Differences between women who begin pill use before and after first intercourse: Ontario, Canada.
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Adolescent↗
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The effectiveness of family planning clinics in serving adolescents.
Data from surveys conducted by The Alan Guttmacher Institute (AGI) in 1981 have been used to create three indicators of the effectiveness of family planning clinics in serving teenagers: the mean delay between first intercourse and first clinic visit (which for teenage clinic patients is 13.2 months); teenage patient retention (67 percent; and the average excess of patient satisfaction over dissatisfaction with clinic policies and services (33 percent). Clinics run by Planned Parenthood are more effective than other types of facility, according to the mean delay indicator, whereas other clinics, such as those associated with community action programs and neighborhood health centers, rank highest in levels of patient satisfaction and patient retention. All three measures indicate that clinics serving 1,000-2,499 family planning patients per year are more effective in serving teenagers than either smaller or larger clinics, and that nonmetropolitan clinics are more effective in providing services than those in cities. Regression analysis shows that clinic administrators might take a number of actions to shorten the mean delay among teenagers between first intercourse and first clinic visit. These include offering community education programs for teenagers, enlisting the support of local churches, developing relationships with local youth groups, opening the clinic during evenings and weekends, accepting more teenagers as walk-in patients and locating a clinic in or near neighborhoods where many teenagers live. Two of the same factors--developing an active relationship with youth groups and opening the clinic to teenagers on evenings and weekends--were also found to be particularly effective in keeping teenagers as clinic patients.(ABSTRACT TRUNCATED AT 250 WORDS)
Adolescent↗
Sexual and fertility behaviors of American females aged 15-19 years: 1985, 1990, and 1995.
OBJECTIVES: This study characterized changes in sexual and reproductive behaviors from 1985 through 1995 among American females aged 15 to 19 years and related these changes to family factors. METHODS: Nationally representative sample survey data from the 1995 National Survey of Family Growth were analyzed with Weibull hazards models of age at first intercourse and first pregnancy and with logistic regression models of contraceptive use at first intercourse and pregnancy outcome. RESULTS: Improvements in the family socioeconomic situations of young women have lessened the risk of teen motherhood, while changes in family structure have increased the risk. Young women whose parents have more than a high school education, who live with both parents, and who attend church delay the timing of first sexual intercourse and are more likely to use a contraceptive. CONCLUSIONS: The trend of increases in teenage motherhood has ended owing to a halt in increases in the proportion of sexually active young women and substantial improvement in contraception, with the greatest improvements among those from advantageous family situations.
Adolescent↗
The experience of pain during women's first sexual intercourse: cultural mythology about female sexual initiation.
A sample of coitally experienced college females was utilized to explore the adequacy of several related beliefs that constitute the cultural mythology of female sexual initiation in American society and to identify possible correlates of the subjective experience of pain during women's first intercourse. The results were that a sizeable minority of the women reported experiencing no pain during their first intercourse, that other subjective reactions (pleasure, guilt, anxiety) were experienced at least as commonly as pain, and that many women acquired considerable noncoital sexual experience prior to their first intercourse. The experience of pain during first intercourse was found to be related directly to young age, conservative sexual values, an expectation of no pain, and negative affect. The report closes with a consideration of future research needs and the presentation of a tentative model of first coital pain in which noncoital sexual experience and qualities attributed to the male partner are projected as indirect influences on first coital pain.
Affect↗
[The first sexual intercourse in girls].
The authors describe the course of the first sexual intercourse in 344 Czech girls examined at the age of 16-18 years. Attention was paid in particular to the following factors: age during first intercourse, period of preceding emotional relationship, age of coital partners, environment where first intercourse took place, motivation of probands, difficulties during first intercourse, contraception used, frequency of sexual intercourse during period following first coitus.
Adolescent↗
First sexual intercourse: age, coercion, and later regrets reported by a birth cohort.
