRH outcome indicated evidence for a protective or risk association.

RESULTS

We found evidence to support two of the four PYD constructs of confidence (belief in the future and self-determination) as protective factors for ASRH outcomes. Evidence was insufficient to draw conclusions about clear and positive identity as a protective factor, and was mixed for self-efficacy. Measures of confidence varied considerably across the studies reviewed, reflecting varying definitions; often, the measures used had limited information on reliability. Few longitudinal investigations were identified, and available studies were inconsistent in how they examined the association between the PYD constructs and ASRH outcomes. Evidence for most constructs was insufficient to identify their influence on specific sub-groups of youth.

CONCLUSIONS

Despite the need for additional research, this review suggests that belief in the future and self-determination are promising protective factors. Further research is needed to better understand the potential for self-efficacy and clear and positive identity as protective factors.

Social Environment and Problem Behavior

In 2007, 48% of U.S. students of grades 9 to 12 had experienced sexual debut, 7% before the age of 13 years. Preventing early intercourse, sexually transmitted diseases, adolescent pregnancy, and the loss of educational opportunity are important concerns for nurses and educators. A secondary data analysis of the Youth Risk Behavior Survey (YRBS) 2003 provided data identifying the relationships among age at sexual debut, gender, location of residence, and perceived school safety (PSS) as framed by the theory of problem behavior. Mean age at sexual debut was 14.4 years. Males were younger at sexual debut than females. Students reporting positive PSS were older at sexual debut. Age at sexual debut was significantly associated with PSS, gender, and location of residence. School nurses are positioned to identify evidence-based programs, facilitate the development of collaborative interventions to improve PSS, and change trajectories of sexual activity leading to poor health outcomes in adolescents and health risk behaviors in adults.

The effects of family structure, parent-child relationship and parental monitoring on early sexual behaviour among adolescents in nine European countries

AIMS

To identify the influence of family structure, parent-child relationship and parental monitoring on adolescents' involvement in early sexual behaviour.

METHODS

The study was undertaken in the context of the World Health Organization collaborative Health Behaviour in School-Aged Children study. The representative samples were drawn from 10 European countries. A group of 14,287 (6716 boys and 7571 girls) 15-year-olds was surveyed. The data were collected by standardized questionnaires. Adolescents were asked about sexual behaviour, family structure, parent-child communication, and parental control. A logistic regression analysis was applied to assess the impact of determinants.

RESULTS

Greenlandic adolescents were predominantly engaged in early sexual behaviour. Intact family was a key protective factor for adolescents' early sexual behaviour. It significantly decreased both boys' and girls' involvement in early sexual behaviour. Close parent-adolescent relationships and a high level of parental monitoring were found to be less protective factors than family structure. Easy communication with parents, especially with the mother, was more significant for girls' than for boys' early sexual behaviour. A low level of maternal monitoring had a higher impact on boys' early sexual behaviour, while a low level of paternal monitoring had a higher impact on girls. For both maternal and paternal monitoring, the strongest relationship was observed among Hungarian adolescents, but among Greenlanders it was not statistically significant.

CONCLUSIONS

Many 15-year-olds in European countries are engaged in early sexual behaviour. A close parent- child relationship and a high level of parental monitoring are not as important for adolescents' early sexual behaviour as an intact family.

African American Adolescent Perceptions of Vulnerability and Resilience to HIV

HIV/AIDS is growing at a disproportional rate among African American adolescents. This trend has occurred despite the fact that 89% of schools have educational programs on HIV/AIDS. Barriers to effective HIV prevention may be related to a failure to develop educational programs based on the cultural competencies of vulnerable populations such as adolescents who are at risk for HIV. The purpose of this qualitative study was to explore African American adolescent perceptions of vulnerability and resilience to HIV/AIDS within a cultural competency paradigm. A group of 8 adolescents at an African American church participated in a focus group to discuss vulnerability and resilience to HIV. To facilitate discussion, the adolescents developed collages from pictures in African American magazines. Content analysis was used to identify themes. The themes revealed were confidence, safe social activities, innocence, image, music/drug culture, and peer pressure.

Concept analysis: sexual decision-making in adolescence

PURPOSE

This papers aims to clarify and explore the topic of adolescent decision-making regarding sexual activity.

SOURCES

Published literature.

CONCLUSIONS

Adolescent decision-making regarding the initiation or continuation of sexual activity is influenced by desire for intimacy, perceived relationship safety, problem-solving ability, cognitive ability, family and peer relationships, and concern regarding pregnancy or sexually transmitted infection.

Psychosocial predictors of adolescent sexual behavior

OBJECTIVE

To find out the psychosocial factors associated with adolescent sexual behavior.

METHODS

A cross sectional study was carried out in Chandigarh Union Territory of India by enrolling 11 th class students from six randomly selected schools. A pre-tested questionnaire containing 83 items was administered after ensuring privacy and confidentiality. Socio-economic status, residence, gender, grade in the class, religion, acculturation level, self esteem, social support and coping behavior were considered as independent explanatory variables and physical sexual contact (which included kissing, hugging and sexual intercourse) was taken as dependent variable.

