Long-Term Influence of Sexual Norms and Attitudes on Timing of Sexual Initiation among Urban Minority Youth. (Research Papers)

Article excerpt

Early initiation of sexual activity has been linked with increased risk for negative health outcomes including HIV, other sexually transmitted diseases, and unintended pregnancy. (1-4) This link may exist because adolescents who have sex at a young age are prone to have unprotected sex, more frequent sexual encounters, and sex with multiple partners. They also are more likely than their peers to have initiated other risk behaviors including alcohol, drug, and tobacco use. (1,5)

While the proportion of adolescents reporting sexual intercourse held steady in recent years, rates of early sexual initiation among African American and Latino youth remain high. According to the 2001 Youth Risk Behavior Survey conducted by the Centers for Disease Control and Prevention (CDC), 25.7% of African American and 11.4% of Latino male high school students had sexual intercourse before age 13 compared to 6.2% of their White counterparts. (6) Differences are similar among female students, with 7.6% of African American and 4.1% of Latina respondents reporting having engaged in sexual intercourse before 13, compared to 3.3% of White females.

Ethnic and racial disparities in the timing of sexual initiation are disturbing given that minority youth and young adults are disproportionately at risk for negative health outcomes associated with early and unprotected sex. According to CDC, African Americans and Hispanics were significantly over-represented in the number of new AIDS cases reported in 1999, accounting for 47% and 19% of these cases, respectively. (7,8) African American youth of both genders account for 56% of HIV cases reported in the 13 to 24 age group. (9) In New York City, where this study was conducted, almost 90% of new cases of HIV infection, and 70% of newly diagnosed AIDS cases, occur among African American and Latino communities. (10) Reported rates of STDs, including gonorrhea, syphilis, and chlamydia, as well as unintended pregnancies, also are higher when compared to Whites. (4,11)

Despite health risks associated with early sexual initiation, little empirical evidence exists on factors that influence sexual behavior among minority youth. Even less is known about a particularly vulnerable group--those who reside in economically disadvantaged urban settings. Data are especially scarce on adolescents who have not reached their teen years, despite the fact that a substantial proportion of minority boys and a smaller number of girls report sexual intercourse before age 15. (5,12) This lack is due in part to difficulties of conducting research on sexuality with younger adolescents. (13) The CDC Youth Risk Behavior Survey, the National Survey of Adolescent Males, and the National Survey of Family Growth focused on youth aged 15 or older. These studies relied on retrospective accounts of sexual activity. The National Longitudinal Survey of Adolescent Health includes younger participants and over-samples minorities, yet given its broad scope, the numbers of African American and Latino youth from urban environments--where early initiation and the consequences of risky sex are so high--are still relatively small.

The need for additional data on younger adolescents is bolstered by several studies that suggest many of the factors that affect sexual behavior, particularly sexual norms and attitudes about sex, may be shaped before youth reach their teen years. (14-17) However, because most of these studies were cross-sectional or had brief longitudinal follow up (over the school year), they provide limited information on causal effects, including whether attitudes and expectations held in early adolescence influence behaviors over the longer-term, into and during the high school years.

Evidence of whether sexual norms and attitudes influence patterns of future sexual behavior can inform prevention programs in several ways. First, it can identify developmental stages when interventions are needed for different populations. …