Sexual initiation

Background: Reproductive and mental health are key domains of adolescent wellbeing but possible interrelationships are poorly understood. This cross-sectional study evaluated the association between psychopathology and reproductive health risk among European adolescents. Methods: A structured self-report questionnaire was delivered to 12,395 pupils of 179 randomly selected schools in 11 European countries within the EU funded "Saving and Empowering Young Lives in Europe" (SEYLE) project. The questionnaire included items about sexual initiation and reproductive health risk factors, such as number of sexual partners, frequency of condom use, and pregnancy involvement. Psychopathology was evaluated with validated instruments and/or ad-hoc questions. Results: Of 11,406 respondents (median age 15; interquartile range [IQR] 14-15; 57% females), 18.8% reported sexual initiation. Sixty percent of them also reported at least one reproductive risk factor. Sexual initiation was significantly more common among pupils older than 15 years (38% versus 13.2% younger pupils) and males (21.3% versus 16.9% females). It was also more common among pupils with depression (age/sex-adjusted odds ratio [aOR] 1.871), anxiety (aOR 2.190), severe suicidal ideation (aOR 2.259), self-injurious behaviour (aOR 2.892), and suicide attempts (aOR 3.091). These associations were particularly strong among pupils ≤15 years old and, for overt psychopathology, among pupils with low non-sexual risk behaviour profile and females. Depression (aOR 1.937), anxiety (aOR 2.282), severe suicidal ideation (aOR 2.354), self-injurious behaviour (aOR 3.022), and suicide attempts (aOR 3.284) were associated with higher reproductive health risk, defined by an increasing number of coexisting reproductive risk factors. Conclusions: These findings suggest an alignment between mental and reproductive health risk and support the value of cross-domain collaboration in adolescent health. The association between psychopathology and reproductive health risk, as well as its variations with age, sex, and associated risk behaviours, should be considered when designing health-promoting or disease-preventing interventions for adolescents.

Se analiza la iniciación sexual en la adolescencia de mujeres uruguayas menores de 24 años a través de un modelo multinomial logit, donde las alternativas son no iniciarse sexualmente, iniciarse sin utilizar un método anticonceptivo o iniciarse utilizando algún método. En primer lugar, el nivel educativo impacta fuertemente en la probabilidad de iniciarse con el uso de métodos anticonceptivos. En segundo lugar, la información sobre los métodos obtenida en el sistema educativo reduce sustancialmente la probabilidad de iniciarse sin utilizarlos, a la vez que la obtenida en el sistema de salud, a pesar de poder estar sesgada por problemas de endogeneidad, es efectiva en la medida que las mujeres que la obtienen aumentan la probabilidad de iniciarse utilizando métodos anticonceptivos. En tercer lugar, se encuentra trasmisión intergeneracional de conductas. Las hijas de madre que lo fueron por primera vez en la adolescencia, tienen menor probabilidad de no iniciarse, mientras que las hijas de madres más educadas es menos probable que se inicien sin utilizar métodos.

Objective-This study used matched samples from schools in the states of Victoria, Australia and Washington, United States (US), to compare sexual behaviour in early adolescence. It was hypothesised that the contrasting dominant policy objectives of harm minimisation in Australia and abstinence in the US would result in state differences for markers of sexual risk, mirroring prior cross-national findings in substance use. Method-A two-stage cluster sampling approach was used to recruit students from the two states. Self-reported sexual behaviour was examined for 1,596 students in annual surveys from Grade 7 in 2002 to Grade 9 in 2004. Prevalence estimates were derived for each measure of sexual behaviour, and comparisons were made between gender groups in each state. Results-State differences were found for girls' first sex, with significantly more girls in Washington than Victoria having had sex by Grade 7. By Grade 9, significantly more girls in Victoria reported sex in the last year and more sexual partners than girls in Washington. A large proportion of Grade 9 students across both states reported inconsistent contraception use. Conclusions-Contradicting the abstinence policy objective, first sex by Grade 7 was more prevalent in Washington than Victoria. Whilst sexual behaviour was more prevalent in Grade 9 in Victoria, the sexually active showed no clear cross-national differences in markers of risk such as contraception use and pregnancy outcomes. Findings demonstrate few cross-national differences in adolescent sexual behaviour despite the different policy contexts of Victoria, Australia and Washington, US.