RESULTS

Two hundred and fifty seven students enrolled for the study had mean age of 17 yr. The prevalence of sexual activity was 20% (95% CI: 13.6%-28.1%) among males and 6% (95% CI: 1.3%-18.8%) among females. Four percent of males and 1% of females reported sexual intercourse. The main reason for not having sexual physical contact was societal norms. After adjusting for confounders in multivariate analysis, male gender (OR: 3.5; 95%CI: 1.5-8.1) and modern attitudes (OR: 0.77; 95%CI: 0.6-0.98) were found to be the risk factors for initiation of sexual activity in adolescence.

CONCLUSION

Cultural norms rather than the individual/psychological factors tend to govern adolescent sexual behavior in Indian society.

Urban African American Pre-Adolescent Social Problem Solving Skills: Family Influences and Association with Exposure to Situations of Sexual Possibility

The results of two studies focusing on the social problem solving skills of African American preadolescent youth are detailed. In the first study data from a sample of 150 African American children, ages 9 to 11 years, was used to examine the association between type of youth social problem solving approaches applied to hypothetical risk situations and time spent in unsupervised peer situations of sexual possibility. Findings revealed that children with more exposure to sexual possibility situations generated a wider range of social problem solving strategies, but these approaches tended to be unrealistic and ambiguous. Further, there was a positive association between the amount of time spent unsupervised and youth difficulty formulating a definitive response to hypothetical peer pressure situations. Children with less exposure to sexual possibility situations tended to be more aggressive when approaching situations of peer pressure. In the second study, data from a non-overlapping sample of 164 urban, African American adult caregivers and their 9 to 11 year old children was examined in order to explore the associations between child gender, family-level factors including family communication frequency and intensity, time spent in situations of sexual possibility, and youth social problem solving approaches. Results revealed that children were frequently using constructive problem solving and help seeking behaviors when confronted by difficult social situations and that there was a significant relationship between the frequency and intensity of parent child communication and youth help seeking social problem solving approaches. Implications for research and family-based interventions are highlighted.

Untangling the health disparities of teen pregnancy

PURPOSE

The purpose of this secondary analysis is to determine whether a developmental maturity model differentially predicts pregnancy for African American, Puerto Rican, and Mexican inner-city teens.

DESIGN AND METHODS

This is a secondary analysis of data from a case control study that tested a model of developmental maturity and teen pregnancy with 183 pregnant and never-pregnant pairs of inner-city teens matched on age, ethnicity, and freshman cohort.

RESULTS

The models differentially predict pregnancy for the separate ethnic groups, with sexual behaviors being the most important factors regardless of ethnicity.

PRACTICE IMPLICATIONS

The health disparities of teen pregnancies may not decrease unless patterns of dating/sexual behaviors are reversed.

Young adolescents' perceptions of peer sexual behaviours: the role of television viewing

OBJECTIVE

To investigate whether young adolescents' perceptions of peers' sexual activity is related to the amount of television viewing, and whether this relationship may be moderated by young adolescents' pubertal development.

METHODS

This study used a sample of 12- and a sample of 15-year-olds; 2127 respondents in a targeted sample of nine schools in Flanders (the Dutch-speaking part of Belgium), completed a questionnaire with questions about their television viewing behaviour, the estimated prevalence of given sexual activities in peers, and self-reports on pubertal development and sexual experience.

RESULTS

In the sample of 12-year-olds, results demonstrated that a quadratic regression equation provides the best description for the relationship between television viewing and perceptions of peer sexual behaviours, indicating that the 'effect' of television only starts off after a level of about 45 h of television viewing per week. Further exploration showed that this relationship remains significant when controlling for gender and sexual experience, and is stronger at more advanced levels of pubertal development. In the sample of 15-year-olds, linear and unmoderated relationships were found. Irrespective of their pubertal status, gender, or level of sexual experience, television viewing is related to higher expectations of peers' sexual activities.

CONCLUSION

Concerns about the impact of television viewing on sexual health should not be limited to older adolescents. This research has identified 12-year-olds who display a higher level of pubertal development and generally spend much time with television viewing as a category of viewers-at-risk.

The Baby Think It Overtm Experience to Prevent Teen Pregnancy: A Postintervention Evaluation

An evaluation was conducted to describe the personal impact of the "In Your Care" pregnancy prevention intervention program using Baby Think It Over infant simulator. Data was collected regarding the attitudes, actual and intended sexual practices, feelings, and opinions of participants 2 or 3 years after the intervention. Student recommendations for program continuation and improvement were also solicited. Male and female 11(th) grade students in rural and suburban Midwestern communities, who had experienced the program 2 or 3 years earlier, completed surveys and were interviewed in focus groups. Participants vividly recalled and described the simulated experience in statements that reflected insight and feelings about parental responsibility and the consequences of teen pregnancy. The teens also made several recommendations for enhancing the program. The findings suggest that simulated experiences can be a powerful strategy for effective learning about complex decisions regarding the risks of sexual activity and the realities of parenting.