OBJECTIVES: To investigate how age at first sexual intercourse is related to the reported circumstances and to determine how these corresponded to views in early adulthood about its timing. DESIGN: Cross sectional study within a birth cohort using a questionnaire presented by computer. SETTING: Dunedin, New Zealand in 1993-4. SUBJECTS: 477 men and 458 women enrolled in the Dunedin Multidisciplinary Health and Development Study, comprising 92% of survivors of the cohort. RESULTS: The median age at first intercourse was 17 years for men and 16 years for women. Only one man (0.2%) but 30 (7%) women reported being forced to have intercourse on the first occasion. For women, there were increasing rates of coercion with younger age at first intercourse. More men than women reported that they and their partner were equally willing (77% (316/413) v 53% (222/419)). Mutual willingness of both partners was greater for those who reported that it was also the first time for their partner. Timing of first intercourse was considered about right by 49% (200/411) of men and 38% (148/388) of women. Many women (54% (211/388) reported that they should have waited longer, and this rose to 70% (90/129) for women reporting intercourse before age 16. CONCLUSIONS: Most women regretted having sexual intercourse before age 16. First intercourse at younger ages is associated with risks that are shared unequally between men and women. This information is important to young people themselves.
Adult↗
The transition of adolescent males to first sexual intercourse: anticipated or delayed?
CONTEXT: Recognition of the different social, psychological and behavioral contexts within which adolescents initiate sexual activity broadens the understanding of teenage sexual behavior beyond the typical dichotomy of sexual experience vs. inexperience. METHODS: Data from the National Survey of Adolescent Males (1988 and 1990-1991) were used in logistic regression analyses to examine the influence of background factors on the transition to first intercourse among 265 teenagers who were not expecting to initiate sex in the next year (delayers) and 187 teenagers expecting to do so (anticipators). RESULTS: The most common reason for sexual inexperience among delayers was a desire to wait until marriage (32%); among anticipators, it was a lack of opportunity to initiate intercourse (35%). Anticipators were significantly more likely than delayers to have first intercourse within one year of the survey (53% vs. 13%). They also were more likely to report risky behaviors, precoital activities and approval of premarital sex; risky behavior predicted their onset of first sex (odds ratio, 1.5). Delayers were more likely to attend, church and have strict parents and a college-educated mother. Having a mother with at least some college education increased the odds of transition to first intercourse for anticipators (5.2) but decreased the odds for delayers (0.2). Having a mother who gave birth as a teenager significantly increased the odds for anticipators (14.5). CONCLUSIONS: Anticipators' sexual behavior occurs in a high-risk context, whereas delayers may have internalized the decision to delay first intercourse and have background factors that encourage the delay.
Adolescent↗
Risk factors for adolescent primigravida in Kaohsiung county, Taiwan.
OBJECTIVES: To study the risk factors for adolescent primigravida in Kaohsiung county, Taiwan. METHODS: This is a population survey on primigravida based on household registry to study risk factors affecting pregnancy of 215 women aged < 18; 341 women aged 18-19; and 590 women aged 20-34. RESULTS: The mean age of menarche, first intercourse, and first pregnancy, as well as the duration of menarche to the first intercourse increased significantly with the increased age of primigravida (P < 0.001). Adolescent primigravida, when compared to adult primigravida, were less likely to communicate well with their parents or be in a dual parent family (P < 0.05). They were also more likely to have alcoholic fathers, have drinking alcohol and smoking health behavior problems, exhibit poor school performance, have relatives or friends who became pregnant as adolescents, have been raped, and exhibit poorer knowledge of contraception before pregnancy (P < 0.05). Dose-response relationship in the odds ratio was found. Non-dual family, adolescent pregnancy in relatives or friends, smoking before pregnancy, and age of menarche were independent factors in multiple logistic regression on adolescent primigravida. CONCLUSIONS: The main risk factors for adolescent primigravida in Kaohsiung county. Taiwan, were family influence, health behavior problems, adolescent pregnancy in relatives or friends, and earlier onset of menarche. The age at which intercourse and smoking start appear to be two crucial factors that can be addressed through education as a means of intervention before pregnancy occurs.
