Female Participation in a High-risk Adolescent Sexual Behavior known as a Train

Background: Our purpose was to estimate the prevalence and analyze the context of participation in a high-risk sexual behavior called “trains” among a sample of adolescent females. Methods: Adolescent girls attending 4 urban teen health centers completed an anonymous self-report survey on risk behaviors using an automated computer-assisted survey instrument (n=500). Respondents were asked a series of questions about trains, defined as sex with more than 1 person at the same time/at the same place. Results: Preliminary results suggest that ~5% of adolescent females report a lifetime history of train involvement. No differences were detected based on racial subgroups. The youngest age at first train participation was 9 years. Slightly less than half reported consistent condom use at last train encounter. Half (50.0%) of participants reporting train involvement indicated they had been pressured to participate, and 25% reported being forced to participate; overall, 58.3% reported participation as non-voluntary. Notably, females reporting train participation were significantly more likely to have been victimized by dating violence (OR 4.65, p<0.001). Discussion: Our results suggest that a small but significant portion of adolescent females have been involved in trains. The majority of such experiences were not voluntary, and inconsistent condom use in this context and high rates of dating abuse among participants suggest that train participation may be indicative of multiple health risks. Additional data is needed to understand this understudied behavior and its relation to the health and safety of women and girls.