Abstract
BackgroundAs early sexual initiation is increasingly common in East Asia, we examined its relations to risky sexual practices in alcohol- and tobacco-using individuals in Taiwan and evaluated whether the associations were mediated through preceding-sex use of illicit drugs.MethodsParticipants, recruited from alcohol- and tobacco-using adults aged 18 to 50 in Taipei through respondent-driven sampling (N = 1115), completed a computer-assisted self-interview covering questions on substance use and sexual experiences. In a subsample of 916 participants who had had sexual experience (median age 27), we examined the relations of early sexual initiation (< 16 years) to multiple sexual partners, casual sex, group sex, and rare condom use. Causal mediation analyses were conducted to examine whether illicit drug use preceding sex mediated these associations.ResultsAround 9.3% reported early sexual initiation and the prevalence of risky sexual practices ranged from 7% (group sex) to 47% (rare condom use). Early initiators had a higher prevalence of regular binge drinking, illicit drug use, and risky sexual practices. In the multivariable analyses, higher odds of multiple sexual partners, casual sex, and group sex were consistently associated with early sexual initiation, gender, and their interaction. Mediation through preceding-sex use of illicit drugs was found between early sexual initiation and the three risky sexual practices, with the proportions mediated ranging from 17 to 19%.ConclusionsEarly sexual initiators were more likely to engage in risky sexual practices and preceding-sex use of illicit drugs partially explained this relationship, calling for more attention to this population’s sexual health.
Highlights
As early sexual initiation is increasingly common in East Asia, we examined its relations to risky sexual practices in alcohol- and tobacco-using individuals in Taiwan and evaluated whether the associations were mediated through preceding-sex use of illicit drugs
Since traditional culture might have been weakened owing to widespread education and increased exchange with Western societies, there have been signs that early sexual initiation is slowly becoming more common in East Asia [2, 15,16,17,18]
Early sexual initiation was defined as having sexual experience before age 16, which is the age definition used in another study of early sexual initiation in Taiwan [2]. Based on this respondent-driven sampling (RDS) sample, this study aims to (1) examine the associations between early sexual initiation and four risky sexual practices, testing the moderation of gender on early sexual initiation; and (2) explore whether the associations between early sexual initiation and each of the risky sexual practices were mediated through preceding-sex use of illicit drugs using a causal mediation analysis
Summary
As early sexual initiation is increasingly common in East Asia, we examined its relations to risky sexual practices in alcohol- and tobacco-using individuals in Taiwan and evaluated whether the associations were mediated through preceding-sex use of illicit drugs. Despite not being uniformly defined, having sex before age 16 has been commonly defined as early sexual initiation by many studies in Europe, the US, and Taiwan [1, 2, 8, 9]. This relationship might be moderated by gender, since males were found to hold more permissive sexual attitudes than females [10, 11]. Since traditional culture might have been weakened owing to widespread education and increased exchange with Western societies, there have been signs that early sexual initiation is slowly becoming more common in East Asia [2, 15,16,17,18]
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