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Factors Associated With Early Sexual Experience Among American Indian and Alaska Native Youth

      Abstract

      Purpose

      American Indian and Alaska Native (AI/AN) youth experience disparities associated with sexual and reproductive health, including early age of sexual initiation. Identifying factors that are most proximally related to early sexual intercourse and that are modifiable through health promotion interventions may help to reduce these disparities. Using a multisystem approach, we assessed individual (biological, psychological, and behavioral), familial, and extrafamilial (peer behavioral) factors associated with lifetime sexual experience among AI/AN early adolescents living in three geographically dispersed U.S. regions.

      Methods

      We analyzed cross-sectional data from 537 AI/AN youth aged 12–14 years, recruited from 27 study sites in Alaska, Arizona, and the Pacific Northwest. We used multilevel logistic regression models to estimate associations between independent variables and lifetime sexual intercourse (oral and/or vaginal sex) individually, within discrete systems, and across systems.

      Results

      The analytical sample was 55.1% female, with a mean age of 13.2 years (standard deviation = 1.06 years); 6.5% were sexually experienced. In the final model, we found that lower next-year intentions to have oral or vaginal sex (psychological factors), avoidance of risky situations, and nonuse of alcohol (behavioral factors) were associated with lower odds of lifetime sexual intercourse (all p ≤ .01). No other variables were significantly associated with lifetime sexual intercourse.

      Conclusions

      Interventions that reduce sexual intentions, exposure to risky situations, and alcohol use may help to delay sexual initiation among AI/AN early adolescents.

      Keywords

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      References

        • Martin J.A.
        • Hamilton B.E.
        • Osterman M.J.
        • et al.
        Births: Final data for 2012.
        Natl Vital Stat Rep. 2013; 62: 1-68
        • Gavin L.E.
        • Warner L.S.
        • O'Neil M.E.
        • et al.
        Vital signs: Repeat births among teens—United States, 2007–2010.
        MMWR Morb Mortal Wkly Rep. 2013; 62: 249-255
        • Centers for Disease Control and Prevention and Indian Health Service
        Indian health surveillance report—sexually transmitted diseases 2011.
        U.S. Department of Health and Human Services, Atlanta, GAJune 2014
      1. Centers for Disease Control and Prevention. Youth risk behavior surveillance system (YRBSS). Youth online: High school YRBS. Available at: http://nccd.cdc.gov/youthonline/App/Default.aspx?SID=HS. Accessed July 15, 2014.

        • de Ravello L.
        • Everett Jones S.
        • Tulloch S.
        • et al.
        Substance use and sexual risk behaviors among AI/AN high school students.
        J Sch Health. 2014; 84: 25-32
        • Kaestle C.E.
        • Halpern C.T.
        • Miller W.C.
        • Ford C.A.
        Young age at first sexual intercourse and sexually transmitted infections in adolescents and young adults.
        Am J Epidemiol. 2005; 161: 774-780
        • O'Donnell L.
        • O'Donnell C.R.
        • Stueve A.
        Early sexual initiation and subsequent sex-related risks among urban minority youth: The reach for health study.
        Fam Plann Perspect. 2001; 3: 268-275
        • Flanigan C.M.
        Sexual activity among girls under age 15: Findings from the national survey of family growth.
        in: Albert B. Brown S. Flanigan C.M. 14 and Younger: The Sexual Behavior of Young Adolescents. National Campaign to Prevent Teen Pregnancy, Washington, DC2003: 57-64
        • Chewning B.
        • Douglas J.
        • Kokotailo P.K.
        • et al.
        Protective factors associated with American Indian adolescents' safer sexual patterns.
        Matern Child Health J. 2001; 5: 273-280
        • Hellerstedt W.
        • Peterson-Hickey M.
        • Rhodes K.L.
        • Garwick A.
        Environmental, social, and personal correlates of having ever had sexual intercourse among American Indian youths.
        Am J Public Health. 2006; 96: 2228-2234
        • Kaufman C.E.
        • Desserich J.
        • Big Crow C.K.
        • et al.
        Culture, context, and sexual risk among Northern Plains American Indian youth.
        Soc Sci Med. 2007; 64: 2152-2164
        • Palacios J.
        • Kennedy H.P.
        Reflections of Native American teen mothers.
        J Obstet Gynecol Neonatal Nurs. 2010; 39: 425-434
        • Mitchell C.M.
        • Rumbaugh Whitesell N.
        • Spicer P.
        • et al.
        • The Pathways of Choice and Healthy Ways Project Team
        Cumulative risk for early sexual initiation among American Indian youth: A discrete-time survival analysis.
        J Res Adol. 2007; 17: 387-412
        • Dailard C.
        Legislating against arousal: The growing divide between federal policy and teenage sexual behavior.
        Guttmacher Policy Rev. 2006; 9
        • Mitchell C.M.
        • Kaufman C.E.
        • The Pathways of Choice and Healthy Ways Project Team
        Structure of HIV knowledge, attitudes and behaviors among American Indian young adults.
        AIDS Educ Prev. 2002; 14: 419-431
        • Bronfrenbrenner U.
        Ecological systems theory.
        Ann Child Dev. 1989; 6: 187-249
        • Kotchick B.A.
        • Shaffer A.
        • Forehand R.
        Adolescent sexual risk behavior: A multi-system perspective.
        Clin Pscychol Rev. 2001; 4: 493-519
        • Shegog R.
        • Markham C.M.
        • the It's Your Game - AI/AN Collaborative Team
        Partnership to prevent teen pregnancy and HIV/STIs among AI/AN Youth: It's your Game…Keep it real.
        IHS Prim Care Provid. 2011; 36: 84-85
        • Centers for Disease Control and Prevention
        Methodology for the youth risk behavior surveillance system—2013.
        MMWR Recomm Rep. 2013; 62: 1-22
        • Prinstein M.J.
        • Boergers J.
        • Spirito A.
        • et al.
        Peer functioning, family dysfunction, and psychological symptoms in a risk factor model for adolescent inpatients' suicidal ideation severity.
        J Clin Child Psychol. 2000; 29: 392-405
        • Kaufman C.E.
        • Mitchell C.M.
        • Beals J.
        • et al.
        Circle of life: Rationale, design, and baseline results of a HIV prevention intervention among young American Indian adolescents of the Northern Plains.
        Prev Sci. 2010; 11: 101-112
        • Brown B.B.
        • Mounts N.
        • Lamborn D.
        • Steinberg L.
        Parenting practices and peer group affiliation in adolescence.
        Child Dev. 1993; 64: 467-482
        • Ball J.
        • Pelton J.
        • Forehand R.
        • et al.
        Methodological overview of the Parents Matter! Program.
        J Child Fam Stud. 2004; 13: 21-34
        • Tortolero S.R.
        • Markham C.M.
        • Peskin M.F.
        • et al.
        It's your Game, Keep It Real: Delaying sexual behavior with an effective middle school program.
        J Adolesc Health. 2010; 46: 169-179
        • Markham C.M.
        • Tortolero S.R.
        • Peskin M.F.
        • et al.
        Sexual risk avoidance and sexual risk reduction interventions for middle school youth: A randomized controlled trial.
        J Adolesc Health. 2012; 50: 279-288
      2. Qualtrics. Available at: http://www.qualtrics.com. Accessed July 23, 2014 .

