Abstract
Purpose
Little is known about associations of adolescents’ socio-economic status (SES) and their sexual activity and risk behaviours. This study examined these associations in Nova Scotia adolescents aged 15–19.
Methods
Students at four high schools in northern Nova Scotia completed surveys examining relationships of family SES factors and: 1) sexual activity (having had vaginal or anal intercourse, intercourse before age 15 (early intercourse)); and 2) risk behaviours (use of contraception/condoms, number of partners and unplanned intercourse after substance use).
Results
Of students present when the survey was administered, 2,135 (91%) responded. Almost half (49%) had had vaginal intercourse, and 7% anal intercourse. In univariate analysis for young women, non-intact family structure and lower parental education were associated with having vaginal, anal and early intercourse. Female risk behaviours showed no significant univariate associations with SES. Young men had univariate associations of family structure, lower maternal education and paternal unemployment with early intercourse, and lower paternal education with anal intercourse. Condom use was higher for young men with employed fathers; those living with both parents less often had >1 sexual partner. In multivariate analysis, most SES associations with females’ sexual activities held, while most for males did not, and few associations of SES and risk behaviours were seen for females.
Conclusions
Indicators of lower SES are associated with sexual activity in young women. Sexual risk behaviours are not often associated with SES in females, though they are more so in males. These findings have implications for sexual health promotion and health services.
MeSH terms: Adolescent, sexual activity, sexual behaviour, socioeconomic factors
Résumé
Objet
On en sait peu sur les liens entre le statut socio-économique (SSE) des adolescents, leur activité sexuelle et leur propension à prendre des risques. Nous avons étudié ces liens chez des adolescents de la Nouvelle-écosse âgés de 15 à 19 ans.
Méthode
Les élèves de quatre écoles secondaires du Nord de la Nouvelle-écosse ont rempli des questionnaires sur les facteurs liés à leur SSE familial et: 1) à leur activité sexuelle (relations vaginales ou anales, relations précoces [avant l’âge de 15 ans]) et 2) à leur propension à prendre des risques (utilisation des contraceptifs ou des condoms, nombre de partenaires, relations non planifiées après avoir consommé de l’alcool ou des drogues).
Résultats
Parmi les élèves présents pendant l’administration du sondage, 2 135 (91%) ont rempli un questionnaire. Près de la moitié (49%) avaient eu des relations vaginales, et 7%, des relations anales. Selon l’analyse univariée des réponses des filles, une structure familiale dissociée et un faible niveau d’instruction parental étaient associés aux relations vaginales et anales et aux relations précoces. La propension des filles à prendre des risques n’était pas associée de façon significative au SSE selon l’analyse univariée. Chez les garçons, la structure familiale, le faible niveau d’instruction maternel et le chômage paternel étaient associés aux relations précoces, et le faible niveau d’instruction paternel, aux relations anales. L’utilisation du condom était plus courante chez les garçons dont le père avait un emploi, et ceux qui vivaient avec leurs deux parents étaient moins nombreux à avoir eu plusieurs partenaires sexuels. L’analyse multivariable a confirmé la plupart des liens entre le SSE et l’activité sexuelle chez les filles, mais infirmé la plupart de ces liens chez les garçons; chez les filles, l’analyse multivariable n’a permis d’établir que très peu de liens significatifs entre le SSE et la propension à prendre des risques.
Conclusions
Les indicateurs d’un faible SSE sont associés à l’activité sexuelle chez les filles. La propension à prendre des risques sexuels n’est pas souvent liée au SSE chez les filles, mais elle l’est davantage chez les garçons. Ces constatations ont des conséquences pour la promotion de la santé sexuelle et les services de santé.
Footnotes
Source of Funding: This research was funded by the Social Sciences and Humanities Research Council (SSHRC) Grant no. 828-1999-1024.
