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PubMed2005

Young age at first sexual intercourse and sexually transmitted infections in adolescents and young adults.

The authors examined the relation between age at first vaginal intercourse and a positive nucleic acid amplification test for sexually transmitted infection (STI). A nationally representative sample of 9,844 respondents aged 18-26 years was tested for chlamydial infection, gonorrhea, and trichomoniasis in wave 3 (2001-2002) of the National Longitudinal Study of Adolescent Health. The authors used multiple logistic regression to assess the relation between age at first sexual intercourse and these STIs and to examine variation by current age, sex, race, and ethnicity. Younger ages at first intercourse were associated with higher odds of STI in comparison with older ages, but the effect diminished with increasing current age. For example, the odds of having an STI for an 18-year-old who first had intercourse at age 13 were more than twice those of an 18-year-old who first had intercourse at age 17 (prevalence odds ratio = 2.25, 95% confidence interval: 1.42, 3.59). In contrast, the odds of having an STI among 24-year-olds with first intercourse at age 13 versus those with first intercourse at age 17 were the same (prevalence odds ratio = 1.11, 95% confidence interval: 0.88, 1.39). Thus, earlier initiation of sexual intercourse is strongly associated with STIs for older adolescents but not for young adults over age 23 years.

Adolescent↗

PubMed1998

First sexual intercourse: anticipation and communication. Interviews with young people in England.

This study investigated anticipation and communication around first sexual intercourse through semi-structured interviews with young people (aged 16 to 29) in England. Ranging from surprise to pre-planning, several different levels of anticipation are explored. The main findings are as follows: communication plays a central role, mediating between the degree of anticipation and the degree to which first intercourse is wanted, protected and enjoyed. First intercourse tends to be characterized by silence, especially during early, spontaneous encounters. Silence does not imply lack of communication-non-verbal communication plays an important role. Where young people are ambivalent, verbal and non-verbal communication may send contradictory messages. The implications of the results for future safer sex campaigns are discussed.

Adolescent↗

PubMed2002

Mediators of the association between age of first sexual intercourse and subsequent human papillomavirus infection.

OBJECTIVE: Previous studies have demonstrated that early age of first sexual intercourse is associated with human papillomavirus (HPV) infection. The objective of this study was to identify a set of risk behaviors and partner characteristics that mediate the association between age of first sexual intercourse and subsequent HPV infection in adolescent and young adult women. METHODS: Female university students completed surveys and underwent HPV testing every 6 months for up to 3 years. HPV-positive participants were matched to HPV-negative participants (252 pairs, total N = 504). Associations were examined between risk behaviors/partner characteristics and both age of first sexual intercourse and HPV infection. Those variables associated with either age of first sexual intercourse or HPV infection were entered into a generalized estimating equation (to account for the matched study design) modeling the association between age of first sexual intercourse and HPV infection. RESULTS: Mean age of first sexual intercourse was 16.7 (+/-1.8) years, and early age of first sexual intercourse was associated significantly with HPV infection (beta = -0.20; odds ratio: 0.82; 95% confidence interval: 0.74-0.90). The association was mediated by number of sexual partners in the past 6 months, history of sexually transmitted infection, alcohol and drug use related to sexual behaviors, and partner's number of sexual partners. CONCLUSION: A set of behavioral risk factors and partner characteristics partially mediate the association between age of first sexual intercourse and subsequent HPV infection.

Adolescent↗

PubMed1996

The initiation of adolescent sexual and contraceptive behavior during changing times.

This paper examines changes in the initiation of adolescent sexual and contraceptive behavior in the United States between 1978 and 1988. Since a number of contextual changes occurred during this time period including a focusing of public attention on adolescent pregnancy along with the widespread publicity surrounding AIDS, we expected that the response to these events not only would change over time, but would also vary across social groups. Using data from Cycles III and IV of the National Survey of Family Growth, we find that the overall population patterns of earlier initiation of sexual intercourse and increased use of condoms at first intercourse are not found in all segments of the population. In general, the effects of race, religion, mother's education, and age changed during this time period. The long-term trend of younger age at first intercourse was halted for Blacks, and reversed for White, fundamentalist Protestants, but continued for all other Whites. Overall, patterns throughout the decade suggest that pressures from parents, religious groups, and others either lead to a later age at first intercourse, or use of contraception, but not both. A notable exception is that increased maternal education leads to both a later age at first intercourse and a higher likelihood of using contraception at first intercourse.

