Virginity pledges among the willing: delays in first intercourse and consistency of condom use

PURPOSE: We examine longitudinal relationships between virginity pledging in adolescence and both sexual initiation and condom use. Prior studies have had mixed results and may not adequately control for prepledge differences between pledgers and nonpledgers. METHODS: Data came from a national sample of 12- to 17-year-olds surveyed in 2001 and reinterviewed 1 and 3 years later. Logistic regression models estimated the association between making a pledge and each outcome. Selection bias was reduced through propensity-score weighting and a rich set of demographic and psychosocial covariates. RESULTS: Pledgers and nonpledgers differed substantially in preexisting characteristics. However, after propensity weighting and statistical controls, pledging was still associated with delayed intercourse. We estimate that in the absence of pledging 42.4% of virgins with characteristics indicating an inclination to pledge initiate intercourse within 3 years; in the presence of the pledge, 33.6% of such youth initiate intercourse. Among those who had sex during this period, pledging was unassociated with condom use. Among those who did not have sex during this period, pledging was unassociated with engagement in noncoital sexual behavior. CONCLUSIONS: Making a virginity pledge appears to be an effective means of delaying sexual intercourse initiation among those inclined to pledge without influencing other sexual behavior; pledging does not appear to affect sexual safety among pledgers who fail to remain abstinent.     

Reborn a virgin: adolescents' retracting of virginity pledges and sexual histories

OBJECTIVES: We examined retractions of virginity pledges and of sexual histories among adolescents taking part in waves 1 and 2 of the National Longitudinal Study of Adolescent Health. METHODS: Logistic regression analyses were used to compare respondents' reports of virginity pledges and sexual histories at waves 1 and 2.Results. Among wave 1 virginity pledgers, 53% denied having made a pledge at wave 2; after control for confounders, pledgers who subsequently initiated sexual activity were 3 times as likely to deny having made a pledge as those who did not initiate sexual activity (odds ratio [OR] = 3.21; 95% confidence interval [CI] = 2.04, 5.04). Among wave 1 nonvirgins who subsequently took virginity pledges, 28% retracted their sexual histories at wave 2; respondents who took virginity pledges were almost 4 times as likely as those who did not to retract reports of sexual experience (OR=3.88; 95% CI=1.87, 8.07). CONCLUSIONS: Adolescents who initiate sexual activity are likely to recant virginity pledges, whereas those who take pledges are likely to recant their sexual histories. Thus, evaluations of sexual abstinence programs are vulnerable to unreliable data. In addition, virginity pledgers may incorrectly assess the sexually transmitted disease risks associated with their prepledge sexual behavior.     

The Association Between Sequences of Sexual Initiation and the Likelihood of Teenage Pregnancy

PurposeFew studies have examined the health and developmental consequences, including unintended pregnancy, of different sexual behavior initiation sequences. Some work suggests that engaging in oral–genital sex first may slow the transition to coital activity and lead to more consistent contraception among adolescents.MethodsUsing logistic regression analysis, we investigated the association between sequences of sexual initiation (i.e., initiating oral–genital or vaginal sex first based on reported age of first experience) and the likelihood of subsequent teenage pregnancy among 6,069 female respondents who reported vaginal sex before age 20 years and participated in waves I and IV of the National Longitudinal Study of Adolescent Health.ResultsAmong female respondents initiating vaginal sex first, 31.4% reported a teen pregnancy. Among female respondents initiating two behaviors at the same age, 20.5% reported a teen pregnancy. Among female respondents initiating oral–genital sex first, 7.9% reported a teen pregnancy. In multivariate models, initiating oral–genital sex first, with a delay of at least 1 year to vaginal sex, and initiating two behaviors within the same year were each associated with a lower likelihood of adolescent pregnancy relative to teens who initiated vaginal sex first (odds ratio = .23, 95% confidence interval: .15–.37; and odds ratio = .78, 95% confidence interval: .60–.92, respectively).ConclusionsHow adolescents begin their sexual lives may be differentially related to positive and negative health outcomes. To develop effective pregnancy prevention efforts for teens and ensure programs are relevant to youths' needs, it is important to consider multiple facets of sexual initiation and their implications for adolescent sexual health and fertility.     

