Correlates of sexual experience among a nationally representative sample of alternative high school students

Little is known about risk and protective factors associated with sexual experience among alternative school students that might prove useful in targeting and guiding early interventions to prevent onset of sexual risk behavior. Researchers analyzed data from the national Alternative High School Youth Risk Behavior Survey. Principal components analysis identified six risk and protective factors: weapon carrying; tobacco use; cocaine, inhalant, and needle use; alcohol and marijuana use; participation in sports; and fighting. Composite variables with significant bivariate relationships to sexual experience, as well as demographic variables, were entered into a logistic regression analysis to determine independent effects of these correlates on students' sexual experience (N = 6.037). Nearly 90% of students reported having sexual intercourse. In multivariate analysis, significant demographic correlates of sexual experience included female gender (58% more likely than males to report ever having sex), African American race (2.83 times more likely than non-Hispanic Whites), and age (28% more likely with each advancing year). Attending school in a rural or suburban region corresponded to a 31% decrease and 46% decrease, respectively, in the odds of ever having sex. Weapon carrying, and cocaine, inhalant, and needle use, were associated with a 35% and 46% increase, respectively, in the odds of ever having sex. Students reporting they had ever used alcohol or marijuana, and those reporting recent fighting behavior, were 2.7 and 1.6 times more likely, respectively, to report sexual experience. Most alternative school students have had sexual intercourse, with those students engaging in substance use, weapon carrying, and fighting behaviors being at greater risk for sexual experience. Prevention programs for high-risk youth attending alternative high schools need to consider how to promote continued abstinence among the small but important minority of alternative school students not yet sexually experienced.     

Daily participation in sports and students' sexual activity

CONTEXT: Previous studies suggest that student athletes may be less likely than nonathletes to engage in sexual behavior. However, few have explored sexual risk behavior among athletes in early adolescence. METHODS: In 2005, a sample of 10,487 students in 26 Los Angeles public middle and high schools completed a self‐administered survey that asked about their demographic characteristics, sports participation, sexual behaviors and expectations, and parental relationships. Chi‐square analyses compared reported levels of daily participation in sports, experience with intercourse, experience with oral sex and condom use at last intercourse by selected characteristics. Predictors of sexual experience and condom use were assessed in multivariate logistic regression analyses. RESULTS: One‐third of students reported daily participation in sports. This group had higher odds of ever having had intercourse and ever having had oral sex than their peers who did not play a sport daily (odds ratios, 1.2 and 1.1, respectively). The increases in risk were greater for middle school sports participants than for their high school counterparts (1.5 and 1.6, respectively). Among sexually experienced students, daily sports participants also had elevated odds of reporting condom use at last intercourse (1.4). CONCLUSIONS: Students as young as middle school age who participate in sports daily may have an elevated risk for STDs and pregnancy. Health professionals should counsel middle school athletes about sexual risk reduction, given that young students may find it particularly difficult to obtain contraceptives, STD testing and prevention counseling.     

Sexual intercourse and oral sex among public middle school students: prevalence and correlates

CONTEXT: Early sexual initiation is associated with elevated teenage pregnancy and STD risk, yet little is known about the prevalence and correlates of sexual behavior among young adolescents. Better information is needed to guide interventions to prevent early sexual debut. METHODS: Data from a 2005 survey of 4,557 sixth‐, seventh‐ and eighth‐grade students at 14 urban public schools in Southern California were analyzed using chi‐square tests and logistic regression, to identify correlates of oral sex, intercourse and both. RESULTS: Overall, 9% of youth had ever had sexual intercourse, and 8% had had oral sex. Three percent reported having had oral sex only, 4% intercourse only and 5% both. Among those who reported intercourse, 69% had used a condom at last intercourse, and 43% had had multiple partners. Being male, being black and having at least one friend who had ever been involved in a pregnancy were positively associated with having had intercourse only and both intercourse and oral sex (odds ratios, 1.7–4.2). Being in eighth grade, expecting to have intercourse in the next six months and currently having a boyfriend or girlfriend were positively associated with all three outcomes (2.1–7.2). Intercourse and oral sex were highly correlated. CONCLUSIONS: Interventions addressing oral sex, intercourse and multiple partners should begin before sixth grade and continue throughout the middle school years. Health professionals should target adolescent risk reduction counseling toward males, blacks, youth with a boyfriend or girlfriend, and those with a friend who has been involved in a pregnancy.     

