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PubMed2002

Use of psychoactive substances and sexual risk behavior in adolescents.

This study investigated the relationship between the use of illicit drugs and sexual-risk-behavior in a sample of students aged 14 to 21 years at a public high school in São Paulo in 1997. A total of 689 useable questionnaires documented the sample in consumption of psychoactive substances and sexual behavior. Sexual behavior of drug users and non-users was compared regarding history of complete sexual intercourse, age at first sexual intercourse, use of condoms, sexual intercourse with sex workers, and prostitution. Drug users (N = 366) presented a higher frequency of complete sexual intercourse (80.8% of users versus 53.5% of non-users), (N = 323, p < .001), a younger age at first sexual intercourse (on average 15.2 years in users versus 15.7 among non-users, p < .005), a trend toward lower use of condoms (56.7% among users versus 65.3% among non-users, p < .1), and more sexual intercourse with sex workers (31.1% among users versus 15% among non-users, p < .001). Sexual-risk-behavior increased with the number of drugs used. Alcohol and marijuana use were associated with the highest sexual-risk-behavior. These data are essential for the development of more specific preventive strategies, focusing on male alcohol and marijuana users.

Adolescent↗
PubMed1997

Reproductive characteristics and post-abortion health consequences in women undergoing illegal and legal abortion in Maputo.

In the Maputo Central Hospital 103 women undergoing induced legal abortion (LA), 103 women with confirmed, recent illegal abortion (IA), and 100 randomly recruited antenatal clinic (AC) attenders were compared in order to find characteristic features regarding obstetric history, reproductive performance and contraceptive knowledge, attitude and practice. Women with IA were younger, had almost never undergone LA, had more often their first sexual intercourse and their first pregnancy below 20 years of age, had less knowledge of contraceptives and more often had never used contraceptives, had fewer previous spontaneous abortions and fewer previous stillbirths than LA women. There were three maternal deaths, all in the IA group. The most frequent illegal abortionist was a health worker (38%). It is concluded that, in this first comparative African study on IA and LA regarding reproductive profile and post-abortion health consequences, the former are at a disadvantage regarding early unprotected sexual intercourse with first pregnancy at a young age and with almost no experience of safe, legal abortion.

Abortion, Illegal↗
PubMed2006

Demography and sex work characteristics of female sex workers in India.

BACKGROUND: The majority of sex work in India is clandestine due to unfavorable legal environment and discrimination against female sex workers (FSWs). We report data on who these women are and when they get involved with sex work that could assist in increasing the reach of HIV prevention activities for them. METHODS: Detailed documentation of demography and various aspects of sex work was done through confidential interviews of 6648 FSWs in 13 districts in the Indian state of Andhra Pradesh. The demography of FSWs was compared with that of women in the general population. RESULTS: A total of 5010 (75.4%), 1499 (22.5%), and 139 (2.1%) street-, home-, and brothel-based FSWs, respectively, participated. Comparison with women of Andhra Pradesh revealed that the proportion of those aged 20-34 years (75.6%), belonging to scheduled caste (35.3%) and scheduled tribe (10.5%), illiterate (74.7%), and of those separated/divorced (30.7%) was higher among FSWs (p < 0.001). The FSWs engaged in sex work for >5 years were more likely to be non-street-based FSWs, illiterate, living in small urban towns, and to have started sex work between 12-15 years of age. The mean age at starting sex work (21.7 years) and gap between the first vaginal intercourse and the first sexual intercourse in exchange for money (6.6 years) was lower for FSWs in the rural areas as compared with those in large urban areas (23.9 years and 8.8 years, respectively). CONCLUSION: These data highlight that women struggling with illiteracy, lower social status, and less economic opportunities are especially vulnerable to being infected by HIV, as sex work may be one of the few options available to them to earn money. Recommendations for actions are made for long-term impact on reducing the numbers of women being infected by HIV in addition to the current HIV prevention efforts in India.

Journal Article↗
PubMedDate not supplied

The risk of adolescent pregnancy in the first months of intercourse.

Because of early age at initiation of intercourse and associated nonuse of contraception, half of first premarital pregnancies to teens occur in the first six months after they begin coitus; one-fifth occur in the first month. Programs to prevent adolescent pregnancy will not succeed unless they reach young people before they begin sexual activity.

Actuarial Analysis↗
PubMed1988

Condyloma and intraepithelial neoplasia of the uterine cervix: a case-control study.