Noncoital sexual activities among adolescents

PURPOSE: Although prior research has demonstrated that many adolescents engage in noncoital sexual behavior, extant peer-reviewed studies have not used nationally representative data or multivariate methods to examine these behaviors. We used data from Cycle 6 of National Survey of Family Growth (NSFG) to explore factors related to oral and anal sex among adolescents. METHODS: Data come from 2,271 females and males aged 15-19 in 2002. Computer-assisted self-administered interviews were used to collect sensitive information, including whether respondents had ever engaged in vaginal, oral or anal sex. We used t tests and multivariate logistic regression to test for differences and identify independent characteristics associated with experience with oral or anal sex. RESULTS: In all, 54% of adolescent females and 55% of adolescent males have ever had oral sex, and one in 10 has ever had anal sex. Both oral sex and anal sex were much more common among adolescents who had initiated vaginal sex as compared with virgins. The initiations of vaginal and oral sex appear to occur closely together; by 6 months after first vaginal intercourse, 82% of adolescents also engaged in oral sex. The strongest predictor of anal sex involvement was time since initiation of vaginal sex and the likelihood of anal sex increased with greater time since first vaginal intercourse. Teens of white ethnicity and higher socioeconomic status were more likely than their peers to have ever had oral or anal sex. CONCLUSIONS: Health professionals and sexual health educators should address noncoital sexual behaviors and risk for sexually transmitted infections risk, understanding that noncoital behaviors commonly co-occur with coital behaviors.     

Predictors of Early Initiation of Vaginal and Oral Sex Among Urban Young Adults in Baltimore, Maryland

Over the past three decades, most research on adolescent sexual behavior has focused on vaginal intercourse and related behaviors, including contraception and unintended pregnancy. In this study, we describe the prevalence and correlates of vaginal, oral, and anal sex in an epidemiologically defined population in Baltimore, Maryland. Young adults (ages 18–24), who had been enrolled in a behavioral intervention trial during elementary school, were interviewed by telephone between 1998 and 2002 to assess their sexual behavior. Of 1679 respondents interviewed, 70.8% were Black and 55% were women. Overall, 93% of the young adults reported vaginal intercourse, 78% reported receiving oral sex, 57% reported performing oral sex, and 10% reported receptive anal intercourse. Among men, 27% reported insertive anal intercourse. Blacks initiated vaginal intercourse at an earlier age than Whites; White women performed oral sex earlier than Black women. Significant interactions were observed between age of first vaginal partner and both gender and race/ethnicity. Blacks with older partners initiated sex at an earlier age than both Blacks with a partner the same age or younger and Whites. We also observed a relationship between older female sex partners and earlier vaginal sex initiation among men. We conclude that older sex partners play an important role in sexual initiation among young adults. In light of the rates of oral and anal sex, sexual education and intervention programs should address the risk for unintended consequences of these behaviors.     

Variation in Sexual Behaviors in a Cohort of Adolescent Females: The Role of Personal,Perceived Peer,and Perceived Family Attitudes

PurposeLittle is known about how adolescent sexual behaviors develop and the influence of personal or perceived social attitudes. We sought to describe how personal, perceived peer, and perceived family attitudes toward adolescent sexual activity influence sexual behaviors of adolescent females' over time.MethodsBetween the years of 1999 and 2006, 358 English-speaking female adolescents, aged 14–17 years, were recruited from three urban adolescent clinics. Participants completed quarterly and annual questionnaires over a span of 4 years. Primary outcomes included engagement in any of the following eight sexual behaviors: kissing, having breasts touched, having genitals touched, touching partners' genitals, oral giving, oral receiving, anal, or vaginal sex. Three attitudinal scales assessed personal importance of abstinence, perceived peer beliefs about when to have sex, and perceived family beliefs that adolescent sex is negative. We used generalized estimating equations to identify predictors of each sexual behavior and compared whether personal, perceived peer, or perceived family attitudes predicted sexual behaviors over time.ResultsThe odds of reporting each sexual behavior increased with age but were lower among those whose personal or perceived family attitudes were less positive. Participants' personal attitudes toward adolescent sex were the strongest predictor of engagement in all eight sexual behaviors even after controlling for perceived peer and perceived family attitudes.ConclusionsFemale adolescent's personal attitudes toward abstinence appear to be the strongest predictor of engagement in a variety of sexual behaviors. Efforts to influence adolescent attitudes toward abstinence may be an important approach to reducing sexual behaviors that increase the risk of pregnancy and sexually transmitted infections.     