Youth Violence and Connectedness in Adolescence: What Are the Implications for Later Sexually Transmitted Infections?

PurposeTo examine associations between (1) youth violence victimization and perpetration and later sexually transmitted infections (STI) and (2) parent–family and school connectedness and later STI, and to explore the moderating role of connectedness on the associations between youth violence victimization and perpetration and later STI.MethodsWe used data from Waves I and IV of the National Longitudinal Study of Adolescent Health, which provided a baseline weighted sample of 14,800 respondents. We used logistic regression to examine associations between youth violence and connectedness with self-reported ever STI diagnosis, including gonorrhea, chlamydia, syphilis, genital herpes, genital warts or human papillomavirus, or human immunodeficiency virus. If participants reported having an STI at Wave I they were excluded from the analysis.ResultsControlling for biological sex, race/ethnicity, age, parent's highest education level, and parent's marital status, both youth violence victimization and perpetration were associated with an increased risk of later STI (adjusted odds ratio [AOR], 1.27, 95% confidence interval [CI], 1.07–1.52; and AOR, 1.21, 95% CI, 1.04–1.41, respectively). Parent–family and school connectedness in adolescence were associated with a decreased risk for later STI (AOR, .96, 95% CI, .95–.98; and AOR, .97, 95% CI, .95–.99, respectively); however, connectedness did not moderate the associations between nonsexual violence involvement and later STI.ConclusionsThese results indicate that youth violence victimization and perpetration may be risk factors for STI later in life. Conversely, parent–family and school connectedness in adolescence appear to protect against subsequent STI. The findings suggest that provider efforts to address youth violence and connectedness in adolescence can promote positive sexual health outcomes in adulthood.     

Understanding sexual risk taking behaviour in Hong Kong university students. A health promotion perspective

BACKGROUND: Levels of sexual experience among Chinese university students are considerably lower than in western countries. Measuring sexual risk-taking behavior of Chinese students is important in designing any effective preventive health programs. This study assessed the prevalence and factors associated with high-risk sexual behavior among students in a Hong Kong university. METHODS: A cross-sectional survey conducted among year 1 and year 3 Chinese undergraduate students in 1997, using a structured, self-administered questionnaire. RESULTS: Of the 1197 students surveyed, only 11% were sexually active (ever had sexual intercourse). Reported sexual activity was higher among year 3 (17%) than year 1 (6.6%) students and higher among males (14.4%) than females (8.3%). Consistent (always) use of condoms was reported by only 43% of the sexually active respondents. Males were more likely to think that premarital sex was acceptable than were females. About 1 in 20 students (55 of 1197) were categorized as belonging to a "greater risk behavior" group, defined by inconsistent or nonuse of condoms during sexual intercourse and having had three or more sexual partners in the past 3 months, or having has sex with prostitutes or ever having a sexually transmitted disease, or using alcohol or other stimulating drugs during sexual intercourse. Males with favorable attitudes toward premarital sex were more likely to belong to the greater risk behavior group. CONCLUSIONS: This study demonstrated the potential risk for contracting sexually transmitted diseases among a substantial proportion of university students, suggesting the need for promotion of preventive education programs.     