Cervical condyloma and cervical intraepithelial neoplasia are related to human papillomavirus infections, some of which may be involved in the etiology of cancer of the uterine cervix. This case-control study was designed to assess the relation of age at first sexual intercourse, number of sexual partners, and cigarette smoking to the risk of cervical condyloma and cervical intraepithelial neoplasia. Cases and controls were premenopausal women under age 50 years who had been referred for examination at the Colposcopy Clinic of Saint-Sacrement Hospital in Quebec from 1982 to 1985. These were 136 cases of histologically confirmed cervical condyloma and 247 cases of cervical intraepithelial neoplasia. The 137 controls were women without anogenital condyloma, dysplasia, or carcinoma. Information on personal characteristics and exposures of subjects was obtained by interview. Associations observed with age at first intercourse were different for condyloma and cervical intraepithelial neoplasia. Relative risk of condyloma varied little with age at first intercourse. In contrast, relative risk of cervical intraepithelial neoplasia increased as age at first intercourse decreased. For the two types of lesions, relative risk was elevated among women with more than one sexual partner and increased steadily with increasing number of cigarettes smoked per day. The association with cigarette smoking was, however, somewhat stronger for cervical intraepithelial neoplasia.

Adult↗
PubMed2001

Sexual behaviour in Britain: early heterosexual experience.

BACKGROUND: Relatively high rates of teenage conception and sexually transmitted infection among young people in Britain have focused attention on early sexual behaviour and its determinants. We report the results of the second National Survey of Sexual Attitudes and Lifestyles (Natsal 2000). METHODS: We did a probability sample survey between 1999 and 2001, of men and women aged 16-44 years in Britain. Participants were interviewed using a combination of computer-assisted face-to-face and self-completion questionnaires, and asked questions regarding first heterosexual intercourse, communication about sex, pregnancy, and sexually transmitted infections (STIs). FINDINGS: We recruited 11161 men and women to the survey (4762 men, 6399 women). The proportion of those aged 16-19 years at interview reporting first heterosexual intercourse at younger than 16 years was 30% for men and 26% for women; median age was 16 years. The proportion of women reporting first intercourse before 16 years increased up to, but not after, the mid-1990s. There has been a sustained increase in condom use and a decline in the proportion of men and women reporting no contraceptive use at first intercourse with decreasing age at interview. Among 16-24 year olds, non-use of contraception increased with declining age at first intercourse; reported by 18% of men and 22% of women aged 13-14 years at occurrence. Early age at first intercourse was significantly associated with pregnancy under 18 years, but not with occurrence of STIs. Low educational attainment was associated with motherhood before 18 years, but not abortion. INTERPRETATION: The increase in the proportion of women reporting first intercourse before age 16 years does not appear to have continued throughout the past decade. Only a small minority of teenagers have unprotected first intercourse, and early motherhood is more strongly associated with educational level than with family background. Factors most strongly associated with risk behaviour and adverse outcomes have considerable potential for preventive intervention.

Adolescent↗
PubMed2006

First sexual partnerships--age differences and their significance: empirical evidence from the 2000 British National Survey of Sexual Attitudes and Lifestyles ('Natsal 2000').

PURPOSE: To describe variations in age differences (ADs) between partners at first heterosexual intercourse and to examine associations between this AD, sociodemographic characteristics, and circumstances of first heterosexual intercourse, by gender. METHODS: A total of 3277 men and 4734 women aged 25-44 years who reported ever having heterosexual intercourse in a probability survey of the British population to obtain an unbiased sample of ADs at first intercourse. Face-to-face interviews collected sociodemographic data and information on first intercourse. Gender-specific cumulative distributions of ADs categorized respondents reporting relatively younger first partners (below fifth percentile) and those reporting relatively older first partners (above 95th percentile). RESULTS: Relatively older first partners were six years older than men and 10 years older than women. Relatively younger first partners were three years younger than men and one year younger than women. Men and women with relatively older first partners were more likely to have just met their partner (odds ratios adjusted for sociodemographic characteristics [AOR] 1.8, 95% confidence interval [CI] 1.2-2.7, and 3.1, 95% CI 2.1-4.6, respectively); had a more willing first partner (AOR 2.1, 95% CI 1.2-3.8, and 1.6, 95% CI 1.2-2.2, respectively); not used condoms at first sex (AOR 1.9, 95% CI 1.2-3.0, and 1.5, 95% CI 1.1-2.0, respectively); and reported a non-autonomous reason for first sex (AOR 1.6, 95% CI 1.1-2.4, women only). Men with relatively younger first partners were more likely to regret the timing of the first occasion (AOR 2.1, 95% CI 1.0-4.5). CONCLUSIONS: First partnerships involving relatively older or younger partners are associated with adverse circumstances of first intercourse. Condoms and other reliable contraception are less likely to be used, and age differences may reflect unequal power relations. Promoting effective communication and negotiation skills may be particularly important for those with relatively older or younger first partners.