Adolescent↗

PubMed2006

Early age of first sexual intercourse and affiliation with deviant peers predict development of SUD: a prospective longitudinal study.

OBJECTIVE: A recent study has reported that early sexual behavior predicts the development of substance use disorders (SUD). However, that relationship was considered by its authors to be only tentative, because it was based on cross-sectional data rather than longitudinal data. Another recent study reported that deviant activities of peers predict development of SUD, although that relationship has not yet been confirmed. The objective of this study was to assess whether early onset of sexual intercourse and affiliation with deviant peers serve as predictors of the development of SUD, using a prospective longitudinal study design. METHOD: We conducted a prospective longitudinal study of adolescents. These subjects were recruited at the age of 10-12years, with follow-up evaluations at ages 14, 16, 19, 22, and 25. The sample included 136 male subjects. Cox regression analyses were performed, with age of first intercourse, neurobehavioral disinhibition, exposure to drugs in the neighborhood, and deviant activities of peers as factors in the analyses. RESULTS: Earlier age at first intercourse and deviant activities of peers each predicted a significantly higher risk of subsequently developing a SUD (Wald=8.3, df=1, p=0.004; Wald=7.5, df=1, p=0.006, respectively). CONCLUSIONS: The results of this study confirm that early onset of sexual intercourse and affiliation with deviant peers predict the early development of substance use disorders, using a prospective longitudinal study design.

Adolescent↗

PubMed1995

Durations of adolescent sexual relationships before and after conception.

PURPOSE: To explore durations of young couples' relationships between meeting and first intercourse, before first conception and for two years following conception and the associations between these durations; to describe the association between these durations and the young women's perceptions of the nature of these relationships. METHODS: Three hundred and seven adolescent women were enrolled in a prospective study while presenting for pregnancy tests (the index event); they were followed for two years in three groups--those with negative tests, those who terminated the pregnancy and those who bore a child. Retrospective information about durations of relationships with first partners and partners at the index event was obtained at baseline; follow-up data was obtained on continuing relationships with the index partner. RESULTS: Durations of relationships between adolescent females and their partners in this sample, both before and after conception, are rarely brief; the median duration of a girl's prior relationship with a partner with whom she conceives is almost two years. Similarly, almost half of the sample is still in a relationship at two years following the index event, a proportion that rises to two-thirds among those who bore a child together. CONCLUSIONS: Contrary to common belief or practice, there may be sufficient time and commitment to include many male partners in intervention programs before, and in parenting programs after, a first conception--a practice which could have positive implications for both adolescent partners and, potentially, for their child.

Adolescent↗

PubMed2004

Prevalence and patterns of gender-based violence and revictimization among women attending antenatal clinics in Soweto, South Africa.

Gender-based violence is a key health risk for women globally and in South Africa. The authors analyzed data from 1,395 interviews with women attending antenatal clinics in Soweto, South Africa, between November 2001 and April 2002 to estimate the prevalence of physical/sexual partner violence (55.5%), adult sexual assault by nonpartners (7.9%), child sexual assault (8.0%), and forced first intercourse (7.3%). Age at first experience of each type of violence was modeled by the Kaplan-Meier method, and Cox hazard models with time-varying covariates were used to explore whether child sexual assault and forced first intercourse were associated with risk of violent revictimization in adulthood. Child sexual assault was associated with increased risk of physical and/or sexual partner violence (risk ratio = 2.43, 95% confidence interval: 1.93, 3.06) and with adult sexual assault by a nonpartner (risk ratio = 2.33, 95% confidence interval: 1.40, 3.89). Forced first intercourse was associated with increased risk of physical and/or sexual partner violence (risk ratio = 2.64, 95% confidence interval: 2.07, 3.38) and nonsignificantly with adult sexual assault by a nonpartner (risk ratio = 2.14, 95% confidence interval: 0.92, 4.98). This study confirms the need for increased attention by the public health community to primary and secondary prevention of gender-based violence, with a specific need to reduce risk among South African adolescents.

