Background Non-consensual sexual activity between young people continues to be a major public health problem with long-term negative health outcomes. To our knowledge no study has yet evaluated violation and rape separately in girls, boys and boys who have sex with men (MSM).

Methods Data were obtained from ‘sex under the age of 25’, a large national study on sexual behaviour and sexual health of 10,404 young people (12–25 years), Netherlands. Current analyses were restricted to sexually experienced young people (n = 6,200). Multinomial regression was used to examine associations for ever experienced (1) violation (unwanted kissing and touching) or (2) rape (vaginal or anal penetration by finger, penis or mouth) compared to consensual sex. Evaluated determinants included sexual behaviour, drug use, social network and attitude. Analyses were stratified for girls (n = 3779), boys (n = 2209) and MSM (n = 212) and controlled for age, educational level and ethnicity.

Results Violation was reported by 29.6% of sexually experienced girls, 20.6% of boys, and 22.6% of MSM. Rape was reported by 24.2%, 4.4% and 14.2% in the three groups, respectively. Rape was significantly associated with a negative attitude to porn (in girls, boys, MSM), receiving non-monetary goods in exchange for sex (girls, boys), use of alcohol and drugs (girls), sex on the internet (girls, boys), talking to friends about sex (MSM), sexual problems (girls, boys), negative self image (girls), multiple sex partners (girls, boys, MSM), early sexual debut (girls) and low self efficacy (girls). All these factors except porn were also associated with violation, although associations were sometimes observed in different groups than for rape.

Conclusion The prevalence of non-consensual sex is alarmingly high in young people who have experience with sex. Girls and young MSM boys appear to be especially vulnerable. Healthcare providers and educators should continue to address these issues in care and education.