Sexual Risk-taking Behaviors Research Articles

Sexual initiation age and related risk-taking behaviours among adolescents in urban secondary schools in Nairobi County

Risky sexual behaviour such as early sexual initiation, inconsistent condom use and sexual intercourse with multiple partners are relatively prevalent among youths in sub-Saharan Africa. Sexual intercourse is an important event in one’s life trajectory and the contributory factors are: proximate and distal environments. The proximate environment includes micro systemic influences such as one's attitudes and beliefs, and extends to one's family. The distal environment includes one's community and culture. However, there are core forces which influence personal choices and behaviours like the self, family and community, and networks and cultural influences. While there are a variety of factors that contribute to early sexual initiation, proper parenting behaviour has been identified as a key strategy for reducing adolescents’ risky sexual behaviours. Even though early sexual initiation process is subject to a number of barriers, there is still less focus on parenting behaviour and its relationship with early sexual initiation among adolescents. Therefore, this study applied social survey to assess sexual initiation age and its related risk-taking behaviors among the adolescents in urban secondary schools in Nairobi County. The study found the common period in which adolescents initiate sex and even befriend strangers as age (15-16years). The findings have shown that children are capable of initiating drug use at any given period. This suggests the need for parent to undertake close monitoring of their children at all ages to curb drug abuse and encourage health talk with them on the effects of drug use.

A mixed Methods Study of Multilevel Factors Influencing Sexual Risk-Taking Behaviors Among Adolescent Girls in Uganda

Sub-Saharan Africa is home to two-thirds of people living with HIV globally. Adolescent girls and young women are twice as likely to be living with HIV compared to young men. Sexual risk-taking behaviors put adolescent girls at risk for adverse health outcomes, including HIV/AIDS. In this study, we conducted semi-structured in-depth interviews to explore multi-level factors that influence decisions to engage in sexual risk-taking among 58 school-going adolescent girls in Uganda. Both protective and risk factors cut across personal, proximal, and distal contexts. At the personal level, future goals and fear of negative health outcomes were identified as the most common protective factors. Positive family relations and peers were cited most frequently as protective factors at the proximal level. At the distal level, poverty was the most common risk factor. Relatedly, families’ ability to provide for adolescent girls’ needs was a protective factor. Study results point to the need for multilevel combination interventions to reduce sexual risk-taking among adolescent girls in Uganda.

Sexual and reproductive health in young women with ADHD from the view of health care professionals

BackgroundSexual risk-taking and struggles in managing romantic relationships may put young women with Attention Deficit Hyperactivity Disorder (ADHD) at risk of sexually transmitted diseases, unplanned pregnancies, and low relational satisfaction. To gain understanding of sexual behaviors and intimate relationships, this study aimed to identify and describe health care professionals’ (HCPs) perceptions and experiences of sexual and reproductive health (SRH) in young women with ADHD.MethodsQualitative interviews were performed with 16 HCPs. Data was analyzed using reflexive thematic analysis.ResultsAnalysis resulted in the themes Struggling to meet expectations, Sexual risk-taking, and Complex romantic relationships. HCPs’ perceptions and experiences indicated that some women were afraid to be judged in clinical meetings when not living up to perceived expectations of sexual behaviors. Lack of impulse control was interpreted by HCPs to result in risk-taking behaviors leading to both negative and positive sexual experiences. Difficulties in assessing intentions of sexual partners were further perceived by HCPs to sometimes lead to sexual regrets or sexual victimization. The HCPs had experience of women wishing for romantic relationships but described these as being complicated by previous experiences, low self-esteem and conflict. ADHD medication and self-knowledge were perceived by HCPs to facilitate the women’s relationship quality.ConclusionsThis study highlights that, from the perspective of HCPs, self-stigmatization and hesitation to raise issues concerning sexuality with HCPs may pose risks for young women with ADHD. It provides insight into sexual risk-taking behaviors, showing the link to regretted sex and sexual victimization. The study concludes that there is a need for HCPs to understand the influence of stigma concerning ADHD and female sexuality as well as how symptoms and outcomes of living with ADHD may impact SRH in order to promote healthy behaviors and relationships in young women.

Validation of the Sexual Discounting Task for Use in Adolescents.

