Correlates of sexual initiation among European adolescents

Abstract

BackgroundSexuality is a physiological component of adolescent development, though early initiation is associated with reproductive health risk. This study aimed at identifying correlates and predictors of sexual initiation in a large multinational cohort of European adolescents.MethodsA questionnaire addressing socio-demographics, behaviours, mental health and sexual activity, was delivered to 11,110 adolescents recruited from 168 randomly selected schools in 10 European countries between 2009 and 2011. A follow-up questionnaire was delivered after 12 months. The longitudinal association of baseline risk behaviors, psychological attributes and contextual vulnerabilities, with sexual initiation during follow-up was evaluated through simple and multivariable age/sex stratified logistic regression. Multinomial logistic regression measured the association between predictors and sexual initiation with or without coexisting reproductive risk factors, such as multiple partners or infrequent condom use.ResultsBaseline sexual experience was reported by 19.2% of 10,757 respondents (median age 15; IQR 14–15; females 59.6%). This was significantly more frequent among pupils older than 15 (41%) and males (20.8%). Of 7,111 pupils without previous experience who were available at follow-up (response rate 81.8%), 17% reported sexual initiation, without differences between females and males. Baseline smoking (age/sex adjusted odds ratio [aOR] 3.63), alcohol use (aOR 2.95), illegal drugs use (aOR 2.72), and poor sleep (aOR 1.71) predicted sexual initiation. Stratified analyses showed a particularly strong association in case of younger and female pupils, and, among girls, when initiation was reported together with multiple partners and/or infrequent condom use. Externalizing (i.e. conduct and hyperactivity) symptoms independently predicted sexual initiation. Internalizing difficulties (i.e. emotional and peer problems) were negatively associated with early and risky sexual initiation among boys. Significant predictors included also being bullied, fighting, truancy, and low parental involvement.ConclusionsAdolescent sexual behaviours are related to non-sexual risk behaviours, psychological difficulties and contextual vulnerabilities. While gateway effects explain some associations, a comprehensive model is needed to understand adolescent sexual behaviours, their physical, mental, and social health outcomes, and their potential positive effects on wellbeing. Tailored interventions may need to consider younger girls as a particularly vulnerable group in view of a strong association between non-sexual and sexual behaviors.

Psychopathology is associated with reproductive health risk in European adolescents

“…However, the timing of sexual initiation alone may not be considered as an independent marker of risk, as risky sexual activity is often associated with non-sexual risk behaviours (e.g. substance abuse) [ 3 , 9 , 34 , 35 ], exposure to childhood trauma [ 9 , 34 , 36 ] or problematic social interactions (e.g. with peers, school or family) [ 9 , 34 ].…”

“…smoking or substance abuse), context vulnerabilities (e.g. bullying, truancy and low parental involvement) and psychological difficulties [ 9 ], which are not uncommon among girls and boys [ 10 ].…”

Human Papillomavirus Vaccination in Male and Female Adolescents Before and After Kidney Transplantation: A Pediatric Nephrology Research Consortium Study

“…In our study, the onset of sexual activity was not assessed out of concerns that in a multisite trial, the investigators could not assure patient confidentiality relative to their parents/caregivers for all participants. However, obtaining this information in future studies would be helpful in assessing clinical risk and outcomes in patients with chronic diseases (33,34). In children with CKD and on dialysis, contrary to what was believed in the past, recent cohort studies have shown that growth and sexual maturation are only slightly delayed compared to healthy subjects (35).…”

Human papillomavirus knowledge, beliefs, and behaviors: A questionnaire adaptation

“…When we assessed differences in knowledge between genders, women showed more correct answers than men; this is likely because women are the primary focus of HPV vaccination efforts [37,38] and because cervical cancer is strongly correlated with HPV and the first cancer to be associated with HPV infections [39]. Although more women than men knew about the HPV vaccine, women indicated fewer preventive behaviors, reporting less condom use compared to other populations [40]. Knowledge about HPV does not appear to be associated with condom use in Fig.…”

“…A review of studies performed in college-aged women showed that participants had a lack of information about HPV and the HPV vaccine [59]. Several other studies have reported similar results [33][34][35][36][37][38][39][40][41][42][43][44][45]. In this questionnaire, we decided to not classify the degree of knowledge as sufficient or insufficient because this is a subjective concept.…”