Leisure-Time Sedentary Behavior, Alcohol Consumption, and Sexual Intercourse Among Adolescents Aged 12-15 Years in 19 Countries From Africa, the Americas, and Asia

Abstract

BackgroundThe association between sedentary behavior and sexual behavior has not been investigated among adolescents. AimThe aim of this study was to: (i) investigate the association between leisure-time sedentary behavior and sexual intercourse, and (ii) test for mediation by alcohol consumption, drug use, physical activity, bullying victimization, parental support/monitoring, loneliness, and depressive symptoms in a large global sample of young adolescents. MethodsData were analyzed from 34,674 adolescents aged 12−15 years participating in the Global School-based Student Health Survey. Participants reported the number of hours spent in leisure-time sedentary behavior on a typical day (<1, 1−2, 3−4, 5−8, and >8 hours). Data on alcohol consumption, drug use, physical activity, bullying victimization, parental support/monitoring, loneliness, and depressive symptoms were considered as potential mediators. OutcomeParticipants reported whether or not they had sexual intercourse in the past 12 months (yes/no). ResultsThe prevalence of past 12-month sexual intercourse was 11.9%, whereas the prevalence of <1, 1−2, 3−4, 5−8, and >8 hours per day of leisure-time sedentary behavior were 26.7%, 35.6%, 21.4%, 11.5%, and 4.9%, respectively. There was a dose-dependent relationship between sedentary behavior and odds of reporting sexual intercourse: compared with <1 hour/day of sedentary behavior, the odds ratio (95% CI) of sexual intercourse associated with 1−2, 3−4, 5−8, and >8 hours/day of sedentary behavior were 1.12 (0.94−1.33), 1.22 (1.01−1.48), 1.34 (1.08−1.66), and 1.76 (1.37−2.27), respectively. There was no significant interaction by sex. The largest proportion of the association between sedentary behavior and sexual intercourse was explained by alcohol use (% mediated 21.2%), with other factors explaining an additional 11.2%. Clinical TranslationInterventions to reduce leisure-time sedentary and/or alcohol consumption may contribute to a reduction in the proportion of adolescents engaging in sexual intercourse at a young age. The strengths and limitations of this study are the large, representative sample of adolescents from 19 countries. However, the cross-sectional design means causality or temporal associations could not be established. ConclusionsIn young adolescents, leisure-time sedentary behavior is positively associated with odds of having sexual intercourse in both boys and girls, in a dose-dependent manner. Alcohol consumption seems to be a key mediator of this relationship.Smith L, Jackson SE, Jacob L, et al. Leisure-Time Sedentary Behavior, Alcohol Consumption, and Sexual Intercourse Among Adolescents Aged 12-15 Years in 19 Countries From Africa, the Americas, and Asia. J Sex Med 2019;16:1355–1363.