Resumo: O objetivo do presente estudo foi avaliar a idade de início das atividades sexuais e fatores associados em adolescentes. Realizou-se estudo transversal em uma amostra representativa de adolescentes de 15 a 18 anos residentes na cidade de Pelotas. Sortearam-se, aleatoriamente, 90 setores a partir de 448 setores censitários, em cada setor foram visitados 86 domicílios. Os adolescentes respondiam a um questionário auto-aplicado e anônimo contendo questões sobre nível socioeconômico, sexo, escolaridade do adolescente e dos pais, idade, religião, morar com os pais, trabalho remunerado, uso de drogas, tabagismo, consumo de álcool e comportamento sexual. A iniciação sexual foi avaliada através da idade da primeira relação. A mediana da idade da primeira relação sexual foi calculada usando-se tabelas de sobrevida, e as medianas foram comparadas através do long rank teste e na análise multivariada utilizou-se a regressão de Cox. Foram entrevistados 960 adolescentes. A mediana da idade da primeira relação sexual foi de 16,7 anos. O risco de ter iniciação sexual em uma idade mais jovem foi maior entre os homens, assim como naqueles adolescentes que não residem com a mãe ou com o pai. O mesmo ocorreu com os jovens que não possuem trabalho remunerado, não praticam sua religiosidade, consumiram bebida alcoólica ou tabaco no último mês e carregaram arma nos últimos 12 meses. A idade da primeira relação sexual foi menor entre os adolescentes fumantes e consumidores de maconha, cocaína ou bebidas alcoólicas. A iniciação sexual é menor entre os adolescentes usuários de tabaco ou outras substâncias psicoativas, o que sugere que os comportamentos em saúde estão interrelacionados.

Background: Reproductive and mental health are key domains of adolescent wellbeing but possible interrelationships are poorly understood. This cross-sectional study evaluated the association between psychopathology and reproductive health risk among European adolescents. Methods: A structured self-report questionnaire was delivered to 12,395 pupils of 179 randomly selected schools in 11 European countries within the EU funded "Saving and Empowering Young Lives in Europe" (SEYLE) project. The questionnaire included items about sexual initiation and reproductive health risk factors, such as number of sexual partners, frequency of condom use, and pregnancy involvement. Psychopathology was evaluated with validated instruments and/or ad-hoc questions. Results: Of 11,406 respondents (median age 15; interquartile range [IQR] 14-15; 57% females), 18.8% reported sexual initiation. Sixty percent of them also reported at least one reproductive risk factor. Sexual initiation was significantly more common among pupils older than 15 years (38% versus 13.2% younger pupils) and males (21.3% versus 16.9% females). It was also more common among pupils with depression (age/sex-adjusted odds ratio [aOR] 1.871), anxiety (aOR 2.190), severe suicidal ideation (aOR 2.259), self-injurious behaviour (aOR 2.892), and suicide attempts (aOR 3.091). These associations were particularly strong among pupils ≤15 years old and, for overt psychopathology, among pupils with low non-sexual risk behaviour profile and females. Depression (aOR 1.937), anxiety (aOR 2.282), severe suicidal ideation (aOR 2.354), self-injurious behaviour (aOR 3.022), and suicide attempts (aOR 3.284) were associated with higher reproductive health risk, defined by an increasing number of coexisting reproductive risk factors. Conclusions: These findings suggest an alignment between mental and reproductive health risk and support the value of cross-domain collaboration in adolescent health. The association between psychopathology and reproductive health risk, as well as its variations with age, sex, and associated risk behaviours, should be considered when designing health-promoting or disease-preventing interventions for adolescents.

Jak smakuje zakazany owoc, kiedy jest się jeszcze dzieckiem? I jaki ma kolor? A zapach? Czy grzechy popełniają tylko niegrzeczne dziewczynki? Czy można przekroczyć tabu i pozostać nadal niewinnym? Jakie niebezpieczeństwa czają się w dziecięcych zabawach? I czy w sielskiej krainie dzieciństwa - pełnej synestezyjnych obrazów, dźwięków, smaków, dotyków i zapachów – możliwa jest inicjacja seksualna małej dziewczynki? Na te oraz inne pytania będę się starała odpowiedzieć w szkicu, którego celem jest analiza literaturoznawcza dwóch krótkich form prozatorskich, czyli opowiadań: Ingi Iwasiów "Smaki i dotyki" oraz Krystyny Kofty "Diabeł stróż grzesznej dziewczynki". Oba teksty starają się przywołać dziecięce wspomnienia, które zabarwiają życie seksualne dorosłych już bohaterek, oraz zwerbalizować zmysłowość tych pierwszych, nieśmiałych doznań; doścignąć ich świeżość i transgresyjną dziewiczość balansującą na granicy dzieciństwa i dorosłości.

