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APHA Scientific Session and Event Listing

Judith Bernstein, PhD¹, Geoffrey Capraro, MD², Emily Rothman, ScD¹, Anel Marchena-Suazo, RN¹, Michelle Sandoval, MPH¹, BUSPH Data Coordinating Center¹, and Edward Bernstein, MD¹. (1) Youth Alcohol Prevention Center, Boston University School of Public Health, 715 Albany St., Boston, MA 02118, 617-414-1415, jbernste@bu.edu, (2) Pediatric Emergency Medicine, Baystate Medical Center (and formerly Boston Medical Center), 759 Chestnut St., Springfield, MA 01199

Objective: Early sexual initiation (ESI) has been linked to adolescent substance use, stress, fighting, and pregnancy, especially among young girls with older partners. The legal age of consent for sexual intercourse is sixteen in many states, but this age-16 cutpoint is not evidence-based. This study explores the association of ESI--controlling for race/ethnicity, gender, parental involvement, and age--with high risk behaviors. Design: A survey of racially/ethnically diverse Pediatric ER patients aged 14-21. Respondents were characterized into ESI (< age 16), and LSI (> age 16) and predictors of risk behaviors identified using regression analyses. ESI was then stratified by partner's age at SI, and age gap >5 years (n=116) was entered into the analysis for each risk outcome. Results: In this sample (n=2124), 980 (47%) reported ESI, 1144 (53%) LSI. ESI was strongly associated with risky behavior outcomes: 2+ pregnancies (OR 3.7), sexually transmitted infections (OR 3.3), criminal justice involvement and frequent marijuana use (OR 3.2), carrying a weapon (OR 2.8), binge drinking (2.0), school dropout (OR 1.8), hurting oneself or being physically hurt by a date (OR 1.9). The numbers of fights and ER visits in the last year were also significantly associated with ESI. Among ESI, those with an age gap were more likely to be depressed (OR 1.9) and/or bullied (OR 2.0), but the age gap variable did not predict other behaviors. Conclusion: SI prior to age 16 is associated with negative sequelae for adolescents. These findings support the current legal standard for age of consent.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

• Describe the association of initiation of sexual intercourse before the age of 16 with four adolescent risk behaviors.
• Delineate between an associated and a causative factor.
• Discuss the implications of this study for program and policy development.

Keywords: Adolescent Health, Sexual Risk Behavior

Presenting author's disclosure statement:

Not Answered