Early Initiation of Sexual-Risk Taking Behaviors among Urban Middle School Students: Prevalence and Protective Factors

Background: Early sexual initiation is associated with increased risk of unintended pregnancy/HIV/STI, making identification of protective factors critical for developing effective intervention programs. This study examined the prevalence of sexual risk-taking, and the self (biological, psychological, behavioral), familial (family structure, family process), and peer-related factors which may protect against early initiation. Methods: 7th grade students from 15 urban middle schools completed surveys on laptop computers (n=1742). Stepwise, multinomial logistic regression was used to identify significant protective factors; the dependent variable was coded as never had sex (0), ever had vaginal sex, or vaginal and oral sex (1), and ever had anal sex, or anal plus any other sex (2). Results: Baseline sample was 59.2% female, 38.8% black, 49.1% Hispanic. Mean age was 13.1 (SD=0.71) years; 8.7% had initiated oral sex, 13.0% vaginal sex, 6.8% anal sex. In multivariate analyses, protective factors for both vaginal and anal sex included: younger age, being Hispanic, less permissive sexual beliefs, greater abstinence intentions, and lesser sexual intentions. Additional protective factors for vaginal sex included not dating an older boyfriend/girlfriend; for anal sex, not having a boyfriend/girlfriend, never having used drugs, and never having French kissed. Greater strength of character was associated with increased likelihood of having had vaginal and anal sex. Higher levels of parental communication were associated with initiation of vaginal sex, whilst greater HIV/STI knowledge was associated with initiation of anal sex. Conclusion: Implications for the development of effective HIV/STI/pregnancy prevention programs addressing multiple sexual behaviors in early adolescence will be discussed.