Adolescent↗
Coerced first sexual intercourse and selected reproductive health outcomes among young women in KwaZulu-Natal, South Africa.
Coercion may play an important role in compelling young women to engage in sexual intercourse at an early age. With a decline in age at first intercourse and increased reporting of coercive first sex, concerns of adverse reproductive health outcomes such as unintended pregnancy and sexually transmitted infections (STIs), including HIV, have become important issues, particularly in the context of a high HIV prevalence. This paper uses data collected in 2001 from the second round of a longitudinal study of 1130 sexually experienced young women in KwaZulu-Natal to investigate the relationship between coerced first intercourse and selected reproductive health outcomes and behaviours. Nearly 46% of all sexually experienced young women had reported that their first sexual encounter had been coerced. Young women who reported being coerced at first sex were significantly more likely to be Black and living in an urban area. Those who had been coerced at first sex were also more likely to report having had an STI and having experienced unintended pregnancy, than those who had not been coerced at first sex. Coercion at first sex is an important social and public health problem that has a serious impact on the reproductive health and behaviours of young women. Interventions should directly address the issue of sexual coercion by ensuring young women are aware of their reproductive rights.
Adolescent↗
[Age at menarche and first sexual intercourse. A cross-sectional study of 17-year old Danish women].
The age at menarche and first intercourse was analyzed from data obtained from a questionnaire sent to 1500 17 year-old randomly selected Danish women (76% responded). The average age at menarche was 13.37 years (SD: 1.24). The median age at the time of the first intercourse was 16.6 years. Late sexual debut was observed for girls who were relatively old at menarche and for those with a higher level of education. Apparently the age at menarche and at first sexual intercourse has not changed significantly in recent years.
Adolescent↗
Attenders at young people's clinics in Southampton: variations in contraceptive use.
This paper presents findings from a survey of 424 people attending nine young people's clinics within the Southampton Community Health NHS Trust. In addition to recording some descriptive background data on the people attending the clinics, one major aim of the study was to investigate whether talking to the sexual partner about contraception before their first intercourse together and delaying this first intercourse influenced contraceptive use. Overall, 40 per cent of people attending the clinics were aged 16 or under, although there was some variation between clinics in the age groups attracted. Most clients were female (88 per cent), had ever had sexual intercourse (92 per cent), reported four or more lifetime partners (42 per cent) but only one partner within the last six months (73 per cent) and were currently in a relationship (75 per cent). Potential for contraception and sexually transmitted infection was widespread; 46 per cent (of non-virgins) had had intercourse without contraception at least 'a few times' and 18 per cent used condoms 'rarely' or 'never'. In terms of first intercourse with current/most recent partner, 17 per cent had not used any contraception and 32 per cent had failed to use condoms. The most important findings from this study were that use of contraception (and condoms in particular) on the occasion of first intercourse with the current or most recent partner was significantly associated with the following; if partners had talked to each other about contraception before having intercourse together for the first time (p<0.001), and also if this first intercourse was delayed beyond four weeks as opposed to over a few days of first 'going-out' together (p<0.001). Suggestions for further in-depth research are made.
Adolescent↗
Use of family planning at first sexual intercourse among young adults in Ecuador.
The purpose of this study was to assess factors associated with the use of family planning at first sexual intercourse among young adults aged 15 to 24 in urban Ecuador. The study population consisted of 1443 young adults (494 females and 949 males) in the cities of Quito and Guayaquil, interviewed by the 1988 Ecuador Young Adult Reproductive Health Survey, who reported having experienced consensual sexual intercourse. Approximately 11% of females and 15% of males reported using contraception at first intercourse. Binary logistic regression was performed to assess jointly the effect of multiple factors on contraceptive use at first intercourse. The regression model was first run on the entire study population and then separately for males and females. In the overall population, the following variables were significantly related to using family planning at first sex: being male; being from Guayaquil; older age; father's completion of secondary school. Having lost one's virginity to a prostitute was significantly associated with non-use of family planning. Males were 3.6 times more likely than females to use family planning during their first sexual intercourse. For each year older a young adult was at first sex, his or her odds of using family planning was multiplied by a factor of 1.3. Twenty-eight per cent of males in this study experienced their first sexual intercourse with a prostitute, and these young men were highly unlikely to use family planning. A male who experienced first intercourse with his girlfriend was more than five times as likely to use contraception than a male who lost his virginity to a prostitute.
