Purpose

This study aimed to investigate the regional and sex differences in the prevalence of early sexual initiation and its correlates among school-going adolescents in 50 countries.

Methods

We used data from the Global School-based Health Survey from 50 countries in 2009–2015 for 124,091 adolescents (53.5% girls) aged 12–15 years. Using meta-analysis with random effects, we estimated the prevalence of early sexual initiation (i.e., having first sexual intercourse at ≤14 years) by sex, region, and country income classification. Multilevel mixed-effect logistic regressions including a random intercept for countries were used to investigate the correlates of early sexual initiation.

Results

Overall, 14.2% (95% confidence interval: 12.1–16.2) of adolescents aged 12–15 years had early sexual initiation, with boys reporting much higher than girls (19.7%, 16.9–22.5 vs. 8.9%, 7.6–10.3). The prevalence of early sexual initiation was the highest in the region of the Americas (18.4%, 15.2–21.5) and the lowest in the South-east Asia region (5.3%, 2.6–8.0). Adolescents from high-income and lower middle-income countries had the highest (19.5%, 13.5–25.5) and the lowest (7.3%, 5.5–9.0) prevalence, respectively. Older age, anxiety, loneliness, suicidal ideation, being bullied, physical fight, school truancy, smoking, drinking alcohol, illicit drug use, physical activity, and being overweight were associated with higher odds of early sexual initiation, whereas female sex, parental monitoring, and peer support were protective. There was little or no evidence of heterogeneity by sex and across regions for these associations.

Conclusions

Substantial differences in the prevalence are observed by sex and across regions for early sexual initiation among adolescents, whereas its correlates remain relatively similar when examined separately by these characteristics.

中文翻译：

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50 个国家 12-15 岁青少年早期性行为发生率和相关性的区域和性别差异

目的

本研究旨在调查 50 个国家的在校青少年早期性行为发生率及其相关性的区域和性别差异。

方法

我们使用了来自 2009-2015 年 50 个国家的全球学校健康调查的数据，其中包括 124,091 名 12-15 岁的青少年（53.5% 为女孩）。使用具有随机效应的荟萃分析，我们按性别、地区和国家收入分类估计了早期性行为（即在≤14 岁时进行首次性交）的流行率。包括国家随机截距在内的多级混合效应逻辑回归用于调查早期性开始的相关性。

结果

总体而言，12-15 岁的青少年中有 14.2%（95% 置信区间：12.1-16.2）有过早的性行为，其中男孩报告的比例远高于女孩（19.7%，16.9-22.5 对 8.9%，7.6-10.3）。早期性行为的流行率在美洲地区最高（18.4%，15.2-21.5），在东南亚地区最低（5.3%，2.6-8.0）。来自高收入和中低收入国家的青少年的患病率分别最高（19.5%，13.5-25.5）和最低（7.3%，5.5-9.0）。年龄较大、焦虑、孤独、有自杀念头、被欺负、打架、逃学、吸烟、饮酒、非法吸毒、身体活动和超重与早期性行为的几率较高有关，而女性性行为、父母监护，同伴支持是保护性的。

结论

在青少年早期性开始的性别和地区之间观察到患病率的显着差异，而当通过这些特征单独检查时，其相关性仍然相对相似。