Adolescent↗
PubMed1997

Sexual behaviour and sex education in Irish school-going teenagers.

The sexual behaviour and factors which affect such behaviour, source of knowledge and education about sex was assessed by means of an anonymous self-administered questionnaire among 2754 pupils (15-18 years) attending 40 (85%) second level schools in Galway City and County. The purpose of the study was to make recommendations in relation to a school sexual health education programme. Overall 21% of pupils had had sexual intercourse, with boys more than twice as likely as girls to have experienced this. The mean age of first sexual intercourse was 15.5 years, 72% reported having used a condom at first intercourse but of 475 pupils who had sexual intercourse regularly only 67% used condoms all the time with 33% using them sometimes or never. Over half reported that first intercourse was with a 'casual' partner and 35% and 9% respectively claimed that alcohol and non-prescribed drugs were a contributory factor. In relation to sexual risk beliefs, 72% believed that condoms used properly reduced the risk of sexually transmitted diseases (STDs) and 78% knew that the contraceptive pill is not protective against human immunodeficiency virus (HIV) infections. While the level of knowledge regarding sex education was generally high over one-third of sexually active respondents had been involved in high-risk behaviour. A need for health education programmes which focus on behaviour change and assertiveness has been identified.

Adolescent↗
PubMedDate not supplied

High-risk sexual behavior among heterosexual undergraduates at a midwestern university.

Approximately 80% of a self-selected sample of 593 heterosexual undergraduate college students studied at a large Midwestern state university in 1988 had ever experienced penile-vaginal or penile-anal intercourse. One-fifth of the 477 sexually experienced women and men said they had had heterosexual and intercourse. The mean age at first vaginal intercourse was 17, while the mean age at first anal intercourse was about 18.5. Although less than four years, on average, had elapsed since the respondents' first vaginal or anal intercourse, females reported having had an average of 5.6 sexual partners, and males reported an average of 11.2 partners.

Adolescent↗
PubMed1988

Teenage sexual intercourse and pregnancy.

One hundred and one pregnant girls aged under 18 years were interviewed to collect information about the development of their sexual awareness, attitudes towards relationships, and about their social context. The data show that the girls were likely to come from homes where the parents were divorced, where the mother married when she was under 21 years of age, and where her first child was conceived out of wedlock. Altogether 76 of these pregnant girls first had intercourse before they were 16 years old. The younger the girl at first intercourse the sooner it occurred in the relationship and for almost half of the girls first intercourse was unplanned. Although almost half used contraception on the first occasion, only one third of the girls used contraceptives regularly. Most expressed the wish that they had delayed intercourse until they were older.

Adolescent↗
PubMedDate not supplied

High-risk sexual behavior at a midwestern university: a confirmatory survey.

According to a 1991 study of sexual behavior based on a random sample of heterosexual undergraduates at a Midwestern university, 80% of the males and 73% of the females had experienced vaginal or anal intercourse. The average age at first vaginal intercourse was 17.2 years for both sexes. Seventeen percent of the sexually experienced males and 18% of the sexually experienced females had engaged in heterosexual anal intercourse; among these respondents, the average age at first anal intercourse was 20.3 for males and 19.1 for females. Although less than four years, on average, had elapsed since the respondents had first had vaginal intercourse, males reported an average of 8.0 lifetime vaginal-sex partners and females reported an average of 6.1. Overall, the findings from this random sample of students are similar to those from a 1988 convenience sample of the same college population.

Adolescent↗
PubMed2001

Association of risk-taking behaviors with adolescent childbearing.