The Sexual Discounting Task (SDT) was developed to evaluate the effects of delay on decision making as it relates to sexual risk-taking behaviors. Though previously validated with other populations, including urban emerging adults, the current study sought to validate the SDT with adolescents. A sample of adolescents (N = 155; 61% female) between ages 14 and 21 (Mage = 19.5years) was recruited to complete the SDT (involving choices between immediate unprotected sex and delayed sex with a condom with hypothetical sexual partners) and the Delay Discounting Task (a delay discounting task for money outcomes). Additionally, they completed several self-report measures assessing demographics, sexual behavior, and sexual history. If the condom was readily available, respondents were more likely to use a condom for partners who were judged "most likely to have an STI" and for those that participants were "least likely to have sex with." Moreover, when a condom was not immediately available, greater self-reported sexual risk-taking was related to greater sexual discounting (i.e., greater effects of delay on decreasing condom use). Furthermore, sexual discounting was greater among partners deemed more desirable and those judged "least likely to have an STI." Differences in sexual discounting were significant after controlling for immediately available condom use. Findings from the current study suggest that the SDT is clinically meaningful for adolescents and is sensitive to factors that influence real-world decisions to use condoms. Future treatment and prevention should consider delay discounting as an important variable affecting sexual risk behavior.

Sexual Risk-taking Behaviours amongst Rural Adolescent Boys in a Province in South Africa: A Qualitative Study

Background Risky sexual behaviours amongst adolescents contribute to public health problems globally and can be linked to cultural norms and lifestyles. This study aimed to explore the influences that are related to sexual risk behaviours amongst adolescent boys in a rural setting in South Africa. Methods The research was guided by Bandura’s social learning theory. The research used a qualitative approach with an exploratory phenomenological research design. Purposive sampling was used; 30 adolescent boys aged 13 to 18 years were recruited from 5 high schools in a province in South Africa. Focus groups were created, and data were analysed using thematic analysis (TA). Results Five themes emerged naturally out of the data, namely: 1) Lack of parental communication about sex; 2) Alcohol use; 3) Media influence; 4) Pregnancy and manhood; and 5) Government grants. Conclusion Findings revealed that the sample of male adolescents was involved in high-risk sex behaviours that were influenced by their sexual desires, consumption of alcohol, desire to prove their manhood, and receiving money from government grants. It was recommended that the Department of Education (DOE) in South Africa should implement and update sex education programmes at both primary and secondary schools.

Costing of a Combination Intervention (Kyaterekera) Addressing Sexual Risk-Taking Behaviors among Vulnerable Women in Southern Uganda.

In Uganda, women engaged in sex work (WESW) are a marginalized population at the intersection of multiple vulnerabilities. The Kyaterekera intervention is targeted at WESW in Rakai and the greater Masaka regions in Uganda and combines a traditional HIV risk-reduction approach with a savings-led economic empowerment intervention and financial literacy training. We estimated the economic costs of the Kyaterekera intervention from a program provider perspective using a prospective activity-based micro-costing method. All program activities and resource uses were measured and valued across the control arm receiving a traditional HIV risk-reduction intervention and the treatment arm receiving a matched individual development savings account and financial literacy training on top of HIV risk reduction. The total per-participant cost by arm was adjusted for inflation and discounted at an annual rate of 3% and presented in 2019 US dollars. The total per-participant costs of the control and intervention arms were estimated at $323 and $1,435, respectively, using the per-protocol sample. When calculated based on the intent-to-treat sample, the per-participant costs were reduced to $183 and $588, respectively. The key cost drivers were the capital invested in individual development accounts and personnel and transportation costs for program operations, linked to WESW's higher mobility and the dispersed pattern of hot spot locations. The findings provide evidence of the economic costs of implementing a targeted intervention for this marginalized population in resource-constrained settings and shed light on the scale of potential investment needed to better achieve the health equity goal of HIV prevention strategies.

