Early sexual initiation and risky sexual practices among alcohol- and tobacco-using young adults in Taiwan: mediation analysis of preceding-sex use of illicit drugs

Abstract

Background As early sexual initiation is increasingly common in East Asia, we examined its relations to risky sexual practices in alcohol- and tobacco-using individuals in Taiwan and evaluated whether the associations were mediated through preceding-sex use of illicit drugs. Methods Participants, recruited from alcohol- and tobacco-using adults aged 18 to 50 in Taipei through respondent-driven sampling (N = 1115), completed a computer-assisted self-interview covering questions on substance use and sexual experiences. In a subsample of 916 participants who had had sexual experience (median age 27), we examined the relations of early sexual initiation (< 16 years) to multiple sexual partners, casual sex, group sex, and rare condom use. Causal mediation analyses were conducted to examine whether illicit drug use preceding sex mediated these associations. Results Around 9.3% reported early sexual initiation and the prevalence of risky sexual practices ranged from 7% (group sex) to 47% (rare condom use). Early initiators had a higher prevalence of regular binge drinking, illicit drug use, and risky sexual practices. In the multivariable analyses, higher odds of multiple sexual partners, casual sex, and group sex were consistently associated with early sexual initiation, gender, and their interaction. Mediation through preceding-sex use of illicit drugs was found between early sexual initiation and the three risky sexual practices, with the proportions mediated ranging from 17 to 19%. Conclusions Early sexual initiators were more likely to engage in risky sexual practices and preceding-sex use of illicit drugs partially explained this relationship, calling for more attention to this population’s sexual health.

Prevalence and associated factors of early sexual initiation among youth female in sub-Saharan Africa: a multilevel analysis of recent demographic and health surveys

“…Based on this, the overall prevalence of early sexual initiation among youth females in -sub-Saharan Africa was 46.39% [95%CI: 41.23%, 51.55%).] which is higher than a study conducted in Indonesia 11% [ 25 ], brazil, 7% [ 10 ], Taiwan 9.3% [ 26 ] and china 18.1% [ 9 ]. The variations might be related to factors associated with early sexual initiation of these countries being high-income countries with improved socio-economic status, youth females education, gender equity, and reproductive health youth female are services compared to SSA, which in turn could improve their levels of understanding of the consequences of early sexual initiation [ 26 , 27 ].…”

Prevalence and factors associated with risky sexual behavior among Brazilian school adolescents

“…There is also an emphasis on the individual expectation of alcohol opening the door to positive sexual experiences, with greater excitement and sexual disinhibition 32,33 . The abusive use of illicit substances, by contrast, frequently lead the user to a strong desire of the drug, favoring the nonuse of a condom and the practice of violent acts to acquire it 21,34 . The association of substances amplifies these outcomes; however, the isolated effect of illicit drugs is greater than that of alcohol and cigarettes regarding RSB 34 .…”

Association between early sexual initiation and sexually transmitted infections among Peruvian reproductive-age women

“…The EOSI has been associated with having multiple sexual partners, paying for sex, inconsistent use of contraception ( 44 ), group and/or casual sex ( 12 ), and depression ( 30 ). These also represent risk factors of STI transmission, thus supporting its association with the EOSI.…”

“…Our study also demonstrated an association between the EOSI and STIs in women with <2 sexual partners during the last year, which might be accounted for by the inconsistent use of condoms, leading to a higher risk of STI transmission ( 55 ). Furthermore, it is important to highlight that several STIs are chronic and could be previously contracted by the women with an EOSI through transmission by the multiple sexual partners they might have had throughout their lives or prior to the year of evaluation ( 56 ), or due to their history of other sexually risky behaviors, such as casual or group sex ( 12 ). In addition, a cause of the EOSI in women is sexual abuse at an early age ( 57 ), wherein the sexual activities usually occurred without the use of condoms ( 58 ).…”

“…Lastly, we did not conduct a mediation analysis because of the lack of certain variables in the database. For example, literature suggests that the use of illicit drugs prior to sexual activity could act as a mediator in the relationship between EOSI and STI ( 12 ). Therefore, we believe this should be analyzed in future studies.…”