BACKGROUND AND PURPOSE: Risk-taking behavior has been shown to be associated with adolescent pregnancy or childbearing. However, the specific risk-taking behavioral factors and the extent to which they are associated with adolescent childbearing is less clear. The purpose of this study was to determine the risk-taking behavioral factors associated with adolescent childbearing. METHODS: In this case-control study, 198 mothers aged from 16 to 19 years with first-born infants born in Taichung City in 1997 were enrolled. The controls were adolescents with no history of childbearing or pregnancy matched for age and residential neighborhood of each case. A self-administered structured questionnaire inquiring about a variety of risk-taking factors was used to gather relevant information. The logistic regression model was used for univariate, combination of variables, and multivariate analysis. RESULTS: Compared to controls, childbearing adolescents were more likely to have risk-taking behaviors including smoking, drinking, use of illegal substances, working at bars or nightclubs, and lack of use of contraception at first sexual intercourse. Logistic regression analysis for various combinations of risk-taking behaviors revealed that the more items of risk-taking behaviors adolescents had, the higher their risk of childbearing. Multiple logistic regression analysis showed that use of alcohol (adjusted OR = 1.9, 95% CI 1.1-3.1), working at sex-related workplace (adjusted OR = 4.7, 95% CI 2.4-9.3), and no use of contraceptive device at first intercourse (adjusted OR = 3.1, 95% CI 1.3-7.2), were significant risk factors for adolescent childbearing in subjects with previous sexual intercourse. CONCLUSION: Adolescent females who used alcohol, worked at bars or nightclubs or used no contraception at first intercourse were more prone to adolescent childbearing, and a combination of risk-taking behaviors could increase the risk of childbearing. These risk-taking factors should be taken into consideration in the development of prevention programs.

Adolescent↗
PubMed2000

Correlation between an early sexual debut, and reproductive health and behavioral factors: a multinational European study.

OBJECTIVE: To investigate whether women who made an early sexual debut differ from those with a later debut regarding genital signs and symptoms. METHODS: The study included women who considered themselves gynecologically healthy and who attended 17 family planning centers in 13 European countries for contraceptive advice. There were 629 women who made their sexual debut at the age of 16 years or earlier (study population) and 927 women who had their first sexual intercourse at the age of 19 years or later (comparison group). Genital symptoms and signs, contraceptive use, smoking, and genital hygiene habits and previous genital infections were recorded on a structured patient record form. Detection of Chlamydia trachomatis was made by means of a polymerase chain reaction on first-void urine. The study was made, on average, 7-10 years after the women's sexual debut. RESULTS: The mean age of first intercourse was 15.3 years for the study group versus 20.7 years for the control group (p < 0.001). The study population had significantly more symptoms, such as vaginal discharge and pruritus, and signs, such as abnormal discharge, erythema of the vaginal mucosa and lower genital tract infections, than the comparison group. Twice as many women in the study group were smokers and there was a ten-fold increase among these subjects of using low-pH solutions for genital hygiene. The prevalence of C. trachomatis infection did not differ between the two groups (p = 0.22). CONCLUSION: Age at first intercourse is not only a predictor of sexual risk behavior, but also a predictor, regarding both signs and symptoms, of future gynecological problems.

Adolescent↗
PubMed1989

Sexual, reproductive and contraceptive risk factors for carcinoma-in-situ of the uterine cervix in Sydney.

Sexual, reproductive and contraceptive risk factors were investigated in a matched community-based case-control study of carcinoma-in-situ of the uterine cervix in Sydney. The risk was related strongly to the number of sexual partners: women who had had seven or more sexual partners in a lifetime had a six-fold increased risk compared with those with one or no partner. Early age at first sexual intercourse was also a risk factor, but this effect was reduced substantially after adjustment for the number of partners, with only a two-fold excess risk persisting for those with first intercourse before the age of 16 years as compared with those whose first sexual intercourse was at the age of 25 years or later. The long-term use of oral contraceptive agents was associated with an elevated risk (relative risk, 2.3 for more than six years of use); this effect was maintained for both oestrogen and progestogen doses. The risk increased with the number of induced abortions that had been undergone (relative risk, 2.2 for two or more abortions), but this effect was not statistically significant. A protective effect was found for women who had had a tubal ligation, for those who practised the rhythm method of birth control, and for women who breastfed. It is possible that these reduced risks may relate to unmeasured variables of life-style.

Adolescent↗
PubMed1983

Coitarche and orgastic capacity.

