Factors associated with early sexual initiation and unsafe sex in adolescents: Substance use and parenting style

• Published in: Journal of adolescence (London, England.) England.), 2020-02, Vol.79 (1), p.128-135
• Main Authors: Reis, Larissa F., Surkan, Pamela J., Valente, Juliana Y., Bertolla, Marcia H.S.M., Sanchez, Zila M.
• Format: Article
• Language: English
• Subjects: Adolescence; Adolescent mothers; Adolescents; Alcohol; Birth control; Boys; Childrearing practices; Disease control; Disease prevention; Drug abuse; Drug use; Drugs; Girls; Households; Intimate partner violence; Marijuana; Parents & parenting; Reproductive health; Risk behavior; Risk factors; Safer sex; Sexual behavior; Sexual intercourse; Sexuality; Sexually transmitted diseases; STD; Substance abuse; Teenagers; Unwanted pregnancy; Youth
• ISSN: 0140-1971; 1095-9254
• DOI: 10.1016/j.adolescence.2019.12.015

Early sexual initiation is an important risk factor for later drug use (Sandfort, Orr, Hirsch, & Santelli, 2008), delinquency (Moilanen, 2015), intimate partner violence (Halpern, Spriggs, Martin, & Kupper, 2009), depression, anxiety and eating disorders (Skolnik et al., 2019; Vasilenko, Kugler, & Rice, 2016). Early sexual initiation is also associated with unsafe sex (Kaplan, Jones, Olson, & Yunzal-Butler, 2013) and youth who engage in early sexual activity are more likely to have multiple partners (Sandfort, Orr, Hirsch, & Santelli, 2008). These behaviors can result in higher risk of sexually transmitted diseases (STDs) (WHO - world health organization, 2016), unplanned pregnancies (Ramiro et al., 2015) and abortions (Sedgh, Finer, Bankole, Eilers, & Singh, 2015). Because youth less than 16 years old are less likely to use or have access to contraception, they are at a high risk for STDs and unintended pregnancy (Mathews et al., 2009). Global research on sexual and reproductive health indicates that the prevalence of sexual activity varies markedly between boys and girls and across countries (Avery & Lazdane, 2010; Centers for Disease Control and Prevention, 2014). In 2015, a national survey in Brazil found that 34.5% of boys and 19.3% of girls between ages 13 and 15 had engaged in sexual intercourse. Younger adolescents are also at higher risk for unsafe sex at first sexual intercourse compared to older adolescents; In Brazil, condom use was less prevalent among adolescents aged 13 and 15 (59.7%) when compared to 16 and 17 year old adolescents (68.2%) (National Survey of School Health; PENSE) (IBGE, 2016). Unsafe sex is also more frequent among Brazilian adolescents from households with few socio-economic assets (Oliveira-Campos, Giatti, Malta, & Barreto, 2013). Both substance use and parenting styles influence early sexual initiation. US studies show that alcohol, tobacco and marijuana use were associated with sexual activity at the age of 15 (Connell, Gilreath, & Hansen, 2009). At the same time, research suggests adolescents with authoritative mothers are less likely to have had sexual intercourse when compared to adolescents with any other parenting style (Pittman & Chase-Lansdale, 2001). However, few studies have examined these risk behaviors in the Brazilian context where norms around parenting and drug use may be distinct or have examined the combined effects of these risk factors on sexual risk behaviors. Therefore, we aimed to investigate how su