Contextual factors associated with sexual behavior among Brazilian adolescents

PurposeThere are few studies about the influence of the context on sexual behavior among adolescents in developing countries, such as Brazil. Adolescent pregnancy and the high incidence of sexually transmitted disease (STDs) among Brazilian youngsters are a public health problem. The object of this study was to investigate whether factors from family and school contexts are associated with sexual behavior among Brazilian adolescents.MethodsThis study used data from 60,973 adolescent participants in the National Survey of School Health. The response variable was sexual behavior, described in three categories (never had sexual intercourse, had protected sexual intercourse, had unprotected sexual intercourse). The explanatory variables were grouped into sociodemographic characteristics, number of risk behavior factors (regular use of alcohol, smoking, and experimenting with illicit drugs), and family and school context. Variables associated with having protected and unprotected sexual relations in each context were identified by means of multinomial logistic regression. The reference was "never had sexual intercourse."ResultsApproximately one fourth of adolescents have already had sexual intercourse, most frequently boys. Among the adolescents who declared sexual initiation, the most part had their first sexual relation with age of 13 years or younger. Almost 21% did not use protection the last time they had sex. The greater the number of risk factors involved, the higher the incidence of protected and unprotected sex. In the family context, living with only one or with neither parent and low parental supervision increased the frequency of protected and unprotected sex. Never eating meals with the parents augmented the incidence of unprotected sex (odds ratio [OR], 1.60). In the school context, students from private schools were less likely to have had protected and unprotected sex (OR, 0.58 and 0.68). Not receiving instructions at school about pregnancy prevention increased the frequency of protected and unprotected sex (OR, 1.33 and 1.74, respectively).ConclusionsFamily and school context factors are associated with sexual behavior. These associations are generally stronger for unprotected sex. Information about the prevention of pregnancy and STDs/AIDS has to be disseminated very early owing to the young age of sexual initiation.     

School Disconnectedness: Identifying Adolescents at Risk in Ontario, Canada

Background:  There is strong theoretical and empirical support for school connectedness as an important element of healthy youth development. The primary objective of this study was to replicate previous research identifying factors differentiating youth who do not feel connected to their schools in a sample of adolescents in Ontario, Canada. A secondary objective was to extend this work by assessing whether physical activity was an additional health behavior that differentiated youth who feel connected to their schools from those who do not.
Methods:  Data for this study were based on questionnaires from 2243 grade 7 to grade 12 students derived from the 2001 cycle of the Ontario Student Drug Use Survey. Logistic regression analysis was used to examine associations between physical activity, other health risk factors, and school disconnectedness.
Results:  The odds of feeling disconnected from their schools were substantially greater for female students who perceived their health or academic performance to be poor, engaged in no vigorous physical activity, reported 3 or more physician visits during the past year, and had low extracurricular involvement. None of the sociodemographic factors or substance use measures was significantly associated with school disconnectedness for any students.
Conclusions:  Our results highlight sex differences in how school disconnectedness is related to health-compromising behaviors such as physical inactivity. Further research is required to examine how boys and girls perceive, interpret, and internalize the school climate. Increasing school connectedness should be a consideration for academic administrators and health-promotion advocates.     

大学生性病感染影响因素研究

目的调查大学生性病患病及其影响因素。方法分析对象来自于浙江省某市高校大学生性行为问卷调查。对2540名已经发生性行为,并回答了是否曾经被诊断为性病的学生,被纳入分析。结果在2540名已经有性行为的学生中,39(1.5%)名学生报告曾经被诊断患过性病。在多因素逻辑回归分析中,排除可能的混杂回素,有一个以上的性伴侣,有过肛门性交的历史,自己或性伴侣怀孕和流产的经历,认为感染性病的可能性"可能/较高/很高",依然显示与被诊断为性病有显著性关联。结论必须尽快在大学生中间开展性病预防工作。防止性病传播不仅需要传播相关知识,还需倡导推迟性行为的发生,减少性伴侣数,每次性行为均要正确使用安全套,以及预防非计划怀孕和人工流产等综合性的措施,同时提供有效的性病诊疗服务。     

Self-reported health risk behaviors among adolescents in Luang Namtha province of Lao PDR: Prevalence and determinants

