Study Objective

To describe sexual initiation patterns in female adolescents and examine their association with adolescent characteristics and racial disparities in adverse sexual health across adolescence into early adulthood.

Design

A prospective, longitudinal, observational study from adolescence to adulthood.

Setting

Nationally representative, the National Longitudinal Study of Adolescent to Adult Health data, in the range of 24-32 years old at final assessment.

Participants

Data from 43,577 US women from 1994 to 2008.

Interventions and Main Outcome Measures

Adolescent sex-related characteristics at the individual-, family-, and school peer-level were assessed, and multiple sex partners, sexually transmitted infections (STIs)/HIV, and intimate partner violence (IPV) were longitudinally tracked. The sexual initiation pattern and its longitudinal association with sexual health were analyzed using latent class analysis and mixed effects Poisson regression models.

Results

Of the 43,577 subjects, the sexual initiation patterns were determined as normative (n = 28,712, 65.9%), late (n = 10,799, 24.8%), and early but unempowered (n = 4,066, 9.3%). The highest rate of the early-unempowered group was shown in Hispanic individuals (1,054/7,307 = 14.4%); they were more likely to be depressed, unsatisfied with their bodies, receiving welfare, and have less educated/permissive parents to their sexual initiation than others. The late group had a higher body mass index and greater satisfaction with their bodies. The highest number of STIs/HIV and IPV victimization was shown in non-Hispanic Black (NHB) and Hispanic individuals, respectively. However, NHB females’ higher number of STIs/HIV was shown in the late/normative groups, not in the early-unempowered group. Among Hispanic females, adolescent sexual initiation patterns were not directly associated with their frequent IPV victimization.

Conclusion

NHB females' higher STI/HIV in late/normative groups and Hispanic females’ frequent IPV victimization regardless of their sexual initiation patterns might indicate that racial/ethnic disparities in female sexual health was not directly determined by adolescent risk behaviors.

中文翻译：

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从青春期到青年期女性性健康的种族/族裔差异：青春期特征有多重要？

学习目标

描述女性青少年的性启动模式，并检查它们与青春期到成年早期不良性健康的青少年特征和种族差异的关联。

设计

一项从青春期到成年的前瞻性、纵向、观察性研究。

环境

具有全国代表性的全国青少年到成人健康纵向研究数据，最终评估的年龄范围为 24-32 岁。

参与者

从 1994 年到 2008 年，来自 43,577 名美国女性的数据。

干预措施和主要结果措施

评估了个人、家庭和学校同龄人的青少年性相关特征，并纵向跟踪了多个性伴侣、性传播感染 (STI)/HIV 和亲密伴侣暴力 (IPV)。使用潜在类别分析和混合效应泊松回归模型分析性启动模式及其与性健康的纵向关联。

结果

在 43,577 名受试者中，性开始模式被确定为正常（n = 28,712, 65.9%）、晚期（n = 10,799, 24.8%）和早期但未授权（n = 4,066, 9.3%）。西班牙裔个体中早期未赋权组的比率最高（1,054/7,307 = 14.4%）；与其他人相比，他们更容易抑郁、对自己的身体不满意、接受福利，并且父母受教育程度较低/对他们的性启蒙更宽容。晚期组的体重指数更高，对身体的满意度更高。分别在非西班牙裔黑人 (NHB) 和西班牙裔个体中显示最高数量的 STI/HIV 和 IPV 受害。然而，NHB 女性的性传播感染/HIV 数量较多显示在晚期/规范组中，而不是在早期未授权组中。在西班牙裔女性中，

结论

NHB 女性在晚期/规范组中较高的 STI/HIV 和西班牙裔女性频繁的 IPV 受害，无论她们的性开始模式如何，这可能表明女性性健康中的种族/民族差异并不是由青少年危险行为直接决定的。