Adverse childhood experiences, sexual risk-taking and non-consensual sexual experiences in a nationally representative study of 15–29-year-old Danes

BackgroundAdverse childhood experiences (ACEs) have been linked with risky health-related behaviors and poor health. ObjectiveThis study aimed to investigate associations of ACEs with a broad panel of sexual risk-taking behaviors and non-consensual sexual experiences among young people in Denmark. Participants and settingBaseline questionnaire data from 15 to 29-year-old participants in the nationally representative cohort study Project SEXUS were used in combination with data from Danish national registers to include a total of 13,132 individuals. MethodsIn logistic regression analyses, confounder-adjusted odds ratios (aORs) with 95 % confidence intervals (CIs) were obtained for associations of five ACE categories (Household challenges, Loss or threat of loss, Material deprivation, Abuse, and Neglect) and a cumulative ACE score with measures of sexual risk-taking and non-consensual sexual experiences. ResultsStatistically significant associations were observed between ACEs and multiple sexual risk-taking behaviors and non-consensual sexual experiences with particularly increased odds among individuals with a history of Abuse, Neglect, or an ACE score of 3 or more. Specifically, Abuse was associated with having received payment for sex (women: aOR 5.38; 95 % CI 2.73–10.61; men: aOR 2.11; 95 % CI 1.22–3.64), with having paid for sex (men: aOR 1.88; 95 % CI 1.41–2.51), and with having been the victim of a sexual assault after age 18 years (women: aOR 3.33; 95 % CI 2.36–4.68). ConclusionsIn this Danish study, multiple measures of sexual risk-taking and non-consensual sexual experiences were markedly more common among young people with ACEs than in those without ACEs. This knowledge should be considered in future initiatives to promote sexual health among young people.

Risk-taking and self-harm behaviors as markers of adolescent borderline personality disorder

Adolescence is a critical period for early identification and intervention of borderline personality disorder (BPD). Risk-taking and self-harm behaviors (RSB) have been identified as promising early markers of BPD and correlates of depression in school-based samples. The present study aimed, first, to examine the association between RSB and BPD in a clinical sample of adolescents and, second, to examine whether RSB are also linked to depression. N = 405 participants (82.7% female) were recruited from an outpatient clinic for adolescents with RSB. RSB assessed included truancy, excessive media use, alcohol, tobacco, and illicit drug use, sexual risk-taking, and self-harm behavior. Regression analyses and generalized linear models were performed to examine the associations between individual RSB or patterns of RSB (identified using latent class analysis, LCA) and a diagnosis and severity of BPD or depression. All RSB (except excessive media use) were positively associated with BPD diagnosis and severity. In contrast, only non-suicidal self-injury (NSSI) and suicide attempts were positively associated with depression diagnosis and severity, while illicit drug use was negatively associated with depression severity. The LCA yielded two classes differing in the occurrence of RSB. The high RSB class was more likely to have a BPD diagnosis and greater BPD severity than the low RSB class. Classes did not differ regarding depression diagnosis or severity. As NSSI and suicide attempts were associated with both BPD and depression, the presence of additional RSB, besides self-harm behavior, may represent a specific risk marker for BPD in adolescents.

Effect of the extensive parallel process model on high-risk sexual behaviors of adolescent girls: A randomized control trial

The present study aims to determine the effect of the extensive parallel process model on high-risk sexual behaviors of adolescent girls. This randomized control trial study employed a pre- and post-test design, incorporating both intervention and control groups, and involved 50 female students in the 2019. The primary instruments employed for data collection in this study comprised a demographic questionnaire encompassing age, educational level, parental education, and birth order of the child within the family. Additionally, the Iranian Adolescents Risk-Taking Scale served as a standardized tool for assessing risk-taking behaviors among Iranian adolescents. Before the intervention, the independent t-test conducted between the test and control groups revealed no statistically significant difference in high-risk sexual behaviors (P=0.23). However, after the intervention, a significant difference was observed between the two groups as indicated by the independent t-test (P<0.01). The ANCOVA test, employed to discern differences while controlling for pre-test effects, demonstrated statistical significance (Eta=0.27, P<0.01), underscoring the enduring impact of the intervention on high-risk sexual behaviors. In conclusion, the efficacy of the extensive parallel process model in mitigating sexual risk-taking behaviors among adolescents underscores its capacity to foster a heightened understanding of the gravity inherent in sexual issues.