The purpose of this study was to assess self-reported prevalence of alcohol, tobacco, and drug use, and sexual risk behaviors, as well as to identify sources of sex education and individual, family, and peer factors that might influence adolescents’ health risk behaviors (HRB). In a community-based, cross-sectional study, 1360 adolescents aged 14–19 years were interviewed from June to September 2008 in Luang Namtha province. Multistage systematic random sampling was used to select participants. Logistic regression was used to identify the determinants of single HRB. Alcohol and tobacco use, and sexual risk behaviors were common. Just under half (42.5%) used alcohol, 9.6% smoked during the past 30 days, and 1.4% had used amphetamine during their lifetime, and 19.6% had ever had sex. Of those, 58.8% were currently sexually active, 40.1% reported having two or more sexual partners, and 34.5% had used a condom during last sexual intercourse. The mean age at sexual debut was 15.3 years for boys and 15.1 years for girls. Khamu ethnicity, not attending school, and peers’ drinking, smoking, and using drugs were significant determinants of current alcohol use, whereas being male, not attending school, Khamu ethnicity, and peers’ smoking and using drugs predicted current smoking. Being male, younger age, Akha ethnicity, having low level of education, peers’ smoking, being sexually active, and being pregnant or having made someone pregnant were significantly associated with ever having sex, whereas being male, Akha and Khamu ethnicities, peers’ smoking, drinking alcohol, and being sexually active were correlated with sexual risk behaviors. Individual and socio-demographic background factors as well as peer influence are determinants of risk behaviors. Thus, efforts should be made to keep adolescents in school, particularly until secondary school, and increase school connectedness.     

Adolescent males involved in pregnancy:: Associations of forced sexual contact and risk behaviors

Purpose: To determine whether sexually active adolescent males who report being the victim of forced sexual contact and engaging in health risk and problem behaviors are more likely to report getting someone pregnant.

Methods: In 1995, 4159 students in Grades 9–12 in 59 randomly selected public high schools in Massachusetts were anonymously surveyed using the Youth Risk Behavior Survey (YRBS). Data were analyzed for 824 sexually active males. Demographic variables and indicators of sexual behavior, pregnancy, violence, and suicide were assessed. Data were analyzed with multiple logistic regression.

Results: A total of 12.0% of sexually active males reported having been involved in a pregnancy. The proportion of males who reported getting a partner pregnant increased with age. Of the sample, 8.1% gave a history of having had sexual contact against their will. Of those who reported forced sexual contact, 36.4% reported having been involved in a pregnancy; of the males who did not report a history of forced sexual contact, 9.4% were involved in a pregnancy (CV = 0.23; p < 0.00001). Based on multiple logistic regression, forced sexual contact [odds ratio (OR) 3.56; 95% confidence interval (CI) 1.79–7.09], frequency of weapon carrying on school property (OR 1.39; 95% CI 1.18–1.64), number of cigarettes smoked per day (OR 1.22; 95% CI 1.08–1.38), number of sexual partners in the previous 3 months (OR 1.43; 95% CI 1.25–1.65), and condom nonuse at last intercourse (OR 1.80; 95% CI 1.06–3.02) correctly classified 89.9% of the males who were involved in a pregnancy.

Conclusion: This study highlights the association between health-risk and problem behaviors, forced sexual contact, and involvement in pregnancy among sexually active male high school students. In our analysis, a history of forced sexual contact was associated with a higher risk of high school males’ involvement in pregnancy. These results strongly suggest the importance of screening sexually active males for a history of forced sexual intercourse and health risk and problem behaviors in the effort to prevent teenage pregnancy and childbearing.     

A survey of risk behaviors for unintended pregnancy and human immunodeficiency virus among youth attending voluntary counseling and testing (VCT) services in nine centers in urban Haiti and Tanzania

Little is known about the behavioral risks for both human immunodeficiency virus (HIV) and unintended pregnancy among sexually active youth attending voluntary counseling and testing (VCT) in developing countries, and whether youth engaging in risky sexual behaviors perceive themselves to be at risk for HIV. Data are from two cross-sectional studies with youth VCT clients in four facilities in Dar es Salaam, Tanzania and five facilities in Port-au-Prince, Haiti. We measured risky behavior for HIV and unintended pregnancy and perceptions of risk among VCT clients who reported ever having had sex. The majority of sexually active clients, 69% of men and 62% of women in Haiti and 65% of men and 60% of women in Tanzania, reported recent risky behaviors for HIV. Clients also reported risk behaviors for unintended pregnancy: 15% of men and 53% of women in Haiti and 21% of men and 29% of women in Tanzania. The majority of clients with risk behaviors in Tanzania, but not in Haiti, perceived themselves at risk. Strategies to meet youth VCT clients' broader reproductive health needs and avoid any missed opportunities should be tested.     

