It's better on TV: does television set teenagers up for regret following sexual initiation?

Positive, Negative, or Mixed Feelings? A Person-Centered Approach to Consequences of First Penile-Vaginal Intercourse in College Students

Many adolescents and young adults have mixed feelings about their experience of first vaginal intercourse, experiencing both positive consequences like physical satisfaction and love, as well as negative consequences like guilt and anxiety. However, no study has examined the patterns of consequences individuals experience after first vaginal intercourse, which can provide a more nuanced sense of young adults' feelings. We used latent class analysis to examine consequences of first vaginal intercourse in a longitudinal study of college students in the Northeastern United States (N = 191; 45.6% female, 30.9% White/European American, 23.6% Asian American/Pacific Islander, 22.5% Hispanic/Latino, 14.7% Black/African American, 8.4% multiracial). For male college students, classes included Multidimensional Positive (49.4%), Intimacy and Satisfaction (4.39%), and Guilt and Regret (16.22%). For female college students, classes included Intimacy, Satisfaction, and Pain (40.84%), Primarily Negative (31.11%), and Mixed Feelings (20.86%). For male students, age at first vaginal intercourse, first intercourse with a non-relationship partner, religiosity, and non-use of contraceptives were associated with class membership; for female students, first intercourse with a non-relationship partner was associated with being* in classes marked by multiple negative consequences. Findings differ by gender and are partially in line with the sexual double standard, but provide a more nuanced picture, with the majority of both male and female college students likely to report positive consequences, specifically intimacy and physical satisfaction.

Feelings about the timing of first sexual intercourse and health-related quality of life among adolescents

BACKGROUND

Early sexual intercourse (SI) may have long-lasting negative impacts on health-related quality of life (HRQoL). So far, these impacts have been studied using age for defining early SI instead of feelings about its timing. The present study examined the association between feelings about the timing of first SI and current HRQoL.

METHODS

Data came from the 2014 cross-sectional Health Behaviour in School-aged Children (HBSC) study in French-speaking Belgium. Among participants aged 16-20 years who already had SI, 1778 were included in analyses. Univariate and multivariate logistic regressions were performed, including potential confounders.

RESULTS

One quarter of adolescents (26.4%) had poor HRQoL, 19.8% expressed a negative feeling about the timing of first SI and 19.6% did not think about it. Compared with adolescents who thought first SI happened at the right time or wished it had happened sooner, adolescents who had a negative feeling about the timing and those who did not think about it were more likely to have a poor HRQoL (cOR = 1.67 (1.28-2.17) and cOR = 1.37 (1.05-1.80), respectively). After adjustment, associations were no more significant (aOR = 1.22 (0.91-1.63) and aOR = 1.22 (0.91-1.64)). Sex disparity in expressing a negative feeling mostly explained the difference between crude and adjusted analyses.

CONCLUSION

Further research is needed to better understand such a complex relationship. The high proportion of adolescents having poor HRQoL and negative feeling about the timing of first SI shows how important it is to find out effective prevention for both domains.

[Qualitative analysis of the integration of sex education for young people in audio-visual media in Kinshasa Democratic Republic of Congo]

L’éducation sexuelle par les médias de masse contribue positivement à la prévention des infections sexuellement transmissibles (IST)/VIH et des grossesses précoces auprès des jeunes. L’objectifs de cette étude sont d’appréhender le niveau d’intégration de l’éducation sexuelle dans les émissions de santé à Kinshasa en République Démocratique du Congo et d’identifier les facteurs facilitant et limitant l’éducation sexuelle des jeunes dans les programmes audio-visuels congolais.

Une triangulation des données provenant de la revue documentaire, de l’observation directe de quatre émissions de santé et des entretiens semi-directifs auprès des 15 responsables de programme audiovisuels, a été exploitée. Une étude de cas d’une expérience réussie dans le domaine a été complétée.

