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PubMed2002

High incidence of cervical human papillomavirus infection in women during their first sexual relationship.

The prevalence of cervical human papillomavirus increases with increasing numbers of sexual partners, leaving the impression that this infection is acquired only as a result of high risk sexual behaviour. Using longitudinal data from 242 women who had only had one sexual partner, we found that the risk of acquiring cervical human papillomavirus infection was 46% (95% CI 28-64) at three years after first intercourse and that the median time from first intercourse to first detection of human papillomavirus was only three months.

Adolescent↗

PubMed2003

Early patterns of sexual activity: age cohort differences in Australia.

Patterns of first sexual activity among Australians born between the 1940s and 1980s were analysed using data from a national telephone survey of 1784 adults (876 males; 908 females). Sixty-one percent of those randomly selected from the Australian electoral roll and contactable by telephone responded. Many trends, including earlier first intercourse--from 20 to 18 years (females) and 18.8 to 17.8 years (males)--were established with the 40-49 year cohort, whose sexual debut was in the late 1960s-70s. Significant age-cohort effects saw women in the contemporary (18-29 year) cohort draw level with males for age at first intercourse and first sex before age 16 and before leaving school. First intercourse contraceptive use climbed from 30% to 80%. Condom use quadrupled to 70%. Australian age-cohort effects are remarkably consistent with those in similar western cultures: gender convergence in sexual experience and increasing avoidance of sexually transmitted disease and pregnancy. If such trends continue, positive long-term outcomes for health and social wellbeing should result.

Adolescent↗

PubMed1992

Determinants of sexual habits in Italian females.

OBJECTIVE: To identify characteristics of women reporting multiple sexual partners and early age at first intercourse in Italy. METHOD: Information on 1139 control women (median age 54 years) interviewed as part of a case-control study of cervical neoplasia conducted in the greater Milan area, Northern Italy were analysed using stratified analysis and multiple logistic regression. RESULTS: Overall, 81% of the study sample reported no more than one sexual partner, 10% two and 9% three or more. The proportion reporting multiple sexual partners tended to be higher among younger and more educated women (4% vs 19% of women with respectively less than 7 and 12 or more years of education reported three or more partners). Ever smokers reported a higher number of sexual partners than never smokers. The proportion of nulliparae reporting three or more sexual partners was higher than that of parous women. These findings were confirmed after taking into account in a multivariate analysis the role of potential confounding factors. Furthermore similar findings emerged from an analysis restricted to women aged 40 years or less. Always considering number of sexual partners, no relationship emerged with marital status, spontaneous or induced abortions, lifetime number of reported Pap smears and contraceptive habits. With reference to age at first intercourse, 25% of the study population reported their first intercourse at age 18 or before, 34% between 19 and 22 years, and 41% at age 23 or later. Younger women (that is, more recent cohorts) more frequently reported earlier age at first intercourse and the proportion of never married women reporting early intercourse was higher (51% vs 22% of never married vs married women). No relationship emerged between education, smoking habits, parity, history of spontaneous or induced abortions, number of Pap smears, contraceptive habits, and age at first intercourse. CONCLUSION: This study documents conservative sexual habits in Northern Italian females (at least on the basis of self reporting) but indicates that any educational compaigns towards safe sex should be focused towards younger women, particularly smokers, unmarried and nulliparae.

Abortion, Induced↗

PubMed2006

Migrant men: a priority for HIV control in Pakistan?

OBJECTIVES: To assess sexual risk behaviour and prevalence of treatable sexually transmitted infections (STI) in migrant male workers in Lahore, Pakistan. METHODS: Behavioural interviews were conducted on a representative sample of 590 migrant men aged 20-49 years. Biological samples were collected from a subsample of 190 and tested for chlamydia, gonorrhoea, and syphilis. RESULTS: Over half (55%) of single men were sexually experienced and 36% of married men reported premarital sex. The median ages at first intercourse and first marriage were 21 years and 28 years, respectively. In the total sample (including virgins), 13% reported any female non-marital partner in the past 12 months, 7% contact with a female sex worker, and 2% sex with a man. Only 10% reported using a condom during most recent contact with a sex worker. STI symptoms in the past 3 months were reported by 8% of men. Laboratory tests disclosed that STI prevalence was 3.2%. CONCLUSIONS: If and when HIV infection spreads among sex workers in Lahore, the reported behaviour of migrant men suggests that they may act as a conduit for further transmission to the general population. Condom promotion focused on the sex trade is likely to be the most effective way of reducing this risk.