Methamphetamine Use Is Independently Associated With Recent Risky Sexual Behaviors and Adolescent Pregnancy

BACKGROUND: Lifetime methamphetamine use among adolescents is estimated to be between 5% and 10%. Youth substance use in general is known to be associated with risky sexual behaviors, but the effect of methamphetamine use on recent risky sexual behaviors and adolescent pregnancy has received little attention. The purpose of this analysis was to evaluate the association between lifetime methamphetamine use and recent (past 3 months) risky sexual behaviors and lifetime adolescent pregnancy, adjusting for other substance use. METHODS: We analyzed data from the 2003 National Youth Risk Behavior Survey, a school‐based paper‐and‐pencil survey that assesses risky health behaviors among a nationally representative sample of 9th‐ to 12th‐grade students. Multivariable logistic regression was used to calculate adjusted odds ratios (AORs) to examine the association between methamphetamine use and being recently sexually active, having 2 or more recent sex partners, and ever being pregnant or getting someone pregnant. RESULTS: Lifetime methamphetamine use was reported by 7.6% of students. After adjustment for demographic covariates and lifetime use of cigarettes, alcohol, marijuana, and other illicit drugs, lifetime methamphetamine use was associated with recent sexual intercourse (AOR = 1.8, 95% confidence interval [CI] = 1.5‐2.3), having 2 or more recent sex partners (AOR = 3.0, 95% CI = 2.2‐4.2), and ever being pregnant or getting someone pregnant (AOR = 2.9, 95% CI = 2.1‐3.9). CONCLUSIONS: Adolescent methamphetamine use is common and is associated with recent risky sexual behaviors and adolescent pregnancy. Prevention strategies for high school students should integrate education on substance abuse, pregnancy, sexually transmitted infections, and human immunodeficiency virus.     

Beyond sexual desire and curiosity: sexuality among senior high school students in Papua and West Papua Provinces (Indonesia) and implications for HIV prevention

When it comes to sexuality and norms, young Indonesians are becoming more open. Concern about this is related to the rapid increase in HIV prevalence in Indonesia, especially in Papua and West Papua Provinces. While much research has been conducted among youth who have left school, little is known about senior high school students' sexuality and sexual practices in these provinces. Using qualitative and quantitative data, we explore perspectives on and experiences of sexuality, contraceptive use, unintended pregnancy and unsafe abortion among 1082 Year 11 students from 16 senior high schools in both provinces. Findings suggest that around 38.3% of students reported having had sexual intercourse and 36.5% of these having had their first sexual encounter before they were 15 years old. Furthermore, contraceptive use among sexually active students was very low. Around 32% of female students who reported having had sexual intercourse also reported having an unintended pregnancy and the majority of them had had unsafe abortions. The paper points to the implications of students' high-risk sexual behaviours for HIV prevention.     

Beyond sexual desire and curiosity: sexuality among senior high school students in Papua and West Papua Provinces (Indonesia) and implications for HIV prevention

When it comes to sexuality and norms, young Indonesians are becoming more open. Concern about this is related to the rapid increase in HIV prevalence in Indonesia, especially in Papua and West Papua Provinces. While much research has been conducted among youth who have left school, little is known about senior high school students' sexuality and sexual practices in these provinces. Using qualitative and quantitative data, we explore perspectives on and experiences of sexuality, contraceptive use, unintended pregnancy and unsafe abortion among 1082 Year 11 students from 16 senior high schools in both provinces. Findings suggest that around 38.3% of students reported having had sexual intercourse and 36.5% of these having had their first sexual encounter before they were 15 years old. Furthermore, contraceptive use among sexually active students was very low. Around 32% of female students who reported having had sexual intercourse also reported having an unintended pregnancy and the majority of them had had unsafe abortions. The paper points to the implications of students' high-risk sexual behaviours for HIV prevention.     