References
- 1.King AJC, Beazley RP, Warren WK, Robertson AS, Radford JL. The Canadian Youth and AIDS Study. Kingston, ON: Queen’s University; 1988. [Google Scholar]
- 2.Poulin C. Nova Scotia Student Drug Use 1996: Highlights Report. Halifax, NS: Nova Scotia Department of Health; 1997. [Google Scholar]
- 3.Federal . Report on Adolescent Reproductive Health. Ottawa, ON: Health and Welfare Canada, Health Services and Promotion Branch; 1989. Provincial and Territorial Working Group on Adolescent Reproductive Health. [Google Scholar]
- 4.Stevens-Simon C, Lowy R. Teenage childbearing. An adaptive strategy for the socioeconomically disadvantaged or a strategy for adapting to socioeconomic disadvantage? Arch Pediatr Adolesc Med. 1995;149:912–15. doi: 10.1001/archpedi.1995.02170210086015. [DOI] [PubMed] [Google Scholar]
- 5.Statistics Canada. Teen pregnancy by outcome of pregnancy and age group, count and rate per 1000 women aged 15 to 19, Canada, provinces and territories, 1998–2000. Available on-line at: https://doi.org/www.statcan.ca/english/freepub/8-221XIE/10003/tables/html (Accessed March 23, 2004).
- 6.Health Canada. Disease Surveillance on-line. Ottawa, ON: Population and Public Health Branch. Available on-line at: https://doi.org/www.hc-sc.gc.ca/pphb-dgspsp/dsol-smed/index.html (Accessed May 4, 2004).
- 7.Peipert JF. Genital chlamydial infections. N Engl J Med. 2003;349:2424–30. doi: 10.1056/NEJMcp030542. [DOI] [PubMed] [Google Scholar]
- 8.Blum RW, Beuhring T, Shew ML, Bearinger LH, Steving RE, Resnick M. The effects of race/ethnicity, income and family structure on adolescent risk behaviors. Am J Public Health. 2000;90:1879–84. doi: 10.2105/AJPH.90.12.1879. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 9.Santelli JS, Lowry R, Brener N, Robin L. The association of sexual behaviors with socioeconomic status, family structure and race/ethnicity among US adolescents. Am J Public Health. 2000;90:1582–88. doi: 10.2105/AJPH.90.10.1582. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 10.Langille D, Curtis L. Factors associated with sexual intercourse before age 15 among female adolescents in Nova Scotia. Can J Human Sexual. 2002;11:91–99. [Google Scholar]
- 11.Statistics Canada. 2002 Community Profiles. 2002. [Google Scholar]
- 12.Becker G. Investment in human capital: A theo-retical analysis. J Political Econ. 1962;70(S):9–49. doi: 10.1086/258724. [DOI] [Google Scholar]
- 13.Streiner DL, Norman GR. Health measurement scales: A practical guide to their development and use. New York, NY: Oxford University Press; 1995. pp. 116–18. [Google Scholar]
- 14.Boyce W, Doherty M, Fortin C, MacKinnon D. Canadian youth, sexual health and HIV/AIDS study: Factors influencing knowledge, attitudes and behaviours. Toronto, ON: Council of Ministers of Education, Canada; 2003. [Google Scholar]
- 15.Poulin C. Nova Scotia Student Drug Use, 2002: Highlights Report. Halifax, HS: Nova Scotia Department of Health; 2002. [Google Scholar]
- 16.Langille DB, Beazley R, Shoveller J, Johnston G. Prevalence of high risk sexual behaviour in ado-lescents attending school in a county in Nova Scotia. Can J Public Health. 1994;85:227–30. [PubMed] [Google Scholar]
- 17.Langille D, Hughes J, Tomblin Murphy G, Rigby J. Contraception among young women attending high school in rural Nova Scotia. Can J Public Health. 2002;92(6):461–64. doi: 10.1007/BF03405040. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 18.Lammers C, Ireland M, Resnick M, Blum R. Influences on adolescents’ decision to postpone onset of sexual intercourse: A survival analysis of virginity among youth aged 13 to 18 years. J Adolesc Health. 2000;26:42–48. doi: 10.1016/S1054-139X(99)00041-5. [DOI] [PubMed] [Google Scholar]