Adult↗

PubMed1986

Smoking and cervical intraepithelial neoplasia. An association independent of sexual and other risk factors?

The connection between smoking and cervical neoplasia has been questioned. The association demonstrated has been suspected to depend on a correlation between smoking and sexual behavior or other risk factors for cervical neoplasia. This case-control study included 140 women with cervical intraepithelial neoplasia diagnosed during pregnancy. For each case, 2 healthy, age-matched women, who simultaneously attended for a pregnancy check at the same maternity clinic, served as controls. Information was obtained on obstetrical and gynecological history, sexual behavior, contraceptive methods, female and male smoking habits and socioeconomic status, using both an interview and a questionnaire. The patients were significantly younger at first intercourse and first pregnancy, had more sexual partners, showed a higher frequency of both female and male smokers and had a different pattern of contraceptive use vis-á-vis the controls. Analyses of covariance were used to identify and check for possible confounding before a log-linear regression analysis was ultimately carried out. Two factors remained closely associated with cervical intraepithelial neoplasia: number of sexual partners, and female smoking. We conclude that smoking seems to be a genuine risk factor for cervical intraepithelial neoplasia.

Adolescent↗

PubMed1995

Perinatal transmission and maternal risks of human papillomavirus infection.

We conducted a prospective study to investigate whether human papillomavirus (HPV) could be vertically transmitted to neonates. Pregnant women (N = 203) were tested for HPV DNA infection during the third trimester and again during labor prior to delivery. Their newborns (N = 203) were tested 1 to 3 days after delivery. Among the mothers, 12.3% (N = 25/203) typed HPV positive at either or both maternal specimen collection periods, whereas only 1.0% of the neonates (N = 2/203) typed positive. This low transmission rate may be due in part to the fact that 65% of mothers who were HPV positive during the third trimester tested HPV negative by labor/delivery. The higher frequency of risks associated with maternal HPV infection were similar to those found in studies of cervical dysplasia and cancer: younger age at first intercourse and first pregnancy, number of sexual partners, and longer duration in use of oral contraceptives. In addition, those who were past smokers and had a shorter recency and latency period in smoking were more likely to be detected with HPV.

Adolescent↗

PubMed2004

Sexual Health.

HEALTH ISSUE: Much attention is devoted to women's reproductive health, but the formative and mature stages of women's sexual lives are often overlooked. We have analyzed cross-sectional data from the Sexual Behaviour module of the 2000/2001 Canadian Community Health Survey (CCHS), and reviewed the literature and available indicators of the sexual health of Canadian women. KEY FINDINGS: Contemporary Canadian adolescents are becoming sexually active at younger ages than in previous generations. The gender gap between young males and females in age at first intercourse has virtually disappeared. The mean age at first intercourse for CCHS respondents aged 15-24 years was between 16 and 17. Canadian-born respondents are significantly younger at first intercourse than those who were born outside of Canada. Few adolescents recognize important risks to their sexual health. Older Canadians are sexually active, and continue to find emotional and physical satisfaction in their sexual relationships. DATA GAPS AND RECOMMENDATIONS: Both health surveys and targeted research must employ a broader understanding of sexuality to measure changes in and determinants of the sexual health of Canadians. There is reluctance to direct questions about sexual issues to younger Canadians, even though increased knowledge of sexual health topics is associated with delayed onset of sexual intercourse. Among adults, sex-positive resources are needed to address aspects of aging, rather than medicalizing age-related sexual dysfunction. Age and gender-appropriate sexual health care, education, and knowledge are important not only for women of reproductive age, but for Canadians at all stages of life.

Journal Article↗

PubMedDate not supplied

Social and environmental factors influencing contraceptive use among black adolescents.

In 1979 survey among sexually active unmarried black adolescents from Chicago found that 28 percent of the young women and 18 percent of the young men used a contraceptive at first intercourse. Statistically significant differences in such contraceptive use among teenage women were found for three social and environmental characteristics: social class, parents' marital status and neighborhood quality. Thus, 41 percent of the young women from the highest social class used contraceptives at first intercourse, but only 17 percent of those from the lowest class did so. The proportions were 35 percent for young women from neighborhoods of high socioeconomic status and 17 percent for those from ghetto neighborhoods. Thirty-six percent of teenage women whose parents had intact marriages as of the adolescent's 11th birthday used contraceptives at first intercourse, compared with 23 percent of those from single-parent and divorced families. Among males, social class was the only one of these three characteristics that was statistically significant; 32 percent of adolescents from the highest class and 11 percent from the lowest practiced contraception at first intercourse. For teenagers of both sexes, career aspirations were of marginal statistical significance in the practice of contraception. Thirty-six percent of young women with high aspirations used contraceptives at first intercourse and 19 percent of those with low aspirations did so. Only four percent of the young men with low career aspirations used contraceptives, compared with 25 percent of those with high aspirations. Number of siblings, parental supervision of dating and having a sister who had become a teenage mother showed no association with contraceptive use.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1995

Provision of sex education and early sexual experience: the relation examined.

