Christine E. Kaestle

Sexual intercourse and the age difference between adolescent females and their romantic partners.

CONTEXT The age difference between a female and her partner may influence relationship dynamics in ways that put the female at increased risk of unintended pregnancies and sexually transmitted diseases. Very little is known, however, about how romantic involvement progresses to intercourse, particularly among adolescent females with older male partners. METHODS Data from 1,975 female participants in the National Longitudinal Study of Adolescent Health were analyzed using logistic regression to determine whether the age difference between an adolescent female and her romantic partner is a risk factor for sexual intercourse. RESULTS Adolescent females involved with an older partner have higher odds of having intercourse with that partner than females with partners their own age, after adjustment for demographic covariates. The magnitude of this association is most dramatic among the youngest females--for example, the odds of intercourse among 13-year-old females with a partner six years older are more than six times the odds among 13-year-old females with a same-age partner (odds ratio, 6.4), while 17-year-old females with partners six years older have about twice the odds of intercourse when compared with those who have a same-age partner (2.1). CONCLUSIONS Young adolescent females with substantially older partners are much more likely than their peers to have sex with their partner, which exposes them to the risks of pregnancy and sexually transmitted diseases.

Perceived Physical Maturity, Age of Romantic Partner, and Adolescent Risk Behavior

Early pubertal timing and advanced physical maturity for age confer elevated risk for problem behaviors for both boys and girls. However, examinations of possible biological and social mediators have been limited. Using more than 4,000 adolescents under age 15 who participated in Waves I and II of the National Longitudinal Study of Adolescent Health (Add Health), we examined the relationship between perceived physical maturity and membership in risk behavior clusters, and tested whether having a romantic partner mediates the maturity/risk behavior relationship. Results of multinomial regression models indicated that for both boys and girls, advanced physical maturity was associated with membership in higher risk clusters, and that having a romantic partner plays an important mediating role in this association. For females, the additional impact of having an older partner, versus any partner at all, was substantial and particularly important for the highest risk clusters. The role of partner age could not be tested for males. Because romantic partners elevate risk for young adolescent males and females, there is a need to identify and understand facets and developmental functions of adolescent romantic relationships that play a role in substance use and sexual decisions.

The Role of Masturbation in Healthy Sexual Development: Perceptions of Young Adults

Despite efforts to identify masturbation as a strategy to improve sexual health, promote relational intimacy, and reduce unwanted pregnancy, STIs, and HIV transmission, masturbation as a context for healthy sexual development has been met with silence or trepidation in the scientific and educational communities. Relegated to the realm of commercial media, rather than rational discourse in families, schools, and the general public, young people receive mixed messages about this non-reproductive sexual behavior. In order to explore how young adults have learned about masturbation and currently perceive masturbation, we conducted a grounded theory study of 72 college students (56 females; 16 males) enrolled in a human sexuality class. Findings revealed that a young adult’s perceptions of and feelings toward masturbation were the result of a developmental process that included: (1) learning about the act of masturbation and how to do it, (2) learning and internalizing the social contradiction of stigma and taboo surrounding this pleasurable act, and (3) coming to terms with this tension between stigma and pleasure. Although nearly all participants learned about masturbation through the media and peers (not parents or teachers), gender was salient in coming to terms with the contradiction of stigma and pleasure. Most of the women reported either still struggling with the contradiction or accepting it as normal. Most of the men recognized the beneficial aspects for healthy sexual development that result from masturbation. Both male and female participants identified differential sexual scripts as contributing to the double standard.

A Forgotten Sexuality: Content Analysis of Bisexuality in the Medical Literature over Two Decades

The authors conducted a content analysis of articles listed in PubMed on bisexual health (N = 348). Methodological approaches favored cross-sectional surveys. Fewer than 20% of the articles analyzed data for bisexuals separately; most combined their data with homosexual participants. Most articles used convenience samples with poor representation of women, socioeconomic status and minorities. One fifth of the articles framed bisexuals as an infection bridge, whereas about one sixth framed bisexuality as a legitimate identity. More than 90% of the bisexuality medical research was atheoretical. To address health inequities, further study is required on the needs of this forgotten minority group.

Selling and Buying Sex: A Longitudinal Study of Risk and Protective Factors in Adolescence

Engaging in trading sex is associated with many co-occurring problems, including elevated risk for sexually transmitted infections. Various dimensions of social support from parents, schools, and mentors may be protective against sex trading and may ameliorate the impact of risk factors. This study analyzes data from respondents to Waves I and III of the National Longitudinal Study of Adolescent Health (Add Health) who had not participated in sex trading for money or drugs in Wave I so that risk and protective factors for first initiations of selling or buying sex could be examined longitudinally. About 2% of the study sample began selling sex and about 2% began buying sex between Wave I and Wave III. The respondent’s sex, race/ethnicity, history of sexual abuse, shoplifting, marijuana use, and experiences of homelessness or running away were significant predictors of trading sex (p < 0.05). Being happy at school was associated with lower selling of sex, and feeling part of school was associated with lower buying of sex even after controlling for demographics and risk factors (p < 0.05). Results indicate a need for early intervention for youth who experience sexual abuse or running away. Elements of school connectedness have a protective effect on selling and buying sex. Promoting school connectedness may advance public health goals.