Sexually Coercive Behavior in Male Youth: Population Survey of General and Specific Risk Factors

Little is known about risk/protective factors for sexually coercive behavior in general population youth. We used a Swedish school-based population survey of sexual attitudes and experiences (response rate 77%) and investigated literature-based variables across sexually coercive (SEX), non-sexual conduct problem (CP), and normal control (NC) participants to identify general and specific risk/protective factors for sexual coercion. Among 1,933 male youth, 101 (5.2%) reported sexual coercion (ever talked or forced somebody into genital, oral, or anal sex) (SEX), 132 (6.8%) were classified as CP, and the remaining 1,700 (87.9%) as NC. Of 29 tested variables, 25 were more common in both SEX and CP compared to NC youth, including minority ethnicity, separated parents, vocational study program, risk-taking, aggressiveness, depressive symptoms, substance abuse, sexual victimization, extensive sexual experiences, and sexual preoccupation. When compared to CP youth only, SEX youth more often followed academic study programs, used less drugs and were less risk-taking. Further, SEX more frequently than CP youth reported gender stereotypic and pro-rape attitudes, sexual preoccupation, prostitution, and friends using violent porn. Finally, in a multivariate logistic regression, academic study program, pro-rape attitudes, sexual preoccupation, and less risk-taking independently remained more strongly associated with SEX compared to CP offending. In conclusion, several sociodemographic, family, and individual risk/protective factors were common to non-sexual and sexually coercive antisocial behavior in late adolescence. However, pro-rape cognitions, and sexual preoccupation, were sexuality-related, specific risk factors. The findings could inform preventive efforts and the assessment and treatment of sexually coercive male youth.     

Self-Reported Pregnancy and Access to Primary Health Care Among Sexually Experienced New Zealand High School Students

Purpose

To determine the prevalence of self-reported pregnancy among sexually experienced high school students, and the association between teenage pregnancy and access to primary health care.

Methods

Between March and October 2007, 96 high schools throughout New Zealand participated in Youth'07, a cross-sectional Health and Wellbeing survey. The dataset included 2,620 (1,217 females and 1,403 males) year 9 through 13 students who reported ever having sexual intercourse and responded to a question about whether they had ever been pregnant or ever caused a pregnancy.

Results

Nationwide, 10.6% of sexually experienced high school students self-reported that they had been pregnant (11.6%) or caused a pregnancy (9.9%). Māori (15.3%) and Pacific Island (14.1%) students had the highest self-reports of pregnancy. Foregone health care was reported by 24.2% of sexually experienced students. Students who self-reported pregnancy reported greater difficulty accessing health care (41.7% vs. 20.6%; odds ratio: 2.6); however, when they accessed care, the majority received confidential care (67.4%) as compared with pregnancy-inexperienced peers (51.6%). Concern about privacy was the most common reason for not accessing health care. Other barriers included uncertainty about how to access care and lack of transportation (all p values < .05).

Conclusions

Self-reported pregnancy among sexually active high school students in New Zealand is high and ethnic disparities exist. Being pregnant or causing a pregnancy is associated with difficulty accessing health care. Further research is needed to identify drivers for ethnic differences and determine what the cause-and-effect relationship between teenage pregnancy and access to health care looks like.     

Family and peer influences on sexual behavior among female college students in Wuhan, China

The prevalence of sexually transmitted infections in China has increased dramatically over the last 20 years, and heterosexual transmission is rapidly becoming the primary route of HIV transmission. Despite this growing epidemic, little is known about the correlates of sexual behavior in young Chinese women. The objective of this study was to assess family and peer factors related to sexual behavior in Chinese female college students. Anonymously completed questionnaires were received from 4,769 unmarried female college students, recruited using randomized cluster sampling by type of university and students' major and grade. Items captured socio-demographic, family, and peer factors. To examine factors associated with sexual behavior, multiple logistic regression was used, yielding odds ratios and 95% confidence intervals. Over 18% of female students participating reported ever having sexual intercourse, of whom 31.52% had their first sexual intercourse at the age of 18 or younger with more than 50% at an age less than 20 years. Several socio-demographic, family, and peer factors were associated with ever having intercourse. Those more likely to engage in premarital sex were older; majored in art; were from one-child, richer and/or divorced families; had a mother with university or above education; had parents with a strict disciplinary style; had middle-school close friends falling in love; and had current close friends living with boyfriends. Interventions to protect young women from sexually transmitted diseases need to target early sex education and address peer and parents influences.     

