The publisher's final edited version of this article is available at J Sch Health See other articles in PMC that cite the published article. Such data are limited for early adolescents. These findings have implications for early adolescent school-based sexual health education. In , births to mothers aged years increased for the first time since the early s.
However, public sensitivity regarding sexual behavior surveys among early adolescents, particularly in public school settings, has impeded this research. Active parental consent is typically required, and parents and school administrators may be reluctant to expose students to explicit questions regarding sexual behavior, particularly those regarding oral and anal sex. Of those students, between 3. Previous studies among older adolescents report contrasting findings regarding the sequence of sexual initiation.
Several studies among 9th- and 10th-grade students indicate earlier initiation of oral sex compared to vaginal sex. Given this lack of detailed information, further epidemiological studies examining sexual behavior among middle school youth are needed to help prioritize effective sexual health education efforts.
The goals of the present study were to 1 examine the prevalence of vaginal, oral, and anal intercourse among a population of urban, public middle school seventh-grade students; 2 to examine the demographic characteristics of those youth who engaged in each type of sexual intercourse, and 3 to examine the sequence of initiation of the 3 types of sexual intercourse.
This information may help to prioritize needs for middle school sexual health education to prevent or mitigate the consequences of early sexual initiation among potentially high-risk youth populations. A total of eighty-nine percent of students were eligible for free or reduced-price lunches, an indicator of low socioeconomic status. Parental consents were returned by Students classified by the school as learning disabled or as having limited English proficiency ie, had their primary instruction in Spanish were excluded from the study sample, leaving youth eligible for participation.
Reasons for nonparticipation included being absent on survey dates or refusal to participate. Data were collected between November and January ; student consent was obtained at the time of the survey. Measures The survey contained multiple items addressing precoital behavior, sexual intercourse, and demographic characteristics.
To mitigate concerns from parents and school personnel regarding exposure of nonsexually experienced seventh-grade students to explicit questions regarding vaginal, oral, and anal sex, 2 precoital items were used to identify and screen for nonsexually experienced youth.
Thus, the precoital items appeared to provide a valid and reliable strategy for avoiding overexposure to sensitive content in this age-group while collecting important information from those youth who were sexually experienced. Only students who indicated participation in 1 or both of these precoital behaviors received items regarding sexual intercourse.
Sexual Intercourse Three sets of questions were used to assess engagement in vaginal, oral, and anal intercourse, each prefaced by a specific definition: For vaginal and anal sex, students who reported being currently sexually active were also asked about the frequency of intercourse without a condom during the past 3 months. Unfortunately, due to the need to limit the number of items, questions regarding condom use during oral sex were not included.
Age was dichotomized as 12 years versus years since the majority of students were 12 years old. Family structure was collapsed into 4 categories: Procedures Surveys were administered on laptop computers via audio computer-assisted self-interview ACASI during regular school hours.
Surveys were conducted in a quiet location such as an empty classroom or library. The use of ACASI systems has been found to be a valid and reliable method for obtaining sensitive information, including sexual risk-taking behavior, as it appears to increase the honesty of reporting over pencil-paper surveys.
It also allowed for an automatic skipping procedure to limit exposure of nonsexually experienced students to sexually explicit items. Analytic Procedures Prior to analysis, 5 students were removed from the data set due to missing data regarding lifetime intercourse, and 23 students were removed due to small counts for a specific age ages 11, 15, and 16 leaving a total sample of for analysis.
Prevalence estimates of condom use for vaginal and anal sex were computed only for students who were currently sexually active ie, reported having sex in the past 3 months. Multivariate logistic regression analysis was used to examine associations between demographic variables and lifetime intercourse experience. Among students who had initiated more than 1 type of intercourse, frequencies were calculated to examine the relative age of initiation for each type of sex ie, whether a specific type of sex was initiated at a younger age, the same age, or an older age relative to the other type of intercourse.