OBJECTIVES: To explore the relation between receipt of sex education and experience of first intercourse. SUBJECTS AND DESIGN: The national survey of sexual attitudes and lifestyles is based on a sample of 18,876 respondents aged 16-59, randomly selected from the Post Office's small-user postcode address file. Data were collected between May 1990 and November 1991 by personal interviews combining a self administered questionnaire with a face to face interview. MAIN OUTCOME MEASURES: Age at first intercourse, use of contraception at first intercourse, actual and preferred source of sex education (including school based lessons). RESULTS: Median age at first intercourse fell by four years for women and three years for men over the past four decades, to 17 for both men and women aged 16-19 at the time of interview. Of those respondents for whom school was the main source of information about sexual matters, men were less likely, and women no more likely, to have had intercourse before the age of 16 than were those citing other main sources, such as friends and the media. Both men and women were more likely to have used some method of contraception. In multivariate analysis, these effects remained after controlling for the effect of current age, educational attainment, and religious affiliation. CONCLUSIONS: These data provide no evidence to support the concern that provision of school sex education might hasten the onset of sexual experience. These findings have important implications for the provision of sexual health education and highlight the need to carry out prospective and randomised studies of the impact of sex education.

Adolescent↗

PubMed2001

Academic goals, achievement, and age at first sexual intercourse: longitudinal, bidirectional influences.

This study examined bidirectional relationships between age at first sexual intercourse and academic goals and achievement. It was hypothesized that lower educational goals and achievement would be associated with initiating sexual intercourse at a younger age, and that initiating sexual activity early would be associated with a decrease in subsequent academic achievement and goals. In longitudinal data spanning 11 years, evidence was found for bidirectional effects. One interpretation of these results is that adolescents with high educational goals and achievement delay having intercourse because of the perceived risks (e.g., pregnancy and sexually transmitted diseases may jeopardize their plans for the future). Conversely, adolescents who engage in sexual intercourse at young ages might undergo a change in attitudes, including reduced interest in academic achievement and goals. The specific educational variables most strongly related to adolescent sexual intercourse in this study differed substantially by race and gender.

Achievement↗

PubMed2000

First sexual intercourse and contraception: a cross-sectional survey on the sexuality of 16-20-year-olds in Switzerland.

BACKGROUND: The onset of sexual activity represents an important development stage with positive aspects, such as love, discovery, intimate relationships, plans for the future, but also with fears of pregnancy, of sexually transmitted diseases and of AIDS. OBJECTIVE: To study perceptions, attitudes, and behaviour related to sexual life, AIDS and contraception; to explore the onset of first sexual relationships and the process of choice of a contraceptive method by the adolescents, in order to improve prevention programmes for young people. METHOD: Analysis of data from a Swiss national survey on adolescent sexuality using a computerised self-administered questionnaire, involving 2075 girls and 2208 boys between the ages of 16 and 20. The use of computers helps improve confidentiality, response rates and acceptability since survey questions are limited to the subjects' sexual experience only. RESULTS: The young people's responses emphasised the importance of emotion in sexual relationships, girls choosing intimacy and fidelity while boys attached more importance to physical pleasure. Three out of four respondents have had a sexual experience and one out of two have had penetrative sexual intercourse. The percentages of condom or oral contraception use are high: at first sexual intercourse, 86.5% used one or the other, while 7.4% did not declare any contraceptive method. The percentages are lower when age at first intercourse is below 15 years, when a girl had an older partner (age difference 7 years and more) and when the 1st relationship is a casual one. During their first stable relationship 41.1% of girls and 30.9% of boys say they have changed their contraceptive method from condom to contraceptive pill, 2.4% of girls and 2.9% of boys say they have given up any form of contraception. Among girls, condom use at first sexual intercourse with a new partner decreases in favour of oral contraception between first and last steady relationships (75.6 vs 58.0%, p < 0.05), the decrease being insignificant between the first and last casual relationships (73.5 and 62.2%, n.s.). Among boys the rates of condom use are equal at first intercourse with the first and last partner (steady relationship: 74.1 and 77.2%; causal relationship: 78.3 and 76.2% respectively). CONCLUSION: The use of condoms is high among Swiss adolescents, particularly at first sexual intercourse. By integrating the prevention of sexually transmitted diseases and of unwanted pregnancies, preventive programmes would address adolescents' needs more effectively.