When and Why Do Young People in the United Kingdom First Use Sexual Health Services?

CONTEXT: Many young people think about and take steps to obtain adequate protection only after having sexual intercourse for the first time. Consequently, they are at increased risk of unintended pregnancy and sexually transmitted infections.
METHODS: Between June and August 1999, a self-administered questionnaire was distributed to attendees at UK youth-targeted sexual health services to investigate when and why they first use a sexual health service, reasons for delaying use, and sexual behavior and contraceptive practice before first use.
RESULTS: Of the 747 respondents, 29% had used a sexual health service before ever having sex, most commonly "to be prepared." In contrast, 61% of respondents had used a service after sexual debut; some of these had obtained condoms elsewhere (25% of women and 33% of men who gave a reason for delay) or had not known about services or their location (11-19%). Among the women, 20-24% had been embarrassed or scared, or concerned about confidentiality or age; 32% had visited a provider because they had had unprotected sex. Sixty-three percent of men who had delayed using a service reported that the ability to obtain free condoms had prompted their first visit. Only 43% of respondents who postponed service use had practiced contraception consistently before visiting a provider.
CONCLUSIONS: Young people need to be realistic about the possibility of having sex. Service use could be increased by providing more youth-specific services and by improving publicity and links between the youth, education and health sectors to dispel fears and myths about services.     

Correlates of the intention to remain sexually inactive among underserved Hispanic and African American high school students

The objective of this study was to apply the Information-Motivation-Behavior (IMB) theoretical framework to examine the correlates of the intention to remain sexually inactive among Hispanic and African American high school students. This study utilized a cross-sectional survey of high school students. The setting was the unified school districts in the County of Los Angeles, California. The participants comprised a geographically defined convenience sample of 502 Hispanic and African American high school students. This study found that only 50% of this sample reported that they plan to remain sexually abstinent until they graduate from high school. Another 21% rejected the notion of remaining abstinent, and 29% were uncertain about their intention to engage in sexual activities before they graduate from high school. Male and African American students were less likely than their female and Latino counterparts to report an intention to remain sexually inactive. Using multinomial logistic regression and controlling for demographic characteristics, this study documented that students with (1) a higher level of perceived peer pressure, (2) a lower level of behavioral and refusal skills for avoiding sexual activity, (3) a more positive attitude toward practicing safe sex, and (4) a lower level of perceived pregnancy repercussions were less likely to claim to remain sexually inactive. The data from this study support the IMB model, which suggests that intervention programs focusing on knowledge alone are inconsequential in altering the intentions of adolescents with respect to their decision to engage in sexual activity. Intervention programs should focus on encouraging youth to postpone sexual activity by reducing peer pressure and building self-efficacy through enhancing motivations and culturally appropriate behavioral skills.     

Sexual initiation, parent practices, and acculturation in Hispanic seventh graders

BACKGROUND: Hispanic youths have high rates of sexually transmitted infections and pregnancies, yet little research has targeted multiple protective/risk factors for early sexual initiation in this group. This study examined two main factors—parenting practices and acculturation—on early sexual initiation among Hispanic middle school students in Texas. METHODS: Using data from Hispanic seventh graders (N = 655) in 15 urban middle schools in southeast Texas, we examined the association between parental monitoring/parent‐child communication about sexual health and sexual initiation. RESULTS: After controlling for age, gender, parent/guardian education, family structure, acculturation level, and intervention status, the likelihood of ever having sex decreased 50% for every 1‐point increase in the parental monitoring score (AOR = 0.50;95%CI = 0.34,0.75). No association was found between ever having sex and parent‐child communication scores (AOR = 1.29;95%CI = 0.76,2.18). Furthermore, parental monitoring differed significantly between acculturation levels, 1‐way analysis of variance F(2,652) = 5.07, p < 0.007. This finding was unrelated to the parental monitoring‐initiation association in the multivariable model. CONCLUSION: Parental monitoring may delay sexual initiation among Hispanic middle school students. Parental monitoring differs by acculturation levels, warranting further investigation. These findings can inform school‐based, parent‐involved interventions designed to delay sexual initiation among Hispanic youth.