Adolescent↗
Early childhood nutrition, education and fertility milestones in Guatemala.
Data on fertility milestones were collected in 1994 and linked to information collected in a trial conducted in eastern Guatemala between 1969 and 1977, to examine whether early childhood nutrition was associated with the timing of fertility milestones. In the original trial, two pairs of villages were randomly allocated to receive either a high energy, high protein supplement (Atole) or a low energy, no-protein supplement (Fresco). Mean age at follow-up was 23.47 y (n = 240). About 62% of women had experienced first birth (median age at first birth = 19.83 y). The median intervals from menarche to first intercourse and from first intercourse to first birth were 5.67 and 0.95 y; they were 1.68 and 0.06 y shorter, respectively, for the Atole group than for the Fresco group. Women who had received Atole in utero and/or during early childhood experienced earlier milestones even after adjusting for socioeconomic status (SES), education and age at the prior event. Median age at first birth was 1.17 y earlier for the Atole group. Better growth during early childhood (not severely stunted) led to earlier milestones (median age at first birth was 1.04 y earlier), primarily among women with illiterate fathers. Completion of primary school significantly delayed fertility milestones; the median age at first birth was 4.27 y later for those who completed primary school compared with those who did not (P < 0.05). In sum, improved nutrition during early childhood results in earlier fertility milestones, but the effects of schooling in delaying fertility milestones are greater in magnitude. Intervention programs that improve early childhood nutrition should be accompanied by investments in education that ensure that girls complete primary school.
Adult↗
Gender and ethnic differences in the timing of first sexual intercourse.
CONTEXT: Whether the effect of gender on the risk of first intercourse in influenced by adolescents ethnicity has received limited attention in research on age at first sex. Such information could provide a more complete understanding of adolescent sexual behavior. METHODS: Life-table analysis using data from a population-based, ethnically diverse sample of 87/Los Angeles County youths was employed to estimate the median age at first sex for each gender-and-ethnicity group. Multivariate analysis using proportional hazards techniques was conducted to determine the relative risk of sexual activity among teenagers in each group. RESULTS: Overall, the teenagers in the sample had a median age at first sex of 16.9 years. Black males had the lowest observed median (15.0), and Asian American males the highest (18.1); white and Hispanic males, and white and black females, reported similar ages (about 16.5 years). Hispanic and Asian American females had rates of first sex about half that of white females, although these protective effects were explained by differences in family structure. Even after controlling for background characteristics, black males had rates of first sex that were about 3-5 times the rates of the other gender-and-ethnicity groups. In addition, Asian American males were less likely than Hispanic males to be sexually experienced, and Hispanic males had almost twice the rates of sexual activity of Hispanic females. CONCLUSIONS: Socioeconomic conditions account for ethnic differences among females in the age at first sex, and cultural influences may contribute to the difference between Hispanic males and females; explanations for black males, however, remain elusive.
Adolescent↗
Heterosexual romantic relationships and sexual behaviors of young adolescent girls.