Adolescent↗

PubMed1997

Gender and social differences in adolescent sexuality and reproduction in Nicaragua.

PURPOSE: The aim of this research was to study gender and social differences in adolescent sexuality and reproduction, as reflected in age at first intercourse and age at first pregnancy, as a basis for future interventions in the municipality of León, Nicaragua. METHODS: In a community-based cross-sectional study including 7789 households, all women aged 15-49 years (n = 10,867) were interviewed about socioeconomic, sexual, and reproductive issues. A random subsample of men (n = 388) and women (n = 413) aged 15-49 years was interviewed in more detail about sexual patterns and reproduction. RESULTS: The median age at first intercourse for women and men was 17.8 and 16.2 years, respectively. Women's average latency period to end of first pregnancy was 22 months. There was a significant tendency to start active sexual life later among today's girls aged 15-20 years, compared to the groups 21-27, 28-35, and 36-49 years old. A similar trend was found in age at first pregnancy. These secular trends were not found among men. Age at first pregnancy for current adolescents was lower among those having less formal education. CONCLUSIONS: The short latency period between first sexual intercourse and end of first pregnancy, probably reflecting lack of access to counseling and contraception, is worrying in light of the growing sexually transmitted disease/human immunodeficiency virus threat. The secular trend of later start of reproduction, however, is a positive sign which partly may be an effect of increasing education in the Nicaraguan society.

Adolescent↗

PubMed1976

Serological and epidemiological considerations of the role of herpes simplex virus type 2 in cervical cancer.

To assess the possible biological significance of the observations that women with cervical cancer tend to be younger at first intercourse than control women, data from 1823 women were analyzed for the relationship between age at 1st intercourse and number of sex partners. Women who were younger at first intercourse had more sex partners than did women who were older at first intercourse. The interdependence of age at first intercourse and number of sex partners does not exlude the possibility that intercourse at an early age represents a biologically significant event in which the neoplastic process is initiated. However, it is equally possible that younger women at first intercourse may have multiple sex partners and be at greater risk of coming in contact with a putative oncogenic agent later in life. In addition, sera from patients with herpesvirus infections were assayed for cross-reacting and type-specific antibodies. Approximately 80% of the total antibody activity was to the cross-reacting antigen and only 20% was to the type-specific antigens in the sera of patients infected with either type 1 or type 2 virus. Among patients infected with both types of virus, less antibody activity to the type-specific antigens and more antibody activity to the cross-reacting antigens were found. These observations are discussed with respect to case-control seroepidemiological studies.

Age Factors↗

PubMed1996

Predicting the timing of first sexual intercourse for at-risk adolescent males.

Event history analysis was used to test a developmental model of the timing of first sexual intercourse in the Oregon Youth Study sample of adolescent males at risk for delinquency. The event history models spanned grades 7-12 with yearly multimethod, multiagent measures. A 3-step mediational model of predictors was tested, including contextual and process factors and boys' characteristics. Predictors included one-time measures of socioeconomic status, parental antisocial behavior, and time-varying measures of parental transitions, parental monitoring, deviant peer association, and the boys' antisocial/delinquent behavior, substance use, physical maturation, academic achievement, and anxiety. As predicted, antisocial/delinquent behavior and substance use along with early physical maturity and parental transitions predicted early onset of sexual intercourse. Anxiety was related to delay of first intercourse. Results and intervention implications are discussed in terms of the developmental findings.

Adolescent↗

PubMed1995

An attempt to estimate the incidence of cervical dysplasia in a group of New Zealand women using contraception. The New Zealand Contraception and Health Study Group.

