Original research articleAge of sexual debut among US adolescents☆
Introduction
First sexual intercourse, or sexual debut, is a normal part of human development. The proportion of high school students who were sexually active has remained steady since 1997, approaching nearly 50% for all high school students with almost 70% of youth experiencing sexual debut by age 18 [1], [2], [3]. Approximately 7.1% of American youth report sexual debut prior to 13, with more male than female youth reporting early sexual debut; by age 16, approximately 30% of females and 34% of males have had sexual intercourse [1], [4].
Examining differences in sexual debut across racial/ethnic groups is important to improve understanding on the effects of culture on sexuality. A vast amount of published data has already examined sexual debut and the data suggests that African Americans tend to initiate sexual intercourse at an earlier age than Caucasian, Hispanic and Asian youth, while Asians experience sexual debut at a later age when compared with these racial/ethnic groups [5], [6]. However, most of the findings are based on community and/or convenience samples with relatively few studies utilizing nationally representative samples that support generalization [7]. In fact, no studies with sample sizes large enough to sufficiently characterize and compare sexual debut across these four major racial/ethnic groups in the general population were found in the existing literature within the last 10 years. This is particularly true for Asians due to the small sample of this population in national data systems. To better inform culturally appropriate sexual health education and health promotion programs, we seek to extend previous research by using 1999–2007 data from the National Youth Risk Behavior Survey (YRBS) to compare patterns of sexual debut in adolescents across gender and racial/ethnic groups.
Much of the literature on sexual debut categorizes time of sexual debut (e.g., early, late) rather than examining the age of sexual debut. For example, Sandfort et al. [8] compared participants' sexual debut with peers of the same gender and with the same racial/ethnic and educational background to classify their onset of sexual intercourse as early, normative or late, and correlate them with long-term sexual health outcomes. Similarly, French and Dishion [9] utilized a high-risk approach for the development of substance use and problem behavior community sample of adolescents to delineate predictors of sexual debut at an early age, defined as intercourse at age 14 or younger. We extend these studies by examining sexual debut across a range of years (age 12 through 17) rather than categorically. This is a more powerful approach to risk behavior analysis, enabling us to explore a nonlinear relationship of sexual debut and reflecting a more accurate measure of this behavior rather than somewhat arbitrarily creating a categorical threshold variable of “early” vs. “normative” or “later.” Moreover, we utilize the Kaplan–Meier method which actually suggests the extent to which being male or female in a certain racial and ethnic group may accelerate the adolescents' sexual debut relative to others who have not had that experience.
Section snippets
Data source and participants
The YRBS was established by the Centers for Disease Control and Prevention (CDC) to measure health-risk behaviors that result in unintentional and intentional injuries, including risky sexual behaviors and substance use behaviors. For each survey period, the YRBS utilizes a three-stage cluster sampling design to produce a representative sample of high school students (9th through 12th grade) attending public, Catholic and other private schools in the United States [10]. The survey has been
Results
A total of 72,137 students were included in the pooled dataset (weighted numbers: 15,364 in 1999, 13,601 in 2001, 15,214 in 2003, 13,917 in 2005 and 14,041 in 2007). Participants from the four major ethnic groups found in this country (Caucasians, African Americans, Hispanics and Asians) were included in the analyses; American Indians/Alaskan Natives and Native Hawaiians/Other Pacific Islanders were excluded from the analyses due to small sample size. This left a total of 66,882 students for
Discussion
The findings of this study indicated that there are considerable gender and racial/ethnic group differences in sexual debut. Factors not well understood, but likely to be of importance in early sexual debut, are the social expectations based on gender, ethnicity and sexuality as defined in certain cultures and communities [13]. For example, sex is not readily discussed in the Hispanic and African-American communities possibly decreasing the transmission of knowledge relevant to sexual
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This publication was made possible by funding from the KL2 RR024994–ICTS Multidisciplinary Clinical Research Career Development Program and Grant Number UL1 RR024992 from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH) and NIH Roadmap for Medical Research. Its contents are solely the responsibility of the authors and do not necessarily represent the official view of NCRR or NIH. This publication was also supported in part by a Midcareer Investigator Award in Women's Health Research (K24 HD01298).