Academic journal article Canadian Journal of Public Health

Older Male Sexual Partner as a Marker for Sexual Risk-Taking in Adolescent Females in Nova Scotia

Academic journal article Canadian Journal of Public Health

Older Male Sexual Partner as a Marker for Sexual Risk-Taking in Adolescent Females in Nova Scotia

Article excerpt

ABSTRACT

Purpose: To examine age differences between Nova Scotia women aged 15-19 and their male sexual partners, and to determine if those adolescents with older partners were more likely to have engaged in sexual risk-taking behaviours.

Methods: A cross-sectional survey (response rate=91%) administered in May 2003 assessed the following sexual risk behaviours: a) not using condom/hormonal contraception at last vaginal intercourse; b) having unplanned vaginal intercourse while using alcohol or drugs; c) having more than one partner in the previous year; d) vaginal intercourse before age 15; and e) ever having anal intercourse. Univariate analysis was carried out to determine associations of sexual risk behaviours with partner age difference. Logistic regression was then used to examine behaviours associated with partner age (p<0.15) in univariate analysis.

Results: Of the young women surveyed, 520 (47.7%) had had vaginal intercourse in the previous year; 515 of these provided information on their last partner's age. Over 10% had partners four or more years older. In multivariate analysis, having a partner ≥4 years older was associated with not using a condom at last intercourse (OR 2.15; 95% CI 1.10-4.20), having more than one partner in the previous year (OR 21.9; 95% CI 1.13-4.28) and having unplanned vaginal intercourse while using alcohol or drugs (OR 2.66; 95% CI 1.34-5.28).

Conclusions: A significant number of female adolescents have older male sexual partners, and such relationships are markers for high-risk sexual behaviours. Partner age is an important consideration for health professionals providing sexual health advice to young women.

MeSH terms: Adolescent; female; risk-taking; sexual behaviour

Adolescent females with older male sexual partners are at increased risk to their sexual health, including risk of sexually transmitted infections (STIs).1-4 STIs, which are most common among those aged 15-24,5 are associated with pelvic inflammatory disease, infertility and ectopic pregnancy.6 Lack of contraception and greater pregnancy risk occur where female adolescents' sexual partners are older.7 Teenage mothers are at increased risk of experiencing decreased educational opportunity and vocational attainment,8 and teenage pregnancy is associated with low birthweight infants, preterm delivery and increased infant mortality.9 The Canadian teenage pregnancy rate in 2002 was 33.9/1000, while the rate for Nova Scotia was 28.1/1000.10

Approximately 50% of Canadian11 and Nova Scotia12,13 females aged 15-19 have had vaginal intercourse at least once. Young women who are in relationships with older male partners may lack power in these relationships, and this may play a role in sexual risk taking.14 In Canada from 1992-1994, of those teenagers giving birth before age 18, 24% had partners more than six years older.15 The goal of this study was to examine age differences between adolescent females in Nova Scotia and their sexual partners at last intercourse to determine if those with partners older than themselves are more likely to have engaged in sexual risk-taking behaviours.

METHODS

Survey procedure

All students (both genders) in grades 10-12 attending four high schools in three counties in northern Nova Scotia were asked to complete a self-report survey which included questions about sexual activity and risk-taking behaviours, partner age and family structure. Survey questions were formulated by the investigators and were evaluated for face and content validity by a national panel of clinicians and researchers with adolescent sexual health expertise. Reliability was assessed by repeat survey administration at another high school in the same area of rural Nova Scotia. Kappa statistics ranged from 0.76 to 1.0. Surveys were administered in May 2003 during regularly scheduled classes by teachers in each classroom, who had been trained in its application by the research team two weeks before the survey took place. …

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