Abstract

BackgroundThe timing and context around the 1st intercourse are associated with risks of sexually transmitted infections and unplanned pregnancies. Negative experience may also affect long-term sexual health. We examined the associations of contextual factors around the 1st intercourse with the feeling that 1st intercourse was too early.MethodsHBSC study is a WHO collaborative cross-national survey. Data were collected among 2,015 French-speaking Belgian adolescents aged 16-20 in 2014 who had already had intercourse. Variable of interest was about the feeling on the timing of 1st intercourse. Using logistic regression model, associations with age difference between partners, contraceptive use (including condom) and sociodemographic factors (for potential confounding effects) were assessed. Number of subsequent intercourse was included in model 2. The potential effect of time between the 1st intercourse and the survey was also included in model 3. Interactions with gender were tested.ResultsOne in five adolescents (19.7%) reported 1st intercourse was too early. After adjustments, girls (OR: 3.0; 95%CI: 2.2-4.0), non-use of contraception (1.8; 1.1-2.9) and an older partner (≥3 years older: 1.7; 1.20-2.5 vs same age partner) were associated with feeling that 1st intercourse was too early. In the 2nd model, all these associations were unchanged and feeling that 1st intercourse was too early was associated with no other sexual intercourse since (3.5; 2.3-5.5). In the 3rd model, all the associations remained statistically significant and the feeling that 1st intercourse was too early was more frequently reported as the gap in time between 1st intercourse and the survey widened (1 year ago: 1.7; 1.1-2.9 – 2 years ago: 3.6; 2.2-6.0 - ≥3 years ago: 4.3; 2.6-7.1).ConclusionFeeling that 1st intercourse was too early was frequently reported, especially by girls and adolescents with an older partner. This feeling was associated with sexual risk behaviours and the time lapse.Main messages• Having their first intercourse when they did not actually feel “ready” could place adolescents at higher risk of non-use of contraception (including condom).• Education programs should help adolescents in assessing their wantedness of 1st intercourse and in defending their decision, especially girls and adolescents with an older partner.

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