Policing toxic masculinities and dealing with sexual violence on Zimbabwean University campuses

University campuses are framed as sexualised spaces marked by high sexual risk-taking behaviour and toxic masculinities that often fuel abusive relationships and sexual violence. More often, the most vulnerable groups, to this violence include sexual minorities, girls and students with disabilities. Drawing on qualitative ethnographic research and semi-structured interviews with students and staff from two universities in Zimbabwe, this article examines how toxic campus ‘cultures’ and campus sexual economies can be transformed and made more inclusive and safer for all students. The study uses Pierre Bourdieu’s theory of practice, especially the field and habitus to understand how toxic masculinities are produced and reproduced on campus, as well as how everyday practice on campus can be instrumentalised to reconfigure coercive sexual practices and toxic masculinities. Although there is a huge body of research on sexual violence in Zimbabwe, very little of this has focused on the prevalence and experiences of this phenomenon within university campus spaces. Therefore, little is known about how students experience, perceive, and navigate sexual violence on campus, as well as institutional responses to sexual violence. Consequently, this study seeks to fill this gap and contribute to the burgeoning scholarship and debates on sexual violence, including coercive sexual practices and heteronormativity in university campus spaces. We seek to contribute to three sustainable development goals, that is goal 3 (good health and well-being), goal 5 (gender quality) and finally goal 10 (reduced inequalities).Contribution: This article foregrounds the ways in which institutions of higher learning respond to sexual violence within the university campus. The key contribution of this article relates to how students’ religious and socio-cultural subjectivities shaped or mediated experiences of and perceptions on sexual violence on campus. Consequently, we assert that the campus religious ‘field’ and students’ spiritual ‘habitus’ had a huge influence on the campus sexual economies.The research contributes to the field of Biblical Theology engaged with Gender Justice, Health and Human Development.

Sexual risk-taking behavior amongst emerging adults in a tertiary institution of learning in Coastal Kenya: A qualitative study of stakeholders' perspectives using causal loop mapping.

It is known from previous studies that university students in sub-Saharan Africa (sSA) engage in sexual risk-taking behaviour (SRTB). However, there is paucity of data on factors contributing to SRTB among university students (emerging adults) at the Kenyan Coast thus hindering intervention planning. This study seeks to provide an in-depth qualitative understanding of the factors contributing to SRTB and their interconnectedness among university students at the Kenyan Coast combining qualitative research with a systems thinking approach. Using the ecological model, and employing in-depth interviews, we explored the perceptions of twenty-six key informants (twenty-one emerging adults and five other stakeholders) on what constitutes and influences SRTB among emerging adults at a tertiary institution of learning in Coastal Kenya. Data were analysed using a thematic framework approach. A causal loop diagram (CLD) was developed to map the interconnectedness of the correlates of SRTB. Our findings show that unprotected sex, transactional sex, cross-generational sex, multiple sex partnerships, gender-based violence, sex under influence of alcohol/drugs, early sex debut, and sharing sex toys were common SRTBs. Based on the ecological model and CLD, most of the reported risk factors were interconnected and operated at the individual level. Our study shows that emerging adults are frequently engaging in unprotected sex. Enhancing sexuality education programs for students in Kenyan universities and strengthening support systems including counselling for those using alcohol/drugs may help reduce SRTB among emerging adults in Kenyan universities.

Sexual health communication among Black father-daughter dyads: A grounded theory study.

Black young adults have disproportionately high rates of HIV and sexually transmitted infections (STIs) when compared with the national average. Although parent-child sexual health communication among Black families has been shown to reduce sexual risk-taking behaviors, far less is known about father-daughter sexual health communication when compared with communication among gender-congruent dyads and mothers. This dearth of knowledge hinders the development of sexual health interventions involving fathers that are sensitive to both the gendered and cultural context. Using constructivist-grounded theory, the present study explores the context surrounding sexual health communication between Black women aged 19-21 (M = 20.3) years and their biological fathers aged 52-60 (M = 56.7) years. Seven father-daughter (N = 7) dyads and an additional five (N = 5) daughters completed individual in-depth semistructured interviews lasting on average 84 min in length. Analysis revealed several social, cultural, and familial contexts impacting father-daughter communication, in addition to factors that either motivate or hinder communication. Daughters who did not engage in sexual health communication with their fathers expressed an interest in doing so, and participants highlighted varying behavioral, emotional, and relational outcomes resulting from father-daughter sexual health communication or the lack thereof. Study findings can inform future intervention development and strengthen the positive role fathers play in ensuring daughters' healthy sexual development. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Association Between School Bullying Victimization and Sexual Risk-Taking among South Korean Adolescents: The Role of Teacher and Parental Relationships.