Bien qu’il soit observé une programmation de quelques émissions de santé dans les grands médias audiovisuels de Kinshasa, leur potentiel pour l’éducation sexuelle n’est que très faiblement exploité. Dans les quatre médias observés, les émissions de santé sont diffusées à des heures de faible audience, et effleurent superficiellement l’éducation sexuelle dans un contexte de prévention des IST/VIH. La participation d’experts n’est pas systématique ; le cas échéant, leur expression n’est pas souvent adaptée à la compréhension du grand public. De plus en plus, ces programmes offrent les possibilités d’interactivité avec la communauté via le téléphone mobile. Parmi les obstacles à l’éducation sexuelle dans les média audiovisuels, il a été identifié le manque de clarté de la loi relative à la liberté de la presse, associée à la peur de la répression ; les freins liés aux considérations socioculturelles, la faible disponibilité de l’expertise, les préjugés sur la non préférence de ces types d’émissions par le public et le manque de retombées financières de ces programmes. Au regard des bénéfices de l’éducation sexuelle sur la vie et le bien-être des jeunes, une meilleure interprétation de la loi, une fédération des acteurs techniques du gouvernement, des partenaires et des médias autour d’un plan conjoint et le focus sur l’éducation aux médias dans le cursus de formation scolaire et universitaire, s’avèrent nécessaires et appropriés pour la protection des générations à venir.

Development of sexual expectancies among adolescents: contributions by parents, peers and the media

To expand the scant research on sexual expectancies development among non-sexually active adolescents, we examined the relationship between adolescents' exposure to four socializing agents--mother/female guardian, father/male guardian, peers, and television programs with high sexual content--and their endorsement of four sexual expectancies: social benefit, pleasure, social risk, and health risk. Data are from Waves 2 and 3 of a three-wave annual longitudinal study conducted among California adolescents, the majority of whom were not sexually active (N = 914, 84%). Structural equation models were conducted to examine cross-sectional and longitudinal associations between the socializing agents and the sexual expectancies. Cross-sectional results indicate associations between peer sexual communication and social benefit, pleasure, and social risk expectancies. A positive association was found between exposure to music videos and social benefit expectancies, and a negative association was found between exposure to music videos and health risk expectancies. Longitudinal results suggest that communication with peers positively predicted pleasure expectancies and negatively predicted social risk expectancies. No other socializing agents were associated with any sexual expectancies. An invariance test found that significant correlations were similar across the different age groups. Results suggest that efforts to support positive sexual decision making among non-sexually active adolescents should target peer sexual communication.

Are sexual media exposure, parental restrictions on media use and co-viewing TV and DVDs with parents and friends associated with teenagers' early sexual behaviour?

Sexual content in teenagers' media diets is known to predict early sexual behaviour. Research on sexual content has not allowed for the social context of media use, which may affect selection and processing of content. This study investigated whether sexual media content and/or contextual factors (co-viewing, parental media restrictions) were associated with early sexual behaviour using 2251 14-15 year-olds from Scotland, UK. A third (n = 733) reported sexual intercourse. In multivariable analysis the likelihood of intercourse was lower with parental restriction of sexual media and same-sex peer co-viewing; but higher with mixed-sex peer co-viewing. Parental co-viewing, other parental restrictions on media and sexual film content exposure were not associated with intercourse. Findings suggest the context of media use may influence early sexual behaviour. Specific parental restrictions on sexual media may offer more protection against early sex than other restrictions or parental co-viewing. Further research is required to establish causal mechanisms.

Development of the virginity beliefs scale

Past research on first sexual intercourse experiences and virginity has largely focused on using demographics such as age at first intercourse as predictors of future sexual behaviors and beliefs. Carpenter ( 2002 , 2005 ) suggested a model of three virginity metaphors that describe how individuals perceive their virginity: gift, stigma, and process. Using Carpenter's framework as a starting point, scale items were developed based on the conceptual understanding of the three metaphors. In Study 1 (N = 223, mean age = 19.9, SD = 2.4), 50 items were factor analyzed, yielding 22 items found to be strong indicators of the three metaphors; ten items for gift, eight for stigma, and four for process. The three subscales were validated using measures of gender-role beliefs and affective reactions to first intercourse. In Study 2 (N = 359, mean age = 19.7, SD = 2.4), confirmatory factor analysis was used to confirm the 22-item factor breakdown. The resulting Virginity Beliefs Scale is discussed in terms of how it applies to Carpenter's original framework and its future research potential.

