Sexual risk behaviors of inner-city middle school students: cluster analysis of associated characteristics and time-to-event analysis of behaviors

Abstract

OBJECTIVE: Evaluation of adolescents' sexual health is an essential function of many healthcare providers. This study aimed to classify adolescents by characteristics believed to be associated with sexual risk behaviors and to determine which subgroup(s), if any, were more likely to engage in sexual risk behaviors (sexual initiation, sexual intercourse with multiple partners, inconsistent use or lack of condom use, and inconsistent use or lack of birth control use) over the course of two years.DESIGN: This was a secondary analysis of data collected from 899 adolescents aged 10-15 years participating in the “Minority Youth Health Project”. Written surveys were administered at baseline and at three, six, 12, 18, and 24 months.MATERIALS AND METHODS: Cluster analysis was conducted to identify similarities in participants based on the following characteristics: partner norms; peer norms; deviant peer involvement; relationship history; parental influence (family structure, parental closeness, parental monitoring); developmental issues (chronological age, onset of puberty compared to peers); substance use; academic achievement/goals; religiosity; and gender. Time to event analysis was used to evaluate whether a subgroup(s) engaged in sexual risk behaviors and the timing of behaviors during the assessment period.RESULTS: Two well-defined subgroups were identified and subsequently labeled “at risk” and “high risk”. Adolescents in the “high risk” group exhibited irresolute peer and partner norms about sex, condom use, and birth control use; deviant peer involvement; history of experimentation with smoking cigarettes, drinking alcohol, smoking marijuana, getting drunk/high; and relaxed parental monitoring. In addition, “high risk” adolescents reported engaging in all sexual risk behaviors approximately two years before their “at risk” peers.CONCLUSIONS: Findings suggest that adolescents can be profiled according to characteristics associated with sexual risk behaviors and that adolescents with particular characteristics were more likely to engage in sexual risk behaviors. Sexual risk behaviors must be evaluated and specific assessment of substance use as well as environmental influences of peers, partners, and parents should be a priority. With additional research, interventions can be designed to modify such characteristics associated with sexual risk behaviors. OBJECTIVE: Evaluation of adolescents' sexual health is an essential function of many healthcare providers. This study aimed to classify adolescents by characteristics believed to be associated with sexual risk behaviors and to determine which subgroup(s), if any, were more likely to engage in sexual risk behaviors (sexual initiation, sexual intercourse with multiple partners, inconsistent use or lack of condom use, and inconsistent use or lack of birth control use) over the course of two years. DESIGN: This was a secondary analysis of data collected from 899 adolescents aged 10-15 years participating in the “Minority Youth Health Project”. Written surveys were administered at baseline and at three, six, 12, 18, and 24 months. MATERIALS AND METHODS: Cluster analysis was conducted to identify similarities in participants based on the following characteristics: partner norms; peer norms; deviant peer involvement; relationship history; parental influence (family structure, parental closeness, parental monitoring); developmental issues (chronological age, onset of puberty compared to peers); substance use; academic achievement/goals; religiosity; and gender. Time to event analysis was used to evaluate whether a subgroup(s) engaged in sexual risk behaviors and the timing of behaviors during the assessment period. RESULTS: Two well-defined subgroups were identified and subsequently labeled “at risk” and “high risk”. Adolescents in the “high risk” group exhibited irresolute peer and partner norms about sex, condom use, and birth control use; deviant peer involvement; history of experimentation with smoking cigarettes, drinking alcohol, smoking marijuana, getting drunk/high; and relaxed parental monitoring. In addition, “high risk” adolescents reported engaging in all sexual risk behaviors approximately two years before their “at risk” peers. CONCLUSIONS: Findings suggest that adolescents can be profiled according to characteristics associated with sexual risk behaviors and that adolescents with particular characteristics were more likely to engage in sexual risk behaviors. Sexual risk behaviors must be evaluated and specific assessment of substance use as well as environmental influences of peers, partners, and parents should be a priority. With additional research, interventions can be designed to modify such characteristics associated with sexual risk behaviors.