Socio-Economic Factors and Adolescent Sexual Activity and Behaviour in Nova Scotia
Langille, Donald B., Hughes, Jean, Murphy, Gail Tomblin, Rigby, Janet A., Canadian Journal of Public Health
Purpose: Little is known about associations of adolescents' socio-economic status (SES) and their sexual activity and risk behaviours. This study examined these associations in Nova Scotia adolescents aged 15-19.
Methods: Students at four high schools in northern Nova Scotia completed surveys examining relationships of family SES factors and: 1) sexual activity (having had vaginal or anal intercourse, intercourse before age 15 (early intercourse)); and 2) risk behaviours (use of contraception/condoms, number of partners and unplanned intercourse after substance use).
Results: Of students present when the survey was administered, 2,135 (91%) responded. Almost half (49%) had had vaginal intercourse, and 7% anal intercourse. In univariate analysis for young women, non-intact family structure and lower parental education were associated with having vaginal, anal and early intercourse. Female risk behaviours showed no significant univariate associations with SES. Young men had univariate associations of family structure, lower maternal education and paternal unemployment with early intercourse, and lower paternal education with anal intercourse. Condom use was higher for young men with employed fathers; those living with both parents less often had >1 sexual partner. In multivariate analysis, most SES associations with females' sexual activities held, while most for males did not, and few associations of SES and risk behaviours were seen for females.
Conclusions: Indicators of lower SES are associated with sexual activity in young women. Sexual risk behaviours are not often associated with SES in females, though they are more so in males. These findings have implications for sexual health promotion and health services.
MeSH terms: Adolescent; sexual activity; sexual behaviour; socioeconomic factors
By high school completion, most Canadian1 and Nova Scotian2 adolescents have had sexual intercourse, sometimes with negative health outcomes including unwanted pregnancy and sexually transmitted infection (STI). Teenage pregnancy is associated with low birthweight, preterm delivery and increased infant mortality,3 and teenage mothers may experience decreased educational and vocational attainment.4 The 2000 pregnancy rate for Canadian women aged 15 to 19 was 38.2/1000; by contrast, it was 31.5/100 in Nova Scotia that year.5 STIs, which are most common among those aged 15 to 24,6 are associated with pelvic inflammatory disease, infertility and ectopic pregnancy.7
Socio-economic status (SES), as indicated by family structure, parental education and income, is associated with adolescent sexual activity in the United States (US).8,9 In young women in Nova Scotia, vaginal intercourse before age 15 is associated with lower paternal education and non-intact family.10 However, little other Canadian evidence is available concerning SES and adolescent sexual activity and behaviours. This research examines associations of parental employment, education and family structure with sexual activity (ever having vaginal or anal intercourse, or intercourse before age 15 (early intercourse)) and sexual risk behaviours (use of contraception and condoms, numbers of partners, and unplanned intercourse after substance use) in adolescents in northern Nova Scotia. We hypothesized that parents' not being employed and having lower educational status, and adolescents' living with other than both parents (nonintact family) would be associated with increased sexual activity and risk behaviour.
Students aged 15-19 at four high schools in three counties participated in a self-report survey asking about SES factors, and sexual activity and behaviours. These schools serve about 40% of students in these rural counties, which have populations of about 50,000 and county seats of approximately 10,000 citizens. Less than 2% of the population represents visible minorities. Average education and income are slightly less than provincial levels. …