Se analiza la iniciación sexual en la adolescencia de mujeres uruguayas menores de 24 años a través de un modelo multinomial logit, donde las alternativas son no iniciarse sexualmente, iniciarse sin utilizar un método anticonceptivo o iniciarse utilizando algún método. En primer lugar, el nivel educativo impacta fuertemente en la probabilidad de iniciarse con el uso de métodos anticonceptivos. En segundo lugar, la información sobre los métodos obtenida en el sistema educativo reduce sustancialmente la probabilidad de iniciarse sin utilizarlos, a la vez que la obtenida en el sistema de salud, a pesar de poder estar sesgada por problemas de endogeneidad, es efectiva en la medida que las mujeres que la obtienen aumentan la probabilidad de iniciarse utilizando métodos anticonceptivos. En tercer lugar, se encuentra trasmisión intergeneracional de conductas. Las hijas de madre que lo fueron por primera vez en la adolescencia, tienen menor probabilidad de no iniciarse, mientras que las hijas de madres más educadas es menos probable que se inicien sin utilizar métodos.

Koncepcja nie została zbudowana na założeniach lecz jest wynikiem obserwacji. W największym możliwym skrócie idea wychowania seksualnego i inicjacji seksualnej dzieci wśród opiekunów/rodziców jest następująca. KAŻDE PIERWSZE DOŚWIADCZENIE JEST NAJWAŻNIEJSZE NIEZALEŻNIE OD TEGO CZEGO ONO DOTYCZY! DLATEGO MUSI BYĆ NIESKAZITELNE I ABSOLUTNIE DOSKONAŁE. A. Podstawowe obserwacje stanowiące podstawą całej koncepcji: 1 Wiedzę zdobywamy przez obserwowanie, naśladowanie i doświadczanie z autorytetami. 2 Najbardziej zaufanymi i pierwszymi autorytetami są dla dziecka jego opiekunowie ponieważ karmią i ubierają zapewniając w ten sposób dzicku poczucie bezpieczeństwa. 3 Opiekunowie/rodzice są dla dziecka źródłem pierwszych wzorców zachowań oraz są pierwszymi wzorcami relacji miedzy kobietą i mężczyzną. 4 Każde pierwsze doświadczenie jest najważniejsze gdyż staje się wzorcem, punktem odniesienia dla doświadczeń następnych tego samego rodzaju. 5 Jeżeli opiekunowie zakazują dziecku czegoś czego sami doświadczają to ograniczają dziecku dostęp do wiedzy, ograniczają jego poznanie niezależnie od tego czego doświadczenie dotyczy. 6 Zakaz (ograniczanie dziecku dostępu do wiedzy) jest najprostszą formą poniżania dziecka przez opiekuna (przemoc), gdyż oznacza, że opiekun traktuje dziecko jako kogoś od siebie odmiennego, kogoś gorszego, kogoś, kto jest niegodnym zakazanego poznania. 7 Zakaz ustanawiany przez opiekuna jest przemocą doświadczaną przez dziecko i jako taki staje się dla dziecka wzorcem! (zakaz/przemoc staje się wzorcem, gdyż zostaje zaakceptowany jako pożądane zachowanie) zachowań w stosunku do

Objective: To evaluate whether parents-adolescents relationships were associated with early sexual debut and having multiple partners, risk factors for sexually transmitted infections, in a low socioeconomic suburb in Mexico City.
Methods: Nine hundred thirty six participants, aged 20-30, responded to an anonymous questionnaire about sexual activity and relationships with parents during adolescence. Logistic regression was conducted.
Results: The majority of participants reported being sexually active (78.3%). Among them, 70% of males and 55% of females had first sex before age 18. Good communication with parents during adolescence was inversely associated with sexual debut <18 (OR=0.40; CI95% 0.30-0.53) and with having >2 sexual partners (OR=0.47; IC95% 0.33-0.68). Sexual debut <18 was positively associated with having had multiple partners (OR=6.69; IC95% 4.64-9.65).
Conclusion: Good parental communication during adolescence may help prevent adolescents from choosing early sexual debut and having multiple partners and, consequently, from acquiring HIV and other STIs. Efforts are necessary to support parents in their relationship with their adolescent children.