African-American and Hispanic adolescents’ intentions to delay first intercourse: parental communication as a buffer for sexually active peers

PurposeParents and peers often create conflicting influences on adolescent sexual delay. This study examines the moderating effects of mothers’ responsiveness during sex discussions on the negative relationship between sexually active peers and sexual delay among African-American and Hispanic adolescents.MethodsInterview data from 530 African-American and Hispanic non–sexually active high school students were used to examine the effects of mother-adolescent sex discussions and peer norms on intentions to delay or initiate intercourse within the next year. Logistic regression was performed to test the moderating effects of adolescents’ reports of mothers’ responsiveness (openness, comfort, and understanding during sex discussions) on the relationship between perceived peer sexual activity and adolescent sexual delay.ResultsThe relationship between mothers’ responsiveness during sex discussions, peer sexual activity, and their effects on adolescent sexual delay is complex. Mother’s responsiveness had a buffering effect on the negative effects of sexually active peers. Among adolescents who perceived a high percentage of their peers to be sexually active, those who reported that their mothers had above-average responsiveness were 1.6 times more likely to plan to delay intercourse than were adolescents who reported that their mothers had average responsiveness.ConclusionsParents and peers are mutually contingent influences in the dynamic social context of adolescents’ lives. Although sexually active peers have a negative effect on adolescent sexual delay, responsive parent-adolescent sex discussions can buffer these effects. Intervention efforts can help parents develop the knowledge and communication skills they need to discuss sexual topics with their children effectively.     

The Influence of Parental Communication and Perception of Peers on Adolescent Sexual Behavior

The authors used the theory of planned behavior to examine the influence of parents and peers on early adolescent sexual attitudes, self-efficacy to limit sexual behavior, and behavioral intentions to have vaginal intercourse. Adolescents (N = 212) provided self-reports of their perception of parent and peer attitudes regarding sexual behavior. The authors used bivariate and regression analyses to examine the relation between parent and peer attitudes with adolescent sexual attitudes, self-efficacy to limit sexual behavior, and behavioral intentions to have vaginal intercourse. Although there were gender differences, the analyses revealed the importance of both parents and peers on adolescent sexual attitudes, self-efficacy to limit sexual behavior, and intentions to have vaginal sex in the next year.     

Sex education and the news: lessons from how journalists framed virginity pledges

This analysis of newspaper articles about virginity pledges published from 1987 to 2001 describes prominent news frames on sex education. The articles focused on True Love Waits, a nationwide virginity pledge campaign encouraging abstinence, and results from Add Health (TLW), a longitudinal study that included questions to evaluate the effects of virginity pledges. Our results show how news frames and sources can vary for related events. Reporting on virginity pledges was often not grounded in science, and reporting on the science of pledges did not reflect a broader context. In this case, reporting may have encouraged support for abstinence-only programs.     

Patterns of Vaginal, Oral, and Anal Sexual Intercourse in an Urban Seventh-Grade Population

Background:  This study examines the prevalence of vaginal, oral, and anal intercourse among a population of urban, public middle school students, the characteristics of early sexual initiators, and the sequence of sexual initiation. Such data are limited for early adolescents.
Methods:  A total of 1279 seventh-grade students (57.3% female, 43.6% black, and 41.8% Hispanic), mean age 12.5 years (SD = 0.63) from 10 middle schools in a large southeastern US public school district completed a cross-sectional survey using audio computer-assisted self-interviews. Main outcomes included lifetime and past 3-months' experience of vaginal, oral, and anal sex; condom use; age of initiation; and number of lifetime partners.
Results:  Overall, 12.0% of students had engaged in vaginal sex, 7.9% in oral sex, and 6.5% in anal sex. Among students who had initiated intercourse, approximately two thirds were currently sexually active and one quarter reported ≥4 lifetime partners. Six percent had engaged in 1 type of intercourse, 4% in 2 types of intercourse, and 4% in all 3 types of intercourse; vaginal sex was typically initiated at an earlier or at the same age as other types of intercourse. Only 2% had engaged in oral sex without engaging in vaginal sex. Although black students were significantly more likely to have initiated sex compared to other racial/ethnic groups, Hispanic students who had initiated each type of intercourse were more likely to be currently sexually active and to have engaged in recent unprotected sex.
Conclusions:  A small percentage of early adolescents are engaging in multiple sexual behaviors. These findings have implications for early adolescent school-based sexual health education.     