PURPOSE: To compare the heterosexual romantic relationships of a cohort sexually experienced and sexually inexperienced adolescent girls, to describe the perceptions of the appropriateness of the age of first intercourse, and to evaluate the reasons why sexually experienced girls chose to have sexual intercourse the first and the most recent times they had sexual intercourse. METHODS: Girls (n = 174) with a mean age of 14.5 years were recruited from an urban-based adolescent clinic to participate in a longitudinal study of psychosexual development. The subjects were interviewed regarding their views about relationships and sexual behaviors. For the purposes of this study, data were analyzed from the first wave of data collection. RESULTS AND CONCLUSIONS: The results of this study revealed that sexually experienced girls were more likely than sexually inexperienced ones to share unique information and spend time with their boyfriends, and to anticipate that their relationships would last longer. Regardless of sexual experience, 35% of their relationships were not mutually exclusive, which places the sexually experienced girls at risk for sexually transmitted infections. Most of the girls felt that they had been "too young" at the time of first intercourse. The reasons the adolescent girls gave for having intercourse the first time and the most recent time were correlated. It would be useful to incorporate the results of this study into subsequent research which identifies strategies to aid girls to postpone the initiation of intercourse, and maintain exclusive sexual relationships. Helping sexually experienced girls to consider why they have had intercourse in the past can aid future decision-making.
Adolescent↗
Adolescent contraceptive use and communication: changes over a decade.
Sexual experiences of 186 adolescents in 1979 were compared to those of 215 adolescents in 1989 who were recruited from the same university to determine if there was an increase over the decade in "safe sex" practices. Self-reported condom use increased between 1979 and 1989 for very first intercourse as well as first intercourse with current partner, although condom use was still far from universal. For other behaviors, there were sexual career changes (i.e., changes from first to current partner) but not decade changes. The percentage of respondents using any method of contraception and the percentage who discussed contraception with their partner increased from first to current partner, but did not increase between 1979 and 1989. The very first intercourse with first partner remained especially troubling since contraceptive use was very low and discussions about contraception prior to sex were very infrequent.
Acquired Immunodeficiency Syndrome↗
Interval between menarche and first sexual intercourse, related to risk of human papillomavirus infection.
The purpose of this investigation was to study the occurrence of human papillomavirus (HPV) infection in relation to the interval between menarche and first intercourse. Two hundred eight subjects, aged 13 to 21 years, were recruited from an ambulatory adolescent clinic. Patients were excluded if they had a history of genital warts or an abnormal Papanicolaou smear. All subjects completed a self-administered questionnaire regarding demographics and their menstrual, sexual, and contraceptive histories. HPV infection was determined by in situ hybridization or changes consistent with HPV on a Papanicolaou smear, or both. The prevalence of HPV infection was 19.2%. The average interval between menarche and onset of sexual activity was 26.6 months for those who were found to have HPV infection compared with 35.7 months for those whose test results were negative (p = 0.02). First sexual intercourse within 18 months of menarche was associated with a significant elevation of risk of HPV infection, in comparison with that in adolescents who postpone first intercourse 3 to 4 years after menarche. These data suggest that factors such as increased biologic vulnerability may play a role in HPV infections among adolescent women.
Adolescent↗
Contraceptive use at first premarital intercourse: United States, 1965-1988.
The proportion of U.S. women who used a contraceptive method at their first premarital intercourse rose from 47 percent in 1975-1979 to 65 percent in 1983-1988. Overall, and among non-Hispanic white women, this change resulted entirely from an increase in the use of condoms by their partners. The proportion of whites who used a condom at first premarital intercourse, for example, increased from 24 percent to 45 percent. Among blacks, condom use at first intercourse increased from 24 percent to 32 percent during that period, and pill use rose from 15 percent to 23 percent. Among all women, the method most often used at first intercourse during every period in the study was the condom, followed by the pill and withdrawal. The proportion of women using a method at first premarital intercourse varies strikingly according to individual characteristics. Among the various demographic subgroups, the proportion who use a method varies from 32 percent of Hispanic women to 68 percent of Jewish women. Whites are more likely to use a method than are blacks, and fundamentalist Prostestants are less likely to use a method than are other Protestants or Catholics. The proportion using a method is higher among women whose mothers completed high school than among those whose mothers did not. In addition, the proportion rises with age at first intercourse. Multiple logistic regression showed that the independent effects of Hispanic origin, Jewish or fundamentalist Protestant religious affiliation and the education of a woman's mother are large and significant.(ABSTRACT TRUNCATED AT 250 WORDS)
Adolescent↗