Gone but not forgotten: virginity loss and current sexual satisfaction

Although loss of virginity remains a salient experience throughout a person's lifetime, little is known about whether this experience has implications for later sexual functioning (e.g., sexual satisfaction). Previous research tends to ask participants about their first time and their current sexual functioning concurrently, which may lead to spillover effects. The authors investigated the relation between first-time sexual intercourse and current sexual satisfaction using an event-sampling methodology. Participants were 331 undergraduate students who answered questions about their first-time sexual encounter and their current sexual functioning (e.g., sexual satisfaction, sexual depression). Participants then described and rated each of their sexual interactions for 2 weeks. Results show that participants who had more positive first-time sexual experiences (e.g., intimacy, respect) report greater feelings of sexual satisfaction and esteem and less sexual depression. A series of multilevel random coefficient modeling analyses revealed that positive first-time experiences were predictive of physical and emotional satisfaction in their current sexual interactions, even when controlling for global sexual satisfaction. These results suggest that one's first-time sexual experience is more than just a milestone in development. Rather, it appears to have implications for their sexual well-being years later.

First sexual intercourse and subsequent regret in three developing countries

PURPOSE

Adolescents who engage in sex can be affected by a range of negative physical and psychological consequences. We intend to analyze the reasons behind first sex, regret, and the association between reasons and regret.

METHODS

A questionnaire was implemented to 8,495 high schools students aged 14-18 years residing in the Philippines, El Salvador, and Peru. Sexually active participants responded whether several circumstances were reasons involved in their first sexual relationship. They also responded whether they regretted having already had sexual relationships.

RESULTS

More than one-third of respondents reported at least one external pressure leading to first sex, and about one-half reported at least one reason implying getting carried away by sexual arousal. More females affirmed they regret having already had sex. Logistic regression shows that reasons for first sex associated with regret were partner insistence, "uncontrolled situations," and seeing sexual images. These reasons were associated with regret even when love was also reported as related to first sex.

CONCLUSIONS

Adolescent sexual experience is often motivated by pressure (such as external pressure [because most friends already had sex or because of partner insistence]) and circumstances (such as getting carried away by sexual arousal [through an "uncontrolled situation" or viewing sexual images]) that lower the control over their decisions concerning sex, rather than by mature decisions, and this may result in later regret. Adolescents should be helped by parents, educators, and policy makers to be aware of these characteristics of sexual behavior of adolescents and empowered to make assertive and informed decisions concerning their sexuality.

Sexual risk behaviors among African-American and Hispanic women in five counties in the Southeastern United States: 2008-2009

PURPOSE

We examined sexual risk behaviors and unrecognized HIV infection among heterosexually active African-American and Hispanic women.

METHODS

Women not previously diagnosed with HIV infection were recruited in rural counties in North Carolina (African American) and Alabama (African American), and an urban county in southern Florida (Hispanic) using multiple methods. They completed a computer-administered questionnaire and were tested for HIV infection.

RESULTS

Between October 2008 and September 2009, 1,527 women (1,013 African American and 514 Hispanic) enrolled in the study. Median age was 35 years (range, 18-59), 33% were married or living as married, 50% had an annual household income of $12,000 or less, and 56% were employed full or part time. Two women (0.13%) tested positive for HIV. In the past 12 months, 19% had been diagnosed with a sexually transmitted infection (other than HIV), 87% engaged in unprotected vaginal intercourse (UVI), and 26% engaged in unprotected anal intercourse (UAI). In multivariate analysis, UAI was significantly (p < .05) more likely among those who reported ever being pregnant, binge drinking in the past 30 days, ever exchanging sex for things needed or wanted, engaging in UVI, or being of Hispanic ethnicity. UAI was also more likely to occur with partners with whom women had a current or past relationship as opposed to casual partners.

CONCLUSION

A high percentage of our sample of heterosexually active women of color had recently engaged in sexual risk behaviors, particularly UAI. More research is needed to elucidate the interpersonal dynamics that may promote this high-risk behavior. Educational messages that explicitly address the risks of heterosexual anal intercourse need to be developed for heterosexually active women and their male partners.