Despite the wealth of research investigating the adverse consequences of bullying, few studies have tested how bullying victimization is related to risky sexual behavior, such as unprotected sex among adolescents. To fill this gap, the current study examined the association between bullying victimization and the non-use of condoms, considering the moderating role of teacher and parental relationships. We employed a series of logistic regression models to examine these relationships among a sample of sexually active Korean adolescents (n = 153; ages 11-17years old). Results showed that bullying victimization was significantly related to greater non-use of condoms. Moreover, relationships with teachers and parents moderated the impact of bullying victimization on non-use of condoms, suggesting that positive relationships with teachers and parents exerted buffering impacts against sexual risk-taking behavior for bullying victims. Practical implications and suggestions for future research are also discussed.

Three years into the implementation of PrEP in France: What do users and health professionals say? (ANRS 95036)

The implementation of pre-exposure prophylaxis (PrEP) as a new tool for prevention against HIV raised particular ethical concerns regarding the individuals’ and the collective's best interests in France. It was questioned whether the beneficence of taking or prescribing PrEP regarding its high efficacy to protect people from HIV is always more important than the maleficence represented by the risks involved, such as healthy people taking a pill with side effects, the growth of sexually transmitted infections or the potential generalization of risk-taking sexual behaviour. The main objective of this study was to explore patients’ and health professionals’ ethical questioning on PrEP. Sixty-nine qualitative interviews were conducted with 45 users and 24 healthcare professionals. Overall, this study shows that those primarily concerned by PrEP tend to dismiss ethical questions regarding PrEP itself in the name of its efficacy and the empowerment it allows, but they would rather stress the impact PrEP can have on individuals’ sexual behaviour and how it can affect their autonomy if it is prescribed blindly without taking into consideration the specific living context and life history of each PrEP user.

Prevalence and risk factors associated with recreational stimulant use among Berlin college students

ABSTRACT Background College students have been recognized as a risk group for substance use. Nevertheless, coherent risk factors for stimulant use remain to be elucidated. The objective of this paper is to identify risk factors associated with the recreational use of MDMA, cocaine, amphetamine and methamphetamine. Methods An online questionnaire was distributed among colleges in Berlin. A sample of 12,914 college students participated, of which 9,382 met the inclusion criteria. Results Past-month prevalence was 7.0% for MDMA, 6.7% for amphetamine, 5.8% for cocaine and 0.1% for methamphetamine. Associated factors included male gender, “other” gender, homosexual and bisexual orientation, open relationship status or being single, engaging in sexual risk-taking behavior, having a psychiatric diagnosis, tobacco use, drinking alcohol and an increased number of (illicit) substances consumed in the past month and in life. Conclusions Berlin college students showed a substantially higher prevalence of stimulant use compared to both the general population and college students in other cities. Certain parameters, e.g., polydrug use, were particularly high in this group. The results can be used in further development of prevention efforts. However, conclusions about causality are limited by the cross-sectional nature of this study, highlighting the necessity for longitudinal studies in this field.

A systematic review on the impact of alcohol use on sexually transmitted infections.

Alcohol use has been associated with multiple types of sexual risk behaviors, such as condomless sex or having multiple sexual partners, behaviors that are linked to the risk of sexually transmitted infections (STIs). The aim of this review was to present updated evidence to demonstrate an association between alcohol consumption and STIs and evaluate the causal nature of this link, as well as to present interventions that reduce alcohol consumption and its effect on STIs. We conducted a systematic review according to the PRISMA guidelines using PubMed and Embase databases. Cohort studies and case-control studies were included. Any level of alcohol use served as the exposure variable, with the outcome restricted to non-HIV STIs, as reviews on alcohol use and HIV already exist. In total, 11 publications satisfied the inclusion criteria. The evidence suggests that there is an association between alcohol use, especially heavy drinking occasions, and STIs, with eight articles finding a statistically significant association. In addition to these results, there is indirect causal evidence from policy studies, and from the field of decision-making and sexual behavior with experimental evidence, that alcohol use increases the likelihood of risk-taking sexual behavior. It is important to have a deeper understanding of the association to develop effective prevention programs at community and individual levels. Preventive interventions should be implemented targeting the general population, in addition to specific campaigns directed at vulnerable subpopulations in order to reduce the risks.

