Early Onset of Sexual Intercourse and Sexual Risk Behaviors in a Diverse Urban Population

Early initiation of sexual intercourse (early sex) is associated with an increased likelihood of sexual risk behaviors, sexually transmitted infections, and pregnancy. To examine racial/ethnic differences in these risks, we analyzed the New York City (NYC) 2007 Youth Risk Behavior Survey (N=9,080), a representative, diverse sample of urban public high school students, examining bivariate and multivariate associations between early sex, defined as before age 14, and sexual risk behaviors among students age 14 and older who ever had sex.

Forty-six percent of NYC public high school students age 14 and older reported ever having sex; among these students, 37% had early sex. Controlling for gender, race/ethnicity and age, early sex was associated with increased odds of multiple sex partners in the past three months (OR=2.9,95% Confidence Interval [CI]:2.0-4.1), alcohol or drugs at last sex (OR=2.3,95%CI:1.7-3.1), no condom use at last sex (OR=1.8,95%CI:1.3-2.3), and pregnancy or causing pregnancy (OR=1.9,95%CI:1.2-2.9). In models stratified by race/ethnicity, early sex was associated with multiple partners among all groups, with pregnancy among both whites (OR=4.1,95%CI:1.1-14.6) and blacks (OR=2.0,95%CI:1.0-4.1) but not Hispanics, and with alcohol or drugs at last sex only among blacks (OR=3.3,95%CI:1.8-5.8) and Hispanics (OR=2.1;95%CI:1.4-3.2). Early sex was strongly associated with no condom use among whites (OR=5.4,95%CI:2.1-13.9), but only marginally associated among blacks (OR=1.6,95%CI:1.0-2.6) and Hispanics (OR=1.5,95%CI:1.0-2.1).

Students reporting early sex were more likely to have engaged in sexual risk behaviors, though associated risks varied by race/ethnicity. Evidence-based interventions to prevent early sex and reduce sexual risk behaviors should target adolescents before they initiate these behaviors.