Sex Redefined: The Reclassification Of Oral‐Genital Contact

CONTEXT: Although partially anecdotal, some evidence suggests that oral‐genital contact is increasingly excluded from young people's notions of what behaviors constitute sex. Such a shift may have implications for STD prevention. METHODS: In 2007, a convenience sample of 477 university students participated in a survey that included the question “Would you say you ‘had sex’ with someone if the most intimate behavior you engaged in was” each of 11 behaviors. Chi‐square tests and independent samples t tests were used to assess gender differences, and chi‐square analyses were used to compare the data with similar data collected in 1991. Predictors of beliefs concerning the classification of oral‐genital contact were assessed using logistic regression analysis. RESULTS: The majority of respondents indicated that penile‐vaginal intercourse and penile‐anal intercourse constitute sex (98% and 78%, respectively), but only about 20% believed the same was true of oral‐genital contact. The proportion classifying oral‐genital contact as sex in 2007 was about half that in 1991. This difference was consistent for both sexes and for both giving and receiving oral‐genital stimulation. Responses did not vary by respondents’ sexual experience or demographic characteristics. CONCLUSIONS: Sociocultural conceptualizations of oral‐genital contact have shifted in a way that may leave people who engage in this activity unmindful of its potential health risks. Sex education programs, which generally focus on penile‐vaginal contact, could help STD prevention efforts by explaining the risks associated with oral‐genital stimulation and the measures that can be taken to minimize those risks.     

A Parent-Based Intervention to Reduce Sexual Risk Behavior in Early Adolescence: Building Alliances Between Physicians,Social Workers,and Parents

PurposeTo evaluate the efficacy of a parent-based intervention to prevent sexual risk behavior among Latino and African American young adults. This was delivered to mothers while waiting for their adolescent child to complete an annual physical examination.MethodsA randomized clinical trial was conducted with 264 mother–adolescent dyads in New York City. Adolescents were eligible for the study only if they were African American or Latino and aged 11–14 years, inclusive. Dyads completed a brief baseline survey and were then randomly assigned to one of the following two conditions: (1) a parent-based intervention (n = 133), or (2) a “standard care” control condition (n = 131). Parents and adolescents completed a follow-up survey nine months later. The primary outcomes included whether the adolescent had ever engaged in vaginal sexual intercourse, the frequency of sexual intercourse, and the frequency of oral sex.ResultsRelative to the control group, statistically significant reduced rates of transitioning to sexual activity and frequency of sexual intercourse were observed, with oral sex reductions nearly reaching statistical significance (p < .054). Specifically, sexual activity increased from 6% to 22% for young adults in the “standard of care” control condition, although it remained at 6% among young adults in the intervention condition at the 9-month follow-up.ConclusionsA parent-based intervention delivered to mothers in a pediatric clinic as they waited for their child to complete a physical examination may be an effective way to reduce sexual risk behaviors among Latino and African American middle-school young adults.     

Heterosexual genital sexual activity among adolescent males: 1988 and 1995

CONTEXT: Researchers have paid little attention to adolescents' experience with genital sexual activity other than vaginal intercourse, even though oral and anal intercourse expose youth to the risk of sexually transmitted diseases. METHODS: Males aged 15-19 interviewed in 1988 and 1995 as part of the National Survey of Adolescent Males were asked questions about whether they had ever engaged in a series of genital sexual activities. These data were collected in a self-administered questionnaire that respondents completed at the end of the interview. RESULTS: In 1995, 55% of males aged 15-19 reported that they had ever engaged in vaginal intercourse, 53% that they had ever been masturbated by a female, 49% that they had ever received oral sex, 39% that they had ever given oral sex and 11% that they had ever engaged in anal sex. More than three-quarters of males who had had vaginal intercourse reported experience with masturbation or oral sex by a female. Moreover, one in five males who had never had vaginal intercourse reported having been masturbated by a female, and one in seven said they had received oral sex. Between 1988 and 1995, the proportion of males who reported having ever been masturbated by a female increased significantly, from 40% to 53%. There were less sizable shifts in the proportions who had received oral sex: Overall proportions were similar in both years, although levels more than doubled among black teenagers, an increase that brings them in line with levels of oral sex reported by white and Hispanic adolescent males in 1995. CONCLUSIONS: Evidence from the National Survey of Adolescent Males showing that a substantial share of male teenagers engage in genital sexual activity beyond vaginal sexual intercourse underlines the importance of monitoring a broad spectrum of sexual behaviors among teenagers. More detailed data with larger samples of both males and females are needed to determine the frequency and timing of these behaviors. Measuring risk for STD infections among teenagers requires attention to all forms of genital sexual activity.     