Adolescent↗

PubMed1986

Sexual factors, venereal diseases, and the risk of intraepithelial and invasive cervical neoplasia.

The relation between major indicators of sexual habits (age at first intercourse and total number of sexual partners), history of selected venereal diseases, and cervical neoplasia was investigated using data from a case-control study of 206 cases of cervical intraepithelial neoplasia compared with 206 age-matched outpatient controls, and of 327 cases of invasive cancer compared with 327 control subjects in hospital for acute conditions unrelated to any of the established or suspected risk factors for cervical cancer. The relative risks increased with decreasing age at first intercourse and increasing number of sexual partners both for intraepithelial and for invasive cancers. The effects of these two variables were independent, since they were only marginally affected by reciprocal adjustment, or by allowance for several other identified potential distorting factors. The negative association with age at first intercourse was particularly strong in the case of invasive cancers, with risk estimates over five-fold elevated for women reporting their first intercourse before age 18 compared with those aged over 22 years. This relation might be discussed in terms of multistage models of carcinogenesis, which predict that the incidence of epithelial carcinomas is a function of duration of exposure. In fact, when age was allowed for, the relative risks of cervical neoplasia were positively and strongly related with the total duration of the interval between age at diagnosis/interview and age at first intercourse. Clinical histories of several sexually transmitted diseases were positively associated with the risk of intraepithelial neoplasia. In particular, genital warts were reported by nine cases but no control subject. No such association, however, emerged for invasive carcinomas. Thus, the current findings confirm that, although intraepithelial neoplasia and invasive cervical cancer appear to share several important epidemiological features, the specific (infectious) agents implicated in dysplastic lesions probably differ to some extent from those causing invasive cancer.

Adult↗

PubMedDate not supplied

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

This study examined the extent to which problem solving, self-image, and other health-related factors predict age at first intercourse among Black and White adolescent females. The volunteer sample was 16 to 19 years old; 52% were Black (n=105), and 48% (n=97) were White. Adolescents were recruited from family planning clinics throughout South Carolina. Stratified analyses identified race as a modifier of the relationship between problem solving and time of first intercourse (early or delayed). Logistic regression revealed three predictors of early age at first intercourse in Black girls, but only one predictor in White girls. There were no race differentials in either age or the proportion of girls initiating early intercourse. However, Black girls who had less problem solving skill than their peers were five times more likely to have early intercourse, three times more likely to practice fewer health-promoting behaviors, and seven times more likely to have 10 or fewer years of education. Early intercourse was significantly associated with unprotected first intercourse. Our findings suggest that interventions may need to be tailored for different risk groups within Black populations of adolescent girls.

Adolescent↗

PubMed2006

Pregnant teenager involvement in sexual activity and the social context.

UNLABELLED: Pregnancy during adolescence represents a challenge to society as a whole. Its incidence is increasing and brings about social and medical consequences to both the teen mothers and their children. The purpose of this study was to evaluate pregnant teenager involvement in sexual activity and the social context. The group studied comprised 152 pregnant teenagers attending the Department of Pediatrics, Santa Casa de Sao Paulo (SCSP) General Hospital. All information was analyzed. The age at first intercourse was 14.2 years and the average period between first intercourse and pregnancy was 1.4 years. Most pregnancies (75%) were neither planned nor wanted, however, most teen mothers (64.3%) did not use any contraceptive method. Of the pregnant teenagers, 68.1% came from unstructured families where in 71% of the teen pregnancy cases, there was a role model (mother, sister, or cousin who already experienced teen pregnancy). The average number of school years attended by the analyzed pregnant teenagers was 8.1 years, however, there was a high dropout rate of 40.1%. The age at first intercourse was low and concurs with the high incidence of unstructured families. The average number of school years attended was high, which would theoretically reflect a greater knowledge with regard to human reproduction, pointing to the multicausality of teen pregnancy and the role played by the family. CONCLUSIONS: We confirmed that teen pregnancy presents multicausal etiology; sexual initiation of pregnant teenagers was quite early with high dropout rates, which indicated that prevention methodology should be based on early detection of risk factors for elaboration of appropriate prevention proposals.

Abortion, Induced↗

PubMed1999

Dopamine receptor genes are associated with age at first sexual intercourse.

