Influencing Middle and High School Students' Decisions to be Sexually Active: What do Confidence, Substance Abuse, Refusal Skills and Condom Use have to do with Intercourse and Oral Sex?

Background: Between 12% and 32% teens (14-17) have engaged in vaginal-penile sexual intercourse. Many factors contribute to teenagers' decisions regarding engagement in intercourse or oral sex. The purpose of this study was to examine factors associated with middle school and high school students' decisions to have sex and to better understand the context of their potentially risky sexual behaviors.

Methods: Data were collected from 384 mid-west middle and high school students. Students responded to a variety of questions including items related to confidence and expectations, personal experiences, and sexual health knowledge and attitudes. Psychological questions were also included to examine the relationship between how adolescents feel about themselves, and how they relate to friends, family and peers regarding their sexuality.

Results: Findings indicate that 36.0% of teens engaged in vaginal-penile sexual intercourse and 42.1% in oral sex. Most teens did not utilized substances (alcohol, tobacco, marijuana) in general, but 8.0% drank alcohol and 8.8% used marijuana before their first sexual intercourse. Most teens (60.9%-74.3%) reported feeling “totally confident” buying, correctly/consistently using, and getting their partner to use a condom if they planned to have sex. Participants also indicated pregnancy and HIV prevention as reasons for not engaging in sexual activity and stated primary reasons for not using a condom included use of another birth control method or not having condoms with them.

Conclusion: These findings present important implications for sexuality education among teens. Future research is needed to better clarify “risky sexual behavior” among adolescents to enhance sexual health education.