Eritsyan K., Odinokova V., Kolpakova O., Marudova N., Rusakova M. Early sex debut and substance use among young people at high risk of getting HIV and associated infections in three European countries//Сборник тезисов Пятой конференции по ВИЧ/СПИДу в Восточной Европе и Центральной Азии, 23-25 марта 2016; под ред. Лиознова Д.А, Карнауховой Е.Ю. г Москва, 2016; с 311.

INTRODUCTION:
In Eastern Europe HIV and associated infections (AI) present a significant threat for young people. Available data suggest
that the current trend in those countries might be an increasing of the role of sexual route of HIV transmission. However,
there is clear lack of the data regarding sexual behavior among young people in different Eastern European countries.
RESEARCH PURPOSE:
In this study we aimed to describe the sexual activity patterns among the youth from high risk groups including prevalence
and correlates of sexual debut at early age.
MATERIALS AND METHODS:
A total of 1596 participants aged 15–24 were enrolled in the study in three countries: Russia (Saint-Petersburg and Kaliningrad),
Latvia (Riga) and Warshaw (Poland) in Spring, 2014. Data were collected by group-administered questionnaires at
educational institutions which according to the regional experts are more popular among who are at greater risk of getting
HIV and AI due to their behavior or unfavorable social circumstances. Logistic regression modeling was used to find
significant predictors and outcomes of sexual debut before the age of 15.
RESULTS:
Sex debut before the age of 15 was reported by 8.2% of female and 17.6% of males. Early sex debut was associated with
male gender (p ≤ 0.001), living in Russia (Kaliningrad [p ≤ 0.05] or St.Petersburg [p ≤ 0.001]), being brought up at an orphanage
or other place other than family (p ≤ 0.01), experience of drug use earlier or at the time of sexual debut (p ≤ 0.01) and
early age of first alcohol intake (p ≤ 0.05). Our data have showed that first sexual experience if takes place early has much
more chances to be unprotected (p ≤ 0.01) and happen under influence of drugs (p ≤ 0.001). In long-term perspective
early sex debut in this study was independently linked with not consistent condom use (p ≤ 0.01) and having multiply sex
partners (p ≤ 0.01).
FINDINGS:
Study results might have important policy implications in terms of primary prevention programming in European region.
First our data suggest the need for special attention to a group of young people: increasing the age of sexual debut should
be one of public health priority since it’s associated with significant immediate and postponed risks. However this data argument
also for introducing adequate sex education interventions for adolescents before the age of sexual activity onset.
Great significant association between protection pattern of first and most recent sexual contact was found in this study.
We tend to interpret this association as a result of attitude towards condom use which was formed before the sexual initiation.
Second important implication follows from the close association of sexual risk behavior and substance use. There
is a clear need to link the prevention efforts aimed on reducing of drug experimenting and those focused on sexual risk
behaviors which are usually run separately.

Introduction: Sexually transmitted infections and unplanned pregnancies affect adolescent sexual health and are serious public health concerns. They result from sexual intercourse in adolescence, which is usually associated with multiple partners, unprotected sex, and condom misuse. This behavior is related to socio-ecological factors that influence lifestyles. The YOURLIFE project aims to find out what young people think and feel about relationships, love, and sexuality, and to assess the associations between these thoughts and attitudes, adolescents' social factors, and sexual health.

Purpose: Adolescents who engage in sex can be affected by a range of negative physical and psychological consequences. We intend to analyze the reasons behind first sex, regret, and the association between reasons and regret. Methods: A questionnaire was implemented to 8495 high schools students, aged 14-18, in the Philippines, El Salvador and Peru. Sexually active participants responded whether several circumstances were reasons involved in their first sexual relationship. They also responded whether they regretted having already had sexual relationships. Results: More than a third of respondents reported at least one external pressure leading to first sex, and about half reported at least one reason implying getting carried away by sexual arousal. More females affirmed they regret having already had sex. Logistic regression shows that reasons for first sex associated with regret were partner insistence, "uncontrolled situations" and seeing sexual images. These reasons were associated with regret even when love was also reported as related to first sex. Conclusions: Adolescent sexual experience is often motivated by pressure and circumstances that lower the control over their decisions concerning sex, such as external pressure (because most friends already had sex or because of partner insistence) or getting carried away by sexual arousal (through an "uncontrolled situation" or viewing sexual images) rather than by mature decisions, and this may result in later regret. Adolescents should be helped by parents, educators and policy makers to be aware of these characteristics of adolescent sex and empowered to make assertive and informed decisions concerning their sexuality.