We attempted to estimate incidence rates of cervical dysplasia and carcinoma in a cohort of 7,199 New Zealand women using contraception. The cohort was followed prospectively with periodic cervical smears, intended to be annual, over a 6-year period. The principal outcome investigated was a diagnosis of cervical dysplasia of any degree, from mild to severe dysplasia and including carcinoma in situ or invasive carcinoma, made cytologically by a central study laboratory and confirmed by histology or deoxyribonucleic acid (DNA) evaluation. These diagnoses are jointly referred to as "dysplasia." Two successive negative (nondysplastic) smears were required before a woman was considered eligible for the analysis of incidence. Even after these two negative smears, the estimated "incidence" of dysplasia declined markedly in each of the 5 years of the study, particularly among women who provided negative smears in each prior year. This suggests that prevalent cases were being diagnosed even after five or more negative smears. Assuming that nearly all of the prevalent cases were removed after five negative smears, our estimate of the annual incidence of cervical dysplasia in this population during this time period would be of the order of 5 per 1,000 per year. We conclude that the sensitivity of cervical testing for identifying cervical dysplasia is quite low in this population but is consistent with values reported from some other populations. Age at first intercourse, age at first pregnancy, number of sex partners, and current cigarette smoking were strongly associated with risk of dysplasia. Our data are equivocal on the question of whether age at first intercourse is a risk factor independently of the closely associated variable, number of sex partners.

Adult↗

PubMed1997

The consistency of recalled age at first sexual intercourse.

It is widely believed that people can remember the age at which they first had sexual intercourse. Questions about age at onset are routinely asked in population sexual behaviour surveys and in clinical history-taking. However, there are limited test-retest data, especially with regard to individual differences in unreliable recall. In this study, telephone interviews and follow-ups an average of 15 months later were conducted with 570 non-virgin subjects aged between 28 and 73 years. Test-retest correlations for recalled age at first intercourse were 0.85 for females and 0.91 for males. Consistency was slightly lower among older people and women with a history of sexual abuse. There were no significant associations between consistency of recall and measures of personality, educational background or history of alcohol dependence and depression.

Adult↗

PubMed2002

The interval between menarche and age of first sexual intercourse as a risk factor for subsequent HPV infection in adolescent and young adult women.

We sought to determine whether the interval between menarche and age of first sexual intercourse is associated with subsequent human papilloma virus (HPV) infection and if so, whether the association is independent of the age of first sexual intercourse. Female university students completed a survey and were screened for cervicovaginal HPV infection. HPV-positive subjects were matched to HPV-negative subjects (n = 504). Mean subject age was 20.4 +/- 2.1 years, age of first sexual intercourse 16.7 +/- 1.8 years, and interval 4.4 +/- 2.0 years. The interval was associated with HPV infection, but the association became nonsignificant in univariate stratified analyses and multivariate models estimating the association between the interval and HPV infection. A short interval is associated with HPV infection, but the association is not independent of age of first sexual intercourse. Age of first sexual intercourse should be considered an important and identifiable risk factor for subsequent HPV infection in research and clinical settings.

Adolescent↗

PubMed1995

[First sexual intercourse in women].

Out of a group of 700 Czech girls aged 16 to 18 years questioned by means of interviews 344 (49.1%) already had their first heterosexual coitus. Thirty-three of them reached orgasm during their first sexual intercourse and during second and further intercourses they were orgasmic mostly or always. The second subgroup comprised 32 girls who were anorgasmic not only during their first sexual intercourse but also during their further sexual life. Statistically significant differences between these two subgroups were found in the following items: Orgasmic girls were more frequently longing for their first sexual intercourse whereas of the anorgasmic girls the motives were curiosity or the effort to satisfy their partners. The majority of these girls experienced the first sexual intercourse as unpleasant and reported frequent occurrence of bleeding. Furthermore, they had to regret more frequently the loss of their fathers during the first 6 years of their lives than the girls of the first subgroup had.

Adolescent↗

PubMed1995

A retrospective study of first sexual intercourse experiences among undergraduates.

Survey data concerning the first sexual intercourse (FSI) experiences of 272 undergraduate students revealed that 6% had experienced FSI against their personal wills (victims); 1% had experienced FSI against the will of the other person (offenders); 81% had experienced FSI at the will of both participants (consenting); and 11% were virgins (does not add up to 100% because of rounding). Examination of the students' perceptions of the various factors contributing to nonconsensual sexual intercourse (NSI) showed that fewer than 50% of the students agreed that situational and psychological factors contribute to NSI. Results also indicated that being a woman and perceptions about the factors that reduce victims' resistance were significant predictors of who would be the victim of FSI. Religious background, the reasons for having a date, and perceptions regarding the factors that enhance motivation to have NSI were significant predictors of FSI offenders. Personal risk behaviors were the strongest predictors of students who experienced FSI at the will of both participants, and risk factors were inversely related to being a virgin.