In a group of 2,159 gynecological patients, aged 21 to 40, the age at the first sexual intercourse was ascertained and correlated with orgastic capacity during coitus in marital life. All had been married for at least 1 year. Of the examined females, 1,093 who reached orgasm mostly or always during sexual intercourse had their first coitus earlier than 394 women with rare and 165 women with no coital orgasm. The difference between orgastic women and examinees with rare orgasm was significant at the 0.01 level. The difference between females with adequate sexual reactivity and females with no coital orgasm was significant at the 0.001 level.

Adolescent↗
PubMed1994

Sexuality, sexual behaviour and contraception in East Germany.

Social factors may influence sexual health and its related behaviour. The political changes in East Germany have revealed a positive attitude towards sexuality and the use of family planning methods. A study on sexual behaviour and the use of contraceptives was undertaken recently, at the end of the old regime and the beginning of the new one. The survey was performed among 3103 male and female respondents (pupils, students and workers) of between 16 and 48 years of age. The results show a decreased number of stable partner relationships among young people, however, love and sexuality are considered to be central values. Before the age of 19 years, the majority of girls (80%) and boys (68%) had had sexual intercourse for the first time, a rate which has not changed during the last decade. There is a tendency to postpone having a first child. Modern contraception is widely accepted and used. There is a growing number of condom users, however, the pill is still the most popular method. Family planning is much more advanced than in the other countries of Eastern Europe. Sex education and counselling should sustain this situation.

Adolescent↗
PubMedDate not supplied

[Characteristics of sexual behavior among teenagers in Belgrade].

INTRODUCTION: The risks associated with teenage sex include pregnancy and a high rate of sexually transmitted diseases (STDs). MATERIAL AND METHODS: The study compared female teenagers. 32 with STDs and 90 with fungal skin infections who were treated in the City Center for Skin and Venereal Diseases in Belgrade from January 2000 to June 2001. An anonymous questionnaire was used to collect data and an univariate logistic regression analysis was performed RESULTS: Thle mean age of participants was 18.2 years. About 40% of respondents reported to have their first sexual intercourse at the age of 14-16 years. The majority of cases and controls had one or two partners, but a greater percentage of cases had six or more partners compared to controls (12.5% vs. 3.3%). Adolescents with STDs frequently had sexual intercourse on the first date (p < 0.05), and more frequently reported previous STDs in their personal history (p < 0.05). Consistent use of condoms was less frequent among cases than among controls, both with steady (9.4% vs. 27.8%) and irregular partners (30.0% vs. 70.6%). The majority of teenagers (95%) thinks that sexual education at schools should be better. DISCUSSION: According to the results obtained, which are in agreement with literature data, teenagers should change their behavior, especially with respect to condom use both during vaginal and anal sex. Health education at schools could probably influence future sexual behavior, and counseling for STDs should be offered to all teenagers attending STD clinics. CONCLUSION: The best way to avoid unwanted pregnancy and STDs is to delay the first sexual experience, reduce the number of sexual partners and increase the protection by condom use.

Adolescent↗
PubMed1987

Practical approaches to screening for cervical cancer.

The Program of the Fundação "Centro de Pesquisa de Oncologia" (FCPO) and the Instituto Brasileiro de Controle do Câncer (IBCC) in São Paulo has examined 980,977 women from 1970 to September 1985. Dysplasias, in situ, and invasive carcinomas were detected in 15,123 women (1.5%). The rates of false-negative and false-positive cytologic diagnoses of the program are 2.3% and 27%, respectively. The following epidemiological variables were evaluated: age, parity, age at first sexual intercourse, age at first pregnancy, education, and age at menarche. It was found that women at higher risk for cervical carcinoma in this population were those 26 years of age or older, with 4 or more pregnancies, women who had the first coitus before 18 years of age, and the first complete pregnancy before 19, as well as illiterate women or those who did not complete the first 4 years of primary school. In Brazil, the frequencies of cervical carcinomas are 25.8% for in situ and 72.2% for invasive (0.4 to 1). In this program, the corresponding percentages are 61.0% for in situ and 39.0% for invasive carcinomas (1.6 to 1). Including dysplasias, the percentages for Brazil are 56.3% for severe dysplasias plus in situ carcinomas and 43.7% for invasive carcinomas (1.3 to 1). In the FCPO/IBCC Program these percentages are 83.2% and 16.8% (5 to 1).

Adolescent↗