Test–Retest Reliability of Self-Reported HIV/STD-Related Measures Among African-American Adolescents in Four U.S. Cities

PurposeTo evaluate the test–retest reliability of self-reported sexuality-related data in a sample of African American adolescents residing in four U.S. cities.MethodsUsing audio computer-assisted self-interviewing (ACASI), 156 African American teens (mean age = 15.5 years) provided data on lifetime and recent sexual behavior, HIV/sexually transmitted disease (STD) testing, and theoretical antecedents of sexual risk behavior on two occasions separated by 2 weeks.ResultsMost self-reports of lifetime sexual behavior and STD/HIV testing were stable across the two assessment points. Test–retest agreement was substantial for dichotomous indices of lifetime sexual behaviors and STD testing (kappas ranging from .61–.87), and for 3-month recall of vaginal sex (kappa = .72) and number of sexual partners (intraclass correlation coefficient [ICC] = .68). Lower reliability estimates emerged for count data of unprotected vaginal sex occasions (ICC = .44). Test–retest reliability estimates for antecedents of sexual risk behavior were highest for a validated measure of HIV-related knowledge (r = .73), but somewhat lower for peer norms (r = .58) and condom use self-efficacy (r = .50).ConclusionsAlthough variability in the stability of self-report data was observed, findings confirm that most sexual behavior, STD and HIV testing history, and psychosocial measures can be assessed reliably among adolescents. Research should continue to identify strategies to enhance the reliability of self-report sexual behavior data from youth at risk for HIV and other sexually transmitted infections.     

Comparison of Teenagers' Early Same-Sex and Heterosexual Behavior: UK Data From the SHARE and RIPPLE Studies

PurposeNorth American research finds increased sexual risk-taking among teenagers with same-sex partners, but understanding of underlying processes is limited. The research carried out in the United Kingdom compares teenagers' early sexual experiences according to same- or opposite-sex partner, focusing on unwanted sex in addition to risk-taking, and exploring underlying psychosocial differences.MethodsMultivariate analyses combined self-reported data from two randomized control trials of school sex education programs (N = 10,250). Outcomes from sexually experienced teenagers (N = 3,766) were partner pressure to have first sex and subsequent regret, and sexual risk measures including pregnancy. Covariates included self-esteem, future expectations, substance use, and communication with mother.ResultsBy the time of follow-up (mean age, 16), same-sex genital contact (touching or oral or anal) was reported by 2.3% of teenagers, with the majority also reporting heterosexual intercourse. A total of 39% reported heterosexual intercourse and no same-sex genital contact. Boys were more likely to report partner pressure (Odds ratio [OR] = 2.56, 95% confidence intervals [CI] = 1.29–5.08) and regret (OR = 2.32; 95% CI = 1.39–3.86) in relation to first same-sex genital contact than first heterosexual intercourse, but girls showed no differences according to partner type. Teenagers with bisexual behavior reported greater pregnancy or partner pregnancy risk than teenagers with exclusively opposite-sex partners (girls, OR = 4.51, 95% CI = 2.35–8.64; boys, OR = 4.43, 95% CI = 2.41–8.14), partially reduced by attitudinal and behavioral differences.ConclusionsThis UK study confirms greater reporting of sexual risk-taking among teenagers with same-sex partners, and suggests that boys in this group are vulnerable to unwanted sex. It suggests limitations to the interpretation of differences, in terms of psychosocial risk factors common to all adolescents.     

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.     

Mass media as a sexual super peer for early maturing girls

PurposeTo investigate the possibility that the mass media (television, movies, music, and magazines) serve as a kind of super peer for girls who enter puberty sooner than their age-mates. Multiple studies have demonstrated significant associations between earlier pubertal timing and earlier transition to first sex. Does puberty also stimulate interest in sexual media content that is seen as giving permission to engage in sexual behavior?MethodsWhite and African-American female adolescents (n = 471; average age 13.7 years) recruited from public middle schools in central North Carolina completed two self-administered surveys in their homes about their pubertal status, interest in and exposure to various media, and perceptions of sexual media content.ResultsEarlier maturing girls reported more interest than later maturing girls in seeing sexual content in movies, television, and magazines, and in listening to sexual content in music, regardless of age or race. Earlier maturing girls were also more likely to be listening to music and reading magazines with sexual content, more likely to see R-rated movies, and to interpret the messages they saw in the media as approving of teens having sexual intercourse.ConclusionsThe mass media may be serving as a kind of sexual super peer, especially for earlier maturing girls. Given the lack of sexual health messages in most media adolescents attend to, these findings give cause for concern. The media should be encouraged to provide more sexually healthy content, and youth service providers and physicians should be aware that earlier maturing girls may be interested in sexual information.     

