Factors Associated with Postponing Sexual Intercourse Among Adolescents

Abstract

Background Research has primarily focused on risks factors that promote early sexual debut among adolescents. The present study was undertaken to identify factors associated with delaying onset of sexual intercourse in this age group, and which can be used in developing more comprehensive pregnancy and sexually transmitted diseases prevention interventions. Methods The study population included 29,944 (7th.–12th. grade students) from a statewide survey of adolescent health, who did not report a history of sexual abuse. There were 15,727 males (52.5%) and 14,217 females (47.5%), who were stratified into early (13–14), middle (15–16) and late (17–18) adolescence. Demographic and personal characteristics that differentiated sexually experienced from non-experienced youth were assessed. Cox regression (survival analysis) was utilized to model age by sexual experience, and to calculate the relative risk (RR) associated with each predictor variable. Predictors included school performance, religious feelings, emotional health, parental expectations, parents, family and other caring adult, social concerns, geographic area of residence, and age at menarche. These characteristics were examined adjusting for parental marital status, race and socioeconomic status (SES). Results Sexual experience was correctly predicted for the three male age groups with 93%, 81% and 65% accuracy, and 97%, 88% and 71% accuracy for the female groups. Demographic factors that predominated increasing the probability of postponing sexual intercourse across gender and age groups were: married parents in household (RR females=.76, males=.71) (p = .0001); middle/higher SES (females RR = .66, males RR = .83) (p = .0001). After adjusting for these sociodemographic factors, the likelihood of sexual debut for female youth with higher school performance was only one fifth that of a comparable group with lower performance (RR = .21; p = .0001); and the risk was less than half for those who had a caring adult (RR = .46; p = .0001) or were concerned about community issues (RR = .45; p = .0001). Also, the risk was less than two thirds if they had strong religious feelings (RR = .63; p = .0001), parents who cared (RR = .60;p = .0001) and high parental expectations (RR = .64; p = .0001). For males, the risk was only about half when they were more concerned about their community (RR = .54;p = 0001), while for those with higher school performance the risk was only one third (RR = .34;p = .0001), and less than two thirds (RR = .60; p = .0001) for those who had a caring adult. Living in a rural area decreased the risk of sexual debut to two thirds for both males and females (RR = .68; p = .0001). Conclusions The study emphasizes that adolescents who live with married parents, have above average school performance, are more religious, experience higher parental expectations and have a caring adult, show a lower risk of early sexual debut than their peers. It also shows that social concern for school and/or community is protective. These findings highlight the importance of how adolescents, parents, school, and community interact and how those interactions influence adolescent sexual debut. Thus, prevention programs aimed at delaying onset of sexual intercourse should focus on these multiple components that heavily influence youth sexual behavior.