- 19.Martens PJ, Mayer T, Derksen S. Factors affecting adolescent reproductive health in Manitoba. Can J Public Health. 2002;93:S36–S43. doi: 10.1007/BF03403617. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 20.Langille D, Curtis L, Flowerdew G. Teenagepregnancy in Nova Scotia: An assessment of community-related factors and short term financial costs. Halifax, NS: Dalhousie University; 2003. [Google Scholar]
- 21.Hardwick D, Patychuk D. Geographic mapping demonstrates the association between social inequality, teen births and STDs among youth. Can J Human Sexuality. 1999;8:77–90. [Google Scholar]
- 22.Singhe S, Darroch JE, Frost JJ. Socioeconomic disadvantage and adolescent women’s sexual and reproductive behavior: The case of five developed countries. Fam Planning Perspect. 2001;33:251–58. doi: 10.2307/3030192. [DOI] [PubMed] [Google Scholar]
- 23.Jolly AM, Orr PH, Hammond G, Young TK. Risk factors for infection in women undergoing testing for Chlamydia trachomatis and Neisseria gonorrhoeae in Manitoba, Canada. Sex Transm Dis. 1995;22:289–95. doi: 10.1097/00007435-199509000-00004. [DOI] [PubMed] [Google Scholar]
- 24.Langille DB, MacKinnon D, Graham J, Marshall EG. So many bricks in the wall: Young Nova Scotia women speak about barriers to effective sexual health education at their school. Sex Education. 2001;1:245–57. doi: 10.1080/14681810120080640. [DOI] [Google Scholar]
- 25.Brown JD, Witherspoon EM. The mass media and American adolescents’ health. J Adolesc Health. 2002;31:153–70. doi: 10.1016/S1054-139X(02)00507-4. [DOI] [PubMed] [Google Scholar]
- 26.Langille D. Maritime Centre of Excellence for Women’s Health. Halifax, NS: Dalhousie University; 2001. Sexual Health Services and Education for Adolescents: Options for Nova Scotia. [Google Scholar]
- 27.Miller BC, Norton MC, Fan X, Christopherson CR. Pubertal development, parental communication, and sexual values in relation to adolescent sexual behaviors. J Early Adolesc. 1998;18:27–52. doi: 10.1177/0272431698018001002. [DOI] [Google Scholar]
- 28.Whitaker DJ, Miller KS, May DC, Levin ML. Teenage partners’ communication about sexual risk and condom use: The importance of parentteenager discussions. Fam Planning Perspect. 1999;31:117–21. doi: 10.2307/2991693. [DOI] [PubMed] [Google Scholar]
- 29.Blanchard JF, Moses S, Greenaway C, Orr P, Hammond GW, Brunham RC. The evolving epidemiology of chlamydial and gonococcal infections in response to control programs in Winnipeg, Canada. Am J Public Health. 1998;88:1496–502. doi: 10.2105/AJPH.88.10.1496. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 30.Langille DB, Hughes J, Tomblin Murphy G, Flowerdew G, Rigby JA. Nova Scotia adolescents and sexual health guidance by physicians. Unpublished manuscript.
- 31.Naugler C, Langille D, Beazley R. On the predictive ability of demographic markers for adolescents’ sexual behaviour. Can J Human Sexuality. 1995;4:103–9. [Google Scholar]
- 32.Blum RW, Beuhring T, Wunderlich M, Resnick MD. Don’t ask, they won’t tell: The quality of adolescent health screening in five practice settings. Am J Public Health. 1996;86:1767–72. doi: 10.2105/AJPH.86.12.1767. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 33.Lynch J, Kaplan G. Socioeconomic position. In: Berkman KF, Kawachi I, editors. Social Epidemiology. New York, NY: Oxford University Press; 2000. pp. 13–35. [Google Scholar]