Is parenting associated with teenagers' early sexual risk-taking, autonomy and relationship with sexual partners?

CONTEXT

Extensive research has explored the relationship between parenting and teenagers' sexual risk-taking. Whether parenting is associated with wider aspects of teenagers' capacity to form satisfying sexual relationships is unknown.

METHODS

Self-reported data were collected in 2007 from 1,854 students, whose average age was 15.5 years, in central Scotland. Multivariate analyses examined associations between parenting processes and sexual outcomes (delayed first intercourse, condom use and several measures reflecting the context or anticipated context of first sex).

RESULTS

Parental supportiveness was positively associated with all outcomes (betas, 0.1-0.4), and parental values restricting intercourse were positively associated with all outcomes except condom use (0.1-0.5). Parental monitoring was associated only with delayed intercourse (0.2) and condom use (0.2); parental rules about TV content were associated with delayed intercourse (0.7) and expecting sex in a relationship, rather than casually (0.8). Frequency of parental communication about sex and parental values endorsing contraceptive use were negatively associated with teenagers' delayed intercourse (-0.5 and -0.3, respectively), and parents' contraceptive values were negatively associated with teenagers' expecting sex in a relationship (-0.5). Associations were partly mediated by teenagers' attitudes, including value placed on having sex in a relationship.

CONCLUSIONS

Parents may develop teenagers' capacity for positive and safe early sex by promoting skills and values that build autonomy and encourage sex only within a relationship. Interventions should promote supportive parenting and transmission of values, avoid mixed messages about abstinence and contraception, and acknowledge that teenagers may learn more indirectly than directly from parents about sex.

Variation in sexual behaviors in a cohort of adolescent females: the role of personal, perceived peer, and perceived family attitudes

PURPOSE

Little is known about how adolescent sexual behaviors develop and the influence of personal or perceived social attitudes. We sought to describe how personal, perceived peer, and perceived family attitudes toward adolescent sexual activity influence sexual behaviors of adolescent females' over time.

METHODS

Between the years of 1999 and 2006, 358 English-speaking female adolescents, aged 14-17 years, were recruited from three urban adolescent clinics. Participants completed quarterly and annual questionnaires over a span of 4 years. Primary outcomes included engagement in any of the following eight sexual behaviors: kissing, having breasts touched, having genitals touched, touching partners' genitals, oral giving, oral receiving, anal, or vaginal sex. Three attitudinal scales assessed personal importance of abstinence, perceived peer beliefs about when to have sex, and perceived family beliefs that adolescent sex is negative. We used generalized estimating equations to identify predictors of each sexual behavior and compared whether personal, perceived peer, or perceived family attitudes predicted sexual behaviors over time.

RESULTS

The odds of reporting each sexual behavior increased with age but were lower among those whose personal or perceived family attitudes were less positive. Participants' personal attitudes toward adolescent sex were the strongest predictor of engagement in all eight sexual behaviors even after controlling for perceived peer and perceived family attitudes.

CONCLUSIONS

Female adolescent's personal attitudes toward abstinence appear to be the strongest predictor of engagement in a variety of sexual behaviors. Efforts to influence adolescent attitudes toward abstinence may be an important approach to reducing sexual behaviors that increase the risk of pregnancy and sexually transmitted infections.

American Academy of Pediatrics. Policy statement--sexuality, contraception, and the media

From a health viewpoint, early sexual activity among US adolescents is a potential problem because of the risk of pregnancy and sexually transmitted infections. New evidence points to the media adolescents use frequently (television, music, movies, magazines, and the Internet) as important factors in the initiation of sexual intercourse. There is a major disconnect between what mainstream media portray-casual sex and sexuality with no consequences-and what children and teenagers need-straightforward information about human sexuality and the need for contraception when having sex. Television, film, music, and the Internet are all becoming increasingly sexually explicit, yet information on abstinence, sexual responsibility, and birth control remains rare. It is unwise to promote "abstinence-only" sex education when it has been shown to be ineffective and when the media have become such an important source of information about "nonabstinence." Recommendations are presented to help pediatricians address this important issue.