The dopaminergic system in the brain seems to play an important role in the regulation of sexual behaviour. The relationship between genes for the D1, D2 and D4 dopamine receptors and age at first sexual intercourse (AFSI) was examined in a sample of 414 non-Hispanic, European-American men and women. A significant association was observed between a DRD2 allele and AFSI and an even stronger association when the DRD2 allele was interacted with a DRD1 allele. A constrained regression model was constructed predicting AFSI using sex and a group of nine psychosocial variables as predictors. Adding the DRD2 and the DRD2-by-DRD1 predictors to this model increased the explained variance by 23 and 55%, respectively. Although these findings suggest a stronger association among males than among females, further research will be necessary to clarify this question, as well as to establish whether the observed association holds in other racial/ethnic groups.

Adolescent↗

PubMedDate not supplied

Determinants and effects of waiting time to coitus.

Nonuse of contraception at first intercourse among adolescents is well documented in the adolescent sexuality research literature. This study provides a formal test of the hypothesis that an increase in the courtship period (i.e., waiting time to intercourse) increases the likelihood that a couple will discuss contraception and use it at first intercourse. The data analyzed are from personal interviews with 1,314 women aged 20-29 in the 1983 National Survey of Unmarried Women. The results are mixed about the effect of waiting time on contraceptive behavior, providing weak support for the hypothesis, but also elucidating individual and relative characteristics of the couples, such as age and education of the respective partners, that affected contraceptive behavior at first intercourse. Support for the hypothesis may prove more robust in data with different characteristics from the survey used here.

Adult↗

PubMed1995

Problem behaviors in inner-city adolescents with chronic illness.

This study examines the prevalence of problem behaviors (sexual activity, substance use, delinquency, and school failure) in a clinical hospital-based sample of 217 inner-city, 14 to 17 year olds with a variety of serious, chronic medical illnesses and compares this prevalence to that in a group of 121 similar-aged, healthy friends with no known chronic illnesses living in the same community. No differences were found between groups in substance use, delinquency, percent who had ever had sexual intercourse, or mean age at first intercourse. There was a significant interaction effect of chronic illness and gender on age at first intercourse (p = .015); boys without chronic illness initiated sexual intercourse at a younger age than their girlfriends without illness. Contrary to expectations, significantly more of the healthy friends had repeated a grade in school than had those with chronic illness (p = .002). Results are discussed in terms of the interrelationships of chronic illness, gender, and environment on problem behaviors.

Acting Out↗

PubMed2026

Bayesian Mendelian randomization reveals a protective effect of later age at first sexual intercourse against erectile dysfunction.

Erectile dysfunction (ED) is a prevalent health condition with significant psychosocial impacts, yet the causal role of age at first sexual intercourse (AFS) remains unclear. This study investigated the causal effect of AFS on the risk of ED using Mendelian randomization (MR) and Bayesian methods. Five traditional 2-sample MR analyses and 5 Bayesian MR analyses were performed using genome-wide association studies summary statistics from European populations. Sensitivity analyses included MR Egger regression, MR-pleiotropy residual sum and outlier, and Cochran Q-test. In mixed-sex cohorts (Groups 1 and 2), inverse variance weighted results demonstrated significant protective effects: odds ratio (OR) = 0.626, θ = -0.469, P = 2.73 × 10-6 for Group 1 and OR = 0.617, θ = -0.483, P = 3.56 × 10-5 for Group 2. The analyses for male-specific cohorts (Groups 3-10) showed weaker but consistent effects. For Group 3, OR = 0.643, θ = -0.442, P = .010. For Group 4, some instrumental variables associated with confounders were removed. The result became statistically insignificant: OR = 0.680, θ = -0.385, P = .064. For Group 5, the instrument selection criteria were relaxed and significance was retained: OR = 0.695, θ = -0.364, P = .016. For Groups 6 to 10, Bayesian MR was used to strengthen the inferences. In particular, for Group 8, which has a strongly informed prior, a posterior mean θ = -0.358 and a 95% credible interval (-0.575, -0.136) were obtained. This study provides evidence supporting a causal protective effect of later AFS on ED risk. While traditional MR analyses in male-specific cohorts yielded suggestive results, Bayesian MR analyses, which allow for the integration of prior evidence, provided more precise estimates and strengthened the causal inference. These findings may inform future sexual health policies. Strengths include the use of male-specific cohorts and Bayesian enhancement for weak instruments. Limitations include reliance on European-ancestry data and inability to stratify ED subtypes.

Male↗