Adult↗

PubMed1990

[The age of sexual debut among Norwegian adolescents].

Kaplan-Meier estimates were used to study age at first intercourse among Norwegian adolescents. The data stemmed from a nation-wide study of 3,000 Norwegian adolescents aged 17-19 years. The response rate was 61.8%. Median age at first intercourse was 17.3 years for girls and 18.0 years for boys. The results indicate that median age at first intercourse has not become lower in Norway since 1975. Age at first intercourse was significantly associated with educational aspirations and frequency of visits to church by respondents and parents. Furthermore, age at first intercourse was significantly associated with smoking behaviour, alcohol consumption, peer affiliation and frequency of visiting a discotheque. These inter-relationships confirm that age at first intercourse is an important indicator of the lifestyle of an individual. Thus, in order to influence the sexual behaviour of adolescents it thus seem appropriate, as a supplement to traditional methods of sex education, to employ health promotion activities which focus on environmental and structural factors.

Adolescent↗

PubMedDate not supplied

Does the timing of the first family planning visit still matter?

CONTEXT: The timing of a first family planning visit relative to first intercourse can affect the likelihood of an early unintended pregnancy. METHODS: Nationally representative data from the 1982, 1988 and 1995 cycles of the National Survey of Family Growth were used to examine changes in the timing of first family planning visits and to explore the degree to which young women are now more likely than in the past to practice contraception independently of making a visit to a provider. Cox proportional hazards models were used to estimate how background variables, visit status and the initiation of contraceptive use affected risks of unintended pregnancy in the four years preceding each survey. RESULTS: The proportion of women who waited a month or more after their first intercourse to see a provider grew slightly between 1978 and 1995, from 76% to 79%; women waited a median of 22 months after first intercourse in 1991-1995. Any contraceptive use at first intercourse increased among both women who delayed a first visit (from 51% to 75%) and among those whose first visit occurred before their first intercourse or within the same month (from 61% to 91%). Cox proportional hazards analysis suggests that the protective effect of a first family planning visit decreased over the period studied, due in part to the increase in early contraceptive use. CONCLUSIONS: The importance of the first family planning visit appears to be declining, as sexually active young women who delay their first visit increasingly do so because they are already using a provider-independent method (primarily the condom). Thus, a multifaceted approach to providing family planning may now be needed, in which independent method use and visits to providers both play a role.

Adolescent↗

PubMed1999

Nature, nurture and first sexual intercourse in the USA: fitting behavioural genetic models to NLSY kinship data.

Fisher (1930) presented both theoretical and empirical results concerning genetic influences on fertility. Since then, only sparse research has been done on the genetics of fertility, although more sophisticated methodogy and data now exist than were available to Fisher. This paper presents a behavioural genetic analysis of age at first intercourse, accounting for genetic, shared environmental, and selected non-shared environmental influences. The data came from the nationally representative National Longitudinal Survey of Youth (NLSY). A newly developed kinship linking procedure was used that identifies links for cousins, half-siblings, full-siblings and twins in the NLSY. The results suggest a genetic influence in the overall dataset, and also among whites and in male-male and opposite-sex pairs. Genetic influences were extremely small or non-existent for blacks and for female-female pairs. Shared environmental influences were small for most subsets of the data, but moderate for female-female pairs. Two specific non-shared environmental influences--self-esteem and locus of control--were ruled out as accounting for any meaningful variance, although other general sources of non-shared environmental influence appear potentially important. Analysis of selected samples from upper and lower tails suggested that genetic influences are important in accounting for both early and late non-virginity. These findings are consistent with work reported by Miller et al. (1999), who used molecular genetic methods. Generally, these findings support the existence of genetic influences and implicate non-shared environmental influences as being important determinants of the timing of loss of virginity among US adolescents and young adults.

Adolescent↗