Impact of Sexual Behaviors on Sexual Attitudes and Adolescent Risk Behavior Engagement

Objective: To examine risk behavior and attitudinal differences among adolescents engaging in sexual intercourse only; oral sex only; and both oral sex and sexual intercourse. Methods: The Youth Risk Behavior Survey was administered in 2006 to 2,726 students in a Midwestern county. Items assessing lifetime oral sex and sexual intercourse were utilized to categorize students. Chi-square analysis and polytomous regression were used to explore variation between groups. Logistic regression was used to investigate the relationship between lifetime sexual behaviors, sexual attitudes, and other health risk behaviors, while controlling for potentially confounding demographic variables. Results: Lifetime oral sex (40.7%) was higher than lifetime sexual intercourse (33.8%) in this population. Among participants, 53.6% reported no sexual behaviors; 12.5% reported oral sex only; 5.7% reported sexual intercourse only; and 28.1% reported both oral sex and sexual intercourse. Oral sex only and sexual intercourse only were each associated with increased risk behaviors. Adolescents engaging in both oral sex and sexual intercourse reported increased risk behaviors such as physical fighting (OR=3.16) and marijuana use (OR=10.90). Adolescents reporting oral sex only and both oral sex and sexual intercourse were more likely to report oral sex was “not a big deal”, having oral sex to avoid sexual intercourse, and were less likely to report student or parent perceptions that sexual behaviors were “wrong” for adolescents. Conclusions: In this population, oral sex was more prevalent. Healthcare providers working with adolescents should recognize adolescents' attitudes regarding oral sex and expand preventive services to include oral sex screening and education.