Onset of Sexual Intercourse among Female Adolescents: The Influence of Perceptions, Depression, and Ecological Factors

doi:10.1016/j.jadohealth.2007.04.017

Journal of Adolescent Health

Volume 41, Issue 4, October 2007, Pages 398-406

https://doi.org/10.1016/j.jadohealth.2007.04.017 Get rights and content

Abstract

Purpose

This study examined the extent to which perceptions of sex, depression, and other personal and social factors influenced onset of sexual intercourse during maturation among female adolescents.

Methods

Data from the National Longitudinal Study of Adolescent Health were used. Participants were 3,644 female adolescents 15–19 years of age who completed the wave 1 In-Home Interview. Logistic regression was used to predict onset of sexual intercourse at waves 1, 2, and 3. Variables examined were age, race, depression, self-esteem, sexual intercourse, religiosity, alcohol use, perceptions of sex, mother connectedness, father connectedness, peer connectedness, and school connectedness. Interaction effects among these variables with depression were examined.

Results

Ambivalent perceptions of sex, in addition to closer relationships with one's father, peers, and school environment, were associated with delaying onset of sexual intercourse among non-depressed teens. Perceptions of sex did not influence engagement in sexual intercourse among depressed adolescents. Close maternal relationships delayed onset of sexual intercourse among depressed adolescent females, whereas the interactions between depression and father connectedness, peer connectedness, and school connectedness were associated with having sex.

Conclusions

Different strategies are needed to address sexual behaviors for non-depressed and depressed female teens. Public health programs concerned with influencing sexual perceptions among non-depressed female adolescents should incorporate parents, peers, and school activities into their planning and implementation. Because depression in combination with connection to the environment was a significant risk factor for sexual intercourse, future research must explore the factors that delay sexual intercourse, particularly for teenage girls with depression.

Section snippets

Participants

Data in this study were drawn from wave 1 (1995), wave 2 (1996), and wave 3 (2002) of the In-Home Questionnaire of the National Longitudinal Study of Adolescent Health (Add Health) [19]. The Add Health Study used a multi-stage clustering design to provide a representative sample of adolescents attending school in the United States. The initial sampling unit of the Add Health Study was the school, with adolescents who participated in the school survey being eligible to participate in In-Home

Sample characteristics

Approximately 10.7% of the sample reported depression and 89.3% reported no depression (Table 1). The majority of the respondents were 16–17 years old. Of the depressed female adolescents, 33% were non-white in comparison to 27% of the non-depressed females. Depressed female adolescents (59%) were more likely to have had sex than teen girls without depression (43.1%). In all, 57% of the depressed females and 48.9% of the non-depressed females reported medium levels of self-esteem. In addition,

Discussion

In this study most of the female adolescents had negative and ambivalent perceptions of sex, regardless of depression status. These findings challenge previously held beliefs that depressed female adolescents have permissive perceptions of sex [27], [13]. Also, previous examination of female adolescents' perceptions of sex organized sexual perceptions into two categories, i.e., positive and negative. The findings in this study suggest that female adolescents with ambivalent perceptions of sex

Acknowledgments

This research is based on data from the Add Health project, a program project designed by J. Richard Udry (PI) and Peter Bearman, and funded by grant P01-HD31921 from the National Institute of Child Health and Human Development to the Carolina Population Center, University of North Carolina at Chapel Hill, with cooperative funding participation by the National Cancer Institute; the National Institute of Alcohol Abuse and Alcoholism; the National Institute on Deafness and Other Communication