Sexual Insistence and Disliked Sexual Activities In Young Adulthood: Differences by Gender And Relationship Characteristics

RESULTS: Seven percent of men and 8% of women had had unwanted sex at their partner’s insistence. A signifi cantly greater proportion of women than of men (12% vs. 3%) had engaged repeatedly in sexual activities they disliked, primarily fellatio and anal sex. Relationship characteristics were associated with sexual insistence, but gender was not. For example, female respondents who reported unreciprocated love for their partner had higher odds of reporting sexual insistence perpetration than those who reported that they and their partner loved each other (odds ratio, 3.9). Females were more likely than males to report repeated participation in disliked sexual activities (3.7); relationship characteristics were relatively unimportant for this outcome. CONCLUSIONS: Young adults of both genders may need education on the importance of accepting a partner’s sexual desires and being sensitive to both a partner’s unwillingness to engage in an activity and the true extent of a partner’s dislike of certain activities. They may also need guidance on how to voice their own preferences and dislikes.

Targeting High-Risk Neighborhoods for Tobacco Prevention Education in Schools

OBJECTIVES We examined whether individual and neighborhood characteristics associated with smoking were also predictive of exposure to smoking prevention education in schools, to determine whether education programs were targeted appropriately to reach neighborhoods with the greatest need. METHODS We merged data from 2 sources-the 2005 Virginia Youth Tobacco Survey (n=2208) and the Census 2000 School District Demographics Project-and used binary multilevel models with random effects to determine whether the same demographic characteristics and neighborhood characteristics predicted both adolescent smoking and exposure to prevention programs. RESULTS We found that although light, medium, and heavy smoking rates were higher in neighborhoods of lower socioeconomic status (relative risk ratio=1.49, 1.36, and 1.65, respectively), prevention programs were less available in those areas (odds ratio=0.82). CONCLUSIONS Our study indicates that school prevention programs are not being effectively targeted and that more effective ways to reach high-risk and disadvantaged neighborhoods are needed.

More Than Just a Punctuation Mark: How Boys and Young Men Learn About Menstruation:

Parents, peers, schools, and the media are the primary contexts for educating young people about sexuality. Yet girls receive more sex education than boys, particularly in terms of menstruation. Lack of attention to how and what boys learn about menstruation has consequences for their private understanding about the biology of reproduction and also for social and cultural ideologies of gendered relationships. In this qualitative study, 23 written narratives from male undergraduates (aged 18-24 years) were analyzed using grounded theory methodology to explore how young men perceive their past and present learning about this uniquely female experience. Findings suggest that most boys first learned about menstruation in their families, primarily through their sisters’ menarche; menstruation is experienced—in boyhood at least—as a gender wedge; and most men described a developmental process of moving from a childish attitude of menstruation as “gross” to seeing themselves as maturing through the experience of an intimate relationship.

How condom use, number of receptive anal intercourse partners and history of external genital warts predict risk for external anal warts.

Few analytic opportunities have allowed us to evaluate the role that specific sexual acts and male latex condoms play in the acquisition of external anal warts (EAW) using longitudinal data. The acquisition of EAWs occurs from epithelial contact with other HPV-infected surfaces, and hence is dependent upon sexual behaviour. Our objectives were to classify the relative importance of condom use, receptive anal intercourse (RAI) and prior history of EGWs on acquisition of EAWs. The observational Multicenter AIDS Cohort Study followed 2925 men over nine semiannual study visits for behavioural and physical examinations with laboratory testing. The main outcome measure was the occurrence of examiner-diagnosed EAWs in a homosexual population. EAWs were diagnosed among 10% of men studied across 22,157 visits reviewed for this study. Men with history of EGWs were more likely than those previously unaffected to have developed EAWs (cOR = 2.4 (2.0, 2.9)), as were men who reported multiple anoreceptive intercourse partners (e.g., compared with men who reported no RAI partners, men with 1, 2–5, ≥6 RAI partners had crude risk ratios 1.0 (0.8, 1.3), 1.6 (1.2, 2.1), 3.9 (2.7, 5.8), respectively). These relations persisted after other demographic and sexual risk factors were controlled for in the analyses. Consistent condom usage showed no protective effect for EAWs in our crude or adjusted analyses. Patient education messages should be tailored to reflect our uncertainty about the protective nature of condoms for the development of anal warts, but to continue to assert the protective effects of a limited lifetime number of sexual partners and the heightened risk for wart recurrence once infected.

How Girls and Boys Get Tobacco: Adults and Other Sources

This study of current tobacco users from the 2005 Virginia Youth Tobacco Survey (N = 426) finds that girls were significantly more likely to receive cigarettes for free, particularly from adults, and were also more likely to receive cigars or cigarillos for free, but were more likely to buy smokeless tobacco from a store compared to boys.