        • Markham C.M.
        • Peskin M.F.
        • Addy R.C.
        • et al.
        Patterns of vaginal, oral, and anal sexual intercourse in an urban seventh grade population.
        J Sch Health. 2009; 79: 193-200
        • Buhi E.R.
        • Goodson P.
        Predictors of adolescent sexual behavior and intention: A theory-guided systematic review.
        J Adolesc Health. 2007; 40: 4-21
        • Hosmer D.
        • Lemeshow S.
        Applied logistic regression.
        John Wiley & Sons, Inc, Hoboken, NJ2000
        • Markham C.M.
        • Lormand D.
        • Gloppen K.
        • et al.
        Connectedness as a predictor of sexual and reproductive health outcomes for youth.
        J Adolesc Health. 2010; 46: S23-41
        • Kaufman C.E.
        • Rumbaugh Whitesell N.
        • Keane E.
        • et al.
        Effectiveness of circle of life, an HIV-preventive intervention for American Indian middle school youths: A group randomized trial in a Northern Plains tribe.
        Am J Public Health. 2014; 104: e106-e112
        • Fishbein M.
        • Yzer M.C.
        Using theory to design effective health behavior interventions.
        Commun Theor. 2003; 13: 164-183
        • Coyle K.K.
        • Kirby D.B.
        • Marin B.
        • et al.
        Draw the line/respect the line: A randomized trial of a middle school intervention to reduce sexual risk behaviors.
        Am J Public Health. 2004; 94: 843-851
        • Jemmott J.B.
        • Jemmott L.S.
        • Fong G.T.
        Efficacy of a theory-based abstinence-only intervention over 24 months: A randomized controlled trial with young adolescents.
        Arch Peds Adol Med. 2010; 164: 152-159
        • Kreuter M.W.
        • Oswald D.L.
        • Bull F.C.
        • Clark E.M.
        Are tailored health education materials always more effective than non-tailored materials?.
        Health Educ Res. 2000; 15: 305-315
        • Smith M.U.
        • Craig Rushing S.
        • the Native STAND Curriculum Development Group
        Native STAND (Students Together Against Negative Decisions): Evaluating a school-based sexual risk reduction intervention in Indian boarding schools.
        Health Educ Monogr Ser. 2011; 28: 67-74
        • Morrison-Beedy D.
        • Carey M.
        • Tu X.
        Accuracy of audio computer-assisted self-interviewing (ACASI) and self-administered questionnaires for the assessment of sexual behavior.
        AIDS Behav. 2006; 10: 541-552
        • Venable P.
        • Carey M.
        • Brown J.
        • et al.
        Test–retest reliability of self-reported HIV/STD-related measures among African-American adolescents in four U.S. cities.
        J Adolesc Health. 2009; 44: 214-221