Predisposing factors related to adolescent sexuality among students in rural and urban school-based health centers in Eastern North Carolina

The purpose of this study was to examine possible predisposing factors which may contribute to adolescents' early sexual behavior in rural and urban communities. Due to the detrimental public health impact of adolescents engaging in early sexual activity, there is a pressing need to explore predisposing factors associated with risky adolescent sexual behavior. Sexual behaviors, demographics, family structure, history of abuse, sexually active friends, and substance use were analyzed with a sample population of 410 rural and urban Wayne County, North Carolina adolescents, aged 10 to 19 years, who were enrolled in a school-based health center between 2005 and 2007, and reported on the Guidelines for Adolescent Preventative Services questionnaire of engaging in high-risk sexual behaviors. Black students residing in single-parent urban households were more likely to engage in sex earlier than other analyzed ethnic groups [OR=5.2; 95% CI=1.1, 23.6]. As age increased, risk of engaging in sex also increased. Rural students were at a higher risk of engaging in early sexual behaviors due to reporting history of abuse, than students residing in urban areas [OR=2.6; 95% CI=1.0, 6.8]. Students who reside in a single- or no-parent household had requested more health education services than those who reside in a dual-parent household. In a logistic regression model, a negative association was observed with parental communication among urban adolescents [OR=0.3; 95% CI=0.1, 0.9]. There is a strong racial disparity on early sexual behavior in Eastern North Carolina. Family structure, education, and communication were among the significant predisposing factors.