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Due to its long-term longitudinal design, the National Longitudinal Study of Adolescent to Adult Health (Add Health) has provided numerous valuable insights into adolescent and young adult sexual behavior. Framed by a conceptual model of sexual behavior and health, I review research using Add Health data to study sexual behavior and health. In this paper, I review research examining both predictors (e.g., neighborhood, family, genetic, individual) and health outcomes (e.g., sexually transmitted infections, mental health) of sexual behavior in adolescents and young adults. Where possible, I focus on long-term longitudinal studies that make use of the unique strengths of the Add Health data. Existing Add Health research has provided considerable information about both the predictors and health consequences of adolescent and young adult sexual behavior. Factors ranging from neighborhoods to genetics predict whether adolescent and young adults engage in sexual behaviors. Findings on long-term outcomes of adolescent sexual behavior suggest that early sexual behavior predicts higher rates of sexually transmitted infections and pregnancy in young adulthood, but not long-term changes to mental health. Unique contributions of Add Health include the ability to examine multidimensional bio-ecological predictors of sexual behavior and to examine long-term effects of sexual behavior and how sexual behaviors and their correlates change across adolescence into adulthood. Future work can leverage these strengths, and in particular the long-term longitudinal nature of the data, to uncover new insights about the developmental course of sexual behavior and health.
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Native Americans (Native) are a subpopulation in the U.S. who endure disparities in substance use and sexual health. Exploration of these inequities must recognize the modern-day impacts of historical trauma resulting in complex social conditions driving these disparities (Centers for Disease Control and Prevention, 2019, 2013; de Ravello et al., 2014; Ehlers et al., 2013; Harling et al., 2013; Hellerstedt et al., 2006; Kaufman et al., 2007a; Rink et al., 2007; Semega et al., 2017). Historical trauma has been likened to a series of traumatic assaults, including but not limited to: forced relocation, forced removal of children to boarding schools, community massacres, pandemics from the introduction of new diseases, and prohibition of spiritual and cultural practices (Evans-Campbell, 2008).
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We conducted secondary analyses of data collected through a community-based randomized controlled trial of RCL evaluated among Native youth (ages 11–19) residing on a rural reservation between 2015–2020 (N = 534, 47.4 % male). We used linear regression, controlling for baseline age and sex, to test between study group differences in outcomes at 3-, 9-, and 12-month post-intervention. Models were stratified by sex and age (11−12, 13−14, and 15+ years of age) to examine differences within these subgroups.
Youth receiving RCL reported lower intention to use substances through 12-months follow-up (p = 0.006). Statistically significant improvements were also observed across peer, parent, and sexual partner risk and protective factors to delay substance use initiation, with notable differences among boys and participants ages 13−14.
RCL is a primary prevention, skills-based program effective in preventing risks for substance use. This evaluation underscores the value in developing programs that influence concurrent adolescent risk behaviors, especially for Native communities who endure multiple health disparities.
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Higher school-level VAE was associated with an increased risk of early sexual debut at 24-months. Students attending schools with higher overall levels of commitment and belonging were less likely to report sexual debut at 36 months. Students reporting stronger personal commitment to learning and teacher relationships at baseline were less likely to report sexual debut at both follow-up points. Associations involving participation and contraception use were largely nonsignificant.
Direct measures of the school environment are more strongly associated with reduced sexual risk behavior in early adolescence than the proxy measure, VAE. Results provide some support for the theory and suggest that personal disposition towards school as well as attending a school with high levels of student commitment and belonging are important for subsequent sexual decision making.
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Original articleOnset of Sexual Intercourse among Female Adolescents: The Influence of Perceptions, Depression, and Ecological Factors

Abstract

Purpose

Methods

Results

Conclusions

Section snippets

Participants

Sample characteristics

Discussion

Acknowledgments

Am J Prev Med

J Am Acad Child Adolesc Psychol

J Am Acad Child Adolesc Psychol

Healthy People 2010

Ecological factors associated with adolescent sexual activity

Soc Work Health Care

Antecedents of adolescents initiation of sex, contraceptive use and pregnancy

Am J Health Behav

Reflections on two decades of research on teen sexual behavior and pregnancy

J School Health

Teen sexual behavior: Applicability of the theory of reasoned action

J Marriage Fam

Adolescents perceptions of abstinence: Risk and benefits

J Adolesc Health

Older adolescents' engagement in causal: Impact of risk perception and psychosocial motivations

J Youth Adolesc

The influence of parental support, depressed affect, and peers on the sexual behavior of girls

J Fam Issues

Self-esteem, depressive symptoms, and adolescents' sexual onset

Soc Psycol Qtly

Fostering Resiliency in Kids: Protective Factors in the Family, School, and Community

Overcoming the Odds: High Risk Children from Birth to Adulthood

The theory of triadic influence: A new theory of health behavior with implications for preventive interventions

Adv Med Soc

Protecting adolescents from harm: Findings from the National Longitudinal Study of Adolescent Health

JAMA

Original article
Onset of Sexual Intercourse among Female Adolescents: The Influence of Perceptions, Depression, and Ecological Factors