Academic journal article American Journal of Health Education

The Language of Love?-Verbal versus Implied Consent at First Heterosexual Intercourse: Implications for Contraceptive Use

Academic journal article American Journal of Health Education

The Language of Love?-Verbal versus Implied Consent at First Heterosexual Intercourse: Implications for Contraceptive Use

Article excerpt

ABSTRACT

Background: Little is known about how young people communicate about initiating intercourse. Purpose: This study was designed to gauge the prevalence of implied versus verbal consent at first intercourse in a U.S. college population, assess effects of consent type on contraceptive use, and explore the influences of gender, race and other factors. Methods: We conducted and analyzed a cross-sectional survey of non-Hispanic white and black students from four universities, exploring associations between verbal and nonverbal consent, contraceptive use and covariates. Results: Among those with consensual first intercourse experiences (N=1883), half (49%) provided nonverbal consent. Black men were the most likely to provide nonverbal consent (61%), followed by white men (55%), black women (51%), and white women (43%). Respondents who used condoms at first intercourse were more likely to provide verbal consent, suggesting that condoms may prompt sexual discussions (or vice versa). In contrast, even when controlling for covariates, those who provided nonverbal consent were less likely to have used contraception (significantly so for women). Discussion: These findings confirm the hypothesis that young people who do not discuss whether to engage in vaginal intercourse for the first time are less likely to use contraception. These results add an important layer to our current conceptual model of sexual development, in particular, how young people adopt, or fail to adopt, behaviors that will keep them healthy once they decide to become sexually active. Translation to Health Education Practice: Enhanced sexual communication skills are greatly needed. Public health practitioners should investigate type of consent in future research and programming, with sensitivity to gender and racial influences.

Am J Health Educ. 2010;41(4):218-230. This paper was submitted to the Journal on August 19, 2009, revised and accepted for publication on December 14, 2009.

BACKGROUND

The public health and medical fields have devoted considerable attention to the timing, context and sequelae of adolescents' sexual initiation, (1-4) which we define here as vaginal intercourse. Although research shows that a number of other sexual behaviors are increasingly associated with virginity loss, especially among same-sex couples, (5-7) the current paper refers to virginity loss as vaginal intercourse. The experience of first vaginal intercourse is imbued with enormous personal and cultural significance) as well as important connections to future health behaviors such as contraceptive use (8) and protection against STIs. (9) First vaginal intercourse has also been understood as an important touchstone of adolescent development, one in which young people learn to engage in romantic and/or sexual relationships. (10)

Given the intensity of the scientific and political spotlight on first sexual intercourse, it is surprising that we know so little about how young people talk--or fail to talk--about how and when to engage in intercourse for the first time. With a few qualitative exceptions from the UK (11) and Australia, (12) minimal research has explored whether young people discuss intercourse beforehand, or rather if intercourse unfolds in a wordless, albeit consensual, fashion--a natural step in the progression of other sexual events. (13) Moreover, although not demonstrated empirically, young people who do not or cannot speak directly about whether to engage in intercourse for the first time may be unlikely to discuss, let alone use, contraception, and such silences may set patterns for future sexual relationships. Thus, examining the prevalence and type of communication about first intercourse may highlight an important point of intervention in young adults' sexual health.

Researchers have explored the degree to which adolescents discuss contraception or STIs before having vaginal intercourse for the first time. …

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