The Association Between Sequences of Sexual Initiation and the Likelihood of Teenage Pregnancy

• Published in: Journal of adolescent health Vol. 52; no. 2; pp. 228 - 233
• Main Authors: Reese, Bianka M, Haydon, Abigail A., Ph.D, Herring, Amy H., Sc.D, Halpern, Carolyn T., Ph.D
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.02.2013; Elsevier
• Subjects: Adolescent; Adolescents; Biological and medical sciences; Birth Control; Confidence intervals; Developmental psychology; Female; Females; Fertility; Fundamental and applied biological sciences. Psychology; Gynecology and obstetrics; Health Behavior; Health Problems; Humans; Initiation; Logistic Models; Longitudinal; Multivariate Analysis; Oral–genital sex; Pediatrics; Personality. Affectivity; Pregnancy; Pregnancy in Adolescence; Pregnant adolescent girls; Prospective Studies; Psychology and medicine; Psychology. Psychoanalysis. Psychiatry; Psychology. Psychophysiology; Risk Factors; Sequences; Sex Ratio; Sexual Behavior; Sexual behaviour; Sexual sequences; Sexuality. Sexual behavior; Teen pregnancy; United States; United States; Sexual sequences; Oral–genital sex; Longitudinal; Adolescents; Teen pregnancy; Sexual behavior; Human; Pregnancy; Oral―genital sex; Adolescent; Sexuality; Contraception; Initiation
• ISSN: 1054-139X; 1879-1972
• DOI: 10.1016/j.jadohealth.2012.06.005

Abstract Purpose Few studies have examined the health and developmental consequences, including unintended pregnancy, of different sexual behavior initiation sequences. Some work suggests that engaging in oral–genital sex first may slow the transition to coital activity and lead to more consistent contraception among adolescents. Methods Using logistic regression analysis, we investigated the association between sequences of sexual initiation (i.e., initiating oral–genital or vaginal sex first based on reported age of first experience) and the likelihood of subsequent teenage pregnancy among 6,069 female respondents who reported vaginal sex before age 20 years and participated in waves I and IV of the National Longitudinal Study of Adolescent Health. Results Among female respondents initiating vaginal sex first, 31.4% reported a teen pregnancy. Among female respondents initiating two behaviors at the same age, 20.5% reported a teen pregnancy. Among female respondents initiating oral–genital sex first, 7.9% reported a teen pregnancy. In multivariate models, initiating oral–genital sex first, with a delay of at least 1 year to vaginal sex, and initiating two behaviors within the same year were each associated with a lower likelihood of adolescent pregnancy relative to teens who initiated vaginal sex first (odds ratio = .23, 95% confidence interval: .15–.37; and odds ratio = .78, 95% confidence interval: .60–.92, respectively). Conclusions How adolescents begin their sexual lives may be differentially related to positive and negative health outcomes. To develop effective pregnancy prevention efforts for teens and ensure programs are relevant to youths' needs, it is important to consider multiple facets of sexual initiation and their implications for adolescent sexual health and fertility.