“A Different Perspective”: Topics Discussed During African American Father-Daughter Sexual Health Communication

<i>African American youth and young adults are disproportionately burdened by HIV and sexually transmitted infections. Although African American parent-child sexual health communication has been shown to reduce adolescent sexual risk-taking behavior, much more is known about mother-child and father-son sexual health communication than father-daughter sexual health communication. The current study explores what sexual health topics African American father-daughter dyads discuss with one another, and which topics are perceived to have the greatest impact on youths’ sexual risk behavior. Seven father-daughter dyads (N=7) and an additional five daughters (n=5) completed individual in-depth semi structured interviews. Daughters were aged 19-21 (M=20.3) years and fathers were aged 52-60 (M=56.7) years. Thematic analysis revealed five themes including: challenging topics to discuss, easy topics to discuss, topics on the continuum, desired topics of communication, and topics with greatest impact on behavior. Although participants shared that discussing sexual health is considered culturally taboo and can be challenging when criticized, several topics were easy to discuss universally, and several topics were both challenging and easy to discuss depending on the context of the conversation and depth of content covered. Sexual health communication was largely perceived as positively impacting daughters’ behaviors and daughters expressed wanting to have these conversations. Study findings can inform future intervention development by indicating which sexual health topics should be prioritized during father-daughter communication given their perceived positive impact. Future research is needed to explore how best to support father-daughter dyads in discussing sexual health topics perceived as challenging.  </i>

The Dimensions of Desire Among Gay, Bisexual, and Other Men Who Have Sex With Men (gbMSM): An Evolutionary Concept Analysis.

Background and Purpose: Within nursing discourses, the concept of desire among gay, bisexual, and other men who have sex with men (gbMSM) is not well understood. Among nurses, this concept is often constructed as being synonymous with sexual and other risk-taking behaviors, which can influence the type of care nurses provide to gbMSM and affect how this group engages with nurses - and their health. This misinterpretation of what desire represents has resulted in gbMSM becoming the target of public health campaigns and nursing interventions aimed at curbing their deviant behaviors. Such an approach by nurses, however, overlooks the meaning of desire among gbMSM. Methods: To enhance nursing knowledge about, and improve nursing practice for, gbMSM, a concept analysis of desire specific to this group was undertaken using Rodger's evolutionary model. For this analysis, 90 articles reviewed from the disciplines of nursing and allied health, medicine, and psychology. Results: Findings from this analysis revealed a complexity to desire among gbMSM that extended well beyond engagement in radical sexual practices and into dimensions of desire for connection, freedom, and acceptance. These revelations were applied to demonstrate how nurses' beliefs about desire and subsequent regulations for "good health" can inhibit the ways in which desire is produced among gbMSM. Implications for Practice: Such findings demonstrate a need to develop future approaches for nursing practice that recognize the innate value and individual perspectives about desire held by this group, which can be uniquely tailored to meet their health needs.

Profiles of Risk-Taking Sexual and Substance Use Behaviors in French-Canadian Emerging Adults: a Latent Class Analysis

Profiles of Risk-Taking Sexual and Substance Use Behaviors in French-Canadian Emerging Adults: a Latent Class Analysis

Importance attributed by adolescents to sexual education: correlation with their attitudes, knowledge, and sexual behavior

Introduction: Sexual education plays an important role in the prevention of risk-taking sexual behaviors. The objective of this study was to evaluate the importance attributed to sexual education by adolescents, correlating it with the assessment they make of their attitudes and with their knowledge towards sexuality. Methods: This observational study included adolescents who attended elementary or high school in the central region of Portugal. A characterization of sociodemographic and sexual data was made and the Adolescent Students’ Attitudes Scale towards Sexuality (E3AS) was applied. Results: We included 394 adolescents with a mean age of 14.9 ± 1.4 years. The majority (89.3%) attributed importance to sexual education. Adolescents that gave more importance to sexual education were the ones that ranked higher the information they learned about sexuality (r = 0.236), had less unprotected sex due to lack of information (r = -0.363) or because they were under the effect of alcohol and/or drugs (r = -0.365) and had a superior classification in F2 (r = 0.380), F5 (r = 0.402) and in the total scale (r = 0.531). Discussion and conclusion: Adolescents that attributed greater importance to sexual education were the ones that ranked higher the information they possessed about sexuality. After initiating sexual activity, a greater importance attributed to sexual education seems to have a protective effect on risk-taking sexual behaviors.