Behavioral and Psychosocial Effects of Two Middle School Sexual Health Education Programs at Tenth-Grade Follow-Up

PurposeAn earlier randomized controlled trial found that two middle school sexual education programs—a risk avoidance (RA) program and a risk reduction (RR) program—delayed initiation of sexual intercourse (oral, vaginal, or anal sex) and reduced other sexual risk behaviors in ninth grade. We examined whether these effects extended into 10th grade.MethodsFifteen middle schools were randomly assigned to RA, RR, or control conditions. Follow-up surveys were conducted with participating students in 10th grade (n = 1,187; 29.2% attrition).ResultsParticipants were 60% female, 50% Hispanic, and 39% black; seventh grade mean age was 12.6 years. In 10th grade, compared with the control condition, both programs significantly delayed anal sex initiation in the total sample (RA: adjusted odds ratio [AOR], .64, 95% confidence interval [CI], .42–.99; RR: AOR, .65, 95% CI, .50–.84) and among Hispanics (RA: AOR, .53, 95% CI, .31–.91; RR: AOR, .82, 95% CI, .74–.93). Risk avoidance students were less likely to report unprotected vaginal sex, either by using a condom or by abstaining from sex (AOR: .61, 95% CI, .45–.85); RR students were less likely to report recent unprotected anal sex (AOR: .34, 95% CI, .20–.56). Both programs sustained positive impact on some psychosocial outcomes.ConclusionsAlthough both programs delayed anal sex initiation into 10th grade, effects on the delayed initiation of oral and vaginal sex were not sustained. Additional high school sexual education may help to further delay sexual initiation and reduce other sexual risk behaviors in later high school years.     

University Students’ Definitions of Sexual Abstinence and Having Sex

We asked 298 heterosexual Canadian university students about their definitions of the terms abstinence and having sex. For both terms, students were provided with a list of 17 sexual behaviors and indicated whether they would include each in their definition. The majority of both male and female students included activities that did not involve genital stimulation in their definition of sexual abstinence and did not include these activities in their definition of having sex. Conversely, most students did not include bidirectional sexual stimulation (penile–vaginal intercourse or penile–anal intercourse) in their definitions of sexual abstinence but did include them in their definitions of having sex. Students were quite mixed in whether activities involving unidirectional genital stimulation (e.g., oral sex, genital fondling) constituted abstinence, having sex, or neither abstinence nor having sex. However, they were more likely to see these behaviors as abstinent than as having sex. Students were more likely to rate a behavior as abstinence if orgasm did not occur. A canonical correlation analysis was used to examine the patterns of association between a number of predictors and inclusions of behaviors involving no genital stimulation, unidirectional stimulation, and bidirectional genital stimulation in abstinence definitions. The results indicated that male participants who were more involved with their religion and sexually conservative, less sexually experienced, and who had not received sexual health education at home were more likely to define bidirectional genital stimulation and less likely to define no genital stimulation and unidirectional sexual stimulation as sexual abstinence. The research and health promotion implications of these results are discussed.     

Beyond age at first sex: patterns of emerging sexual behavior in adolescence and young adulthood

PurposeAlthough the emergence of sexual expression during adolescence and early adulthood is nearly universal, little is known about patterns of initiation.MethodsWe used latent class analysis to group 12,194 respondents from waves I and IV of the National Longitudinal Study of Adolescent Health (Add Health) into one of five classes based on variety, timing, spacing, and sequencing of oral-genital, anal, and vaginal sex. Multinomial logistic regression models, stratified by biological sex, examined associations between sociodemographic characteristics and class membership.ResultsApproximately half of respondents followed a pattern characterized predominately by initiation of vaginal sex first, average age of initiation of approximately 16 years, and spacing of >1 year between initiation of the first and second behaviors; almost one-third initiated sexual activity slightly later but reported first experiences of oral-genital and vaginal sex within the same year. Classes characterized by postponement of sexual activity, initiation of only one type of behavior, or adolescent initiation of anal sex were substantially less common. Compared with white respondents, black respondents were more likely to appear in classes characterized by initiation of vaginal sex first. Respondents from lower socioeconomic backgrounds were more likely to be in classes distinguished by early/atypical patterns of initiation.ConclusionsA small number of typical and atypical patterns capture the emergence of sexual behavior during adolescence, but these patterns reveal complex associations among different elements of emerging sexuality that should be considered in future research.