Abstract
Purpose
To examine age differences between Nova Scotia women aged 15–19 and their male sexual partners, and to determine if those adolescents with older partners were more likely to have engaged in sexual risk-taking behaviours.
Methods
A cross-sectional survey (response rate=91%) administered in May 2003 assessed the following sexual risk behaviours: a) not using condom/hormonal contraception at last vaginal intercourse; b) having unplanned vaginal intercourse while using alcohol or drugs; c) having more than one partner in the previous year; d) vaginal intercourse before age 15; and e) ever having anal intercourse. Univariate analysis was carried out to determine associations of sexual risk behaviours with partner age difference. Logistic regression was then used to examine behaviours associated with partner age (p<0.15) in univariate analysis.
Results
Of the young women surveyed, 520 (47.7%) had had vaginal intercourse in the previous year; 515 of these provided information on their last partner’s age. Over 10% had partners four or more years older. In multivariate analysis, having a partner ≥4 years older was associated with not using a condom at last intercourse (OR 2.15; 95% CI 1.10–4.20), having more than one partner in the previous year (OR 21.9; 95% CI 1.13–4.28) and having unplanned vaginal intercourse while using alcohol or drugs (OR 2.66; 95% CI 1.34–5.28).
Conclusions
A significant number of female adolescents have older male sexual partners, and such relationships are markers for high-risk sexual behaviours. Partner age is an important consideration for health professionals providing sexual health advice to young women.
MeSH terms: Adolescent, female, risk-taking, sexual behaviour
Résumé
Objet
Examiner les différences liées à l’âge entre les femmes néo-écossaises de 15 à 19 ans et leurs partenaires sexuels masculins, puis déterminer si les adolescentes ayant des partenaires plus vieux sont plus susceptibles d’avoir des comportements sexuels à risque.
Méthode
Un sondage transversal (taux de réponse de 91 %) administré en mai 2003 portait sur les comportements sexuels à risque suivants: a) ne pas avoir utilisé un condom ou un contraceptif hormonal lors de la dernière pénétration vaginale; b) avoir eu une relation sexuelle non planifiée, avec pénétration vaginale, tout en ayant consommé de l’alcool ou de la drogue; c) avoir eu plus d’un partenaire au cours de l’année précédente; d) avoir eu des relations sexuelles avec pénétration vaginale avant l’âge de 15 ans; et e) avoir eu des relations sexuelles avec pénétration anale. Nous avons effectué une analyse univariée pour déterminer les liens entre les comportements sexuels à risque et la différence d’âge avec le partenaire. Au moyen d’une analyse de régression logistique, nous avons ensuite examiné les comportements associés à l’âge du partenaire (p<0,15) dans l’analyse univariée.
Résultats
De toutes les jeunes femmes sondées, 520 (47,7 %) avaient eu des relations sexuelles avec pénétration vaginale au cours de l’année précédente; 515 d’entre elles ont fourni des renseignements sur l’âge de leur dernier partenaire. Plus de 10 % avaient eu des partenaires âgés de 4 ans ou plus qu’elles. Lors de l’analyse multivariée, le fait d’avoir eu un partenaire ayant 4 ans ou plus que soi était associé au fait de ne pas avoir utilisé un condom lors de la dernière pénétration (RC = 2,15; IC de 95 % = 1,10-4,20), au fait d’avoir eu plus d’un partenaire au cours de l’année précédente (21,9; 1,13-4,28) et au fait d’avoir eu une relation sexuelle non planifiée avec pénétration vaginale tout en ayant consommé de l’alcool ou de la drogue (2,66; 1,34–5,28).
Conclusion
Un nombre significatif d’adolescentes ont un partenaire sexuel masculin plus âgé, et ce type de relation est un indicateur de comportements sexuels à risque élevé. L’âge du partenaire est un facteur dont devraient tenir compte les professionnels de la santé qui offrent des conseils de santé sexuelle aux jeunes femmes.
Footnotes
Study Funding: The Social Sciences and Humanities Research Council of Canada
References
- 1.Begley E, Crosby R, DiClemente RJ, Wingood GM, Rose E. Older partners and STD prevalence among pregnant African American teens. Sex Transm Dis. 2003;30:214–15. doi: 10.1097/00007435-200303000-00006. [DOI] [PubMed] [Google Scholar]
- 2.Boyer CB, Shafer MA, Teitle E, Wibbelsman CJ, Seeberg D, Schacter J. Sexually transmitted diseases in a health maintenance organization teen clinic: Associations of race, partner’s age and marijuana use. Arch Pediatr Adolesc Med. 1999;153:838–44. doi: 10.1001/archpedi.153.8.838. [DOI] [PubMed] [Google Scholar]
- 3.Ford K, Lepkowski JM. Characteristics of sexual partners and STD infection among American adolescents. Int J STD AIDS. 2004;15:260–65. doi: 10.1258/095646204773557802. [DOI] [PubMed] [Google Scholar]
- 4.Kordoutis PS, Loumakou M, Sarafidou JO. Heterosexual relationship characteristic, condom use and safe sex practices. AIDS Care. 2000;12:767–82. doi: 10.1080/09540120020014318a. [DOI] [PubMed] [Google Scholar]
- 5.Health Canada, Population and Public Health Branch. Disease surveillance on-line. Available online at: https://doi.org/www.phac-aspc.gc.ca/std-mts/stddata_june05/tab1-1_e.html (Accessed February 15, 2006).
- 6.Peipert JF. Genital chlamydial infections. N Engl J Med. 2003;349:2424–30. doi: 10.1056/NEJMcp030542. [DOI] [PubMed] [Google Scholar]
- 7.Geli DA. Measuring contraceptive use patterns among teenage and adult women. Fam Plann Perspect. 1999;31:73–80. doi: 10.2307/2991642. [DOI] [PubMed] [Google Scholar]
- 8.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]
- 9.HealthWelfare Canada. Report on Adolescent Reproductive Health. Ottawa, ON: Health Services and Promotion Branch; 1989. [Google Scholar]
- 10.Statistics Canada. Teen Pregnancy, by Outcome of Pregnancy and Age Group, Count and Rate per 1,000 Women, Canada, Provinces and Territories. 1998. [Google Scholar]
- 11.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 of Canada; 2003. [Google Scholar]
- 12.Poulin C. Nova Scotia Student Drug Use 1998 Highlights Report. Halifax, NS: Nova Scotia Department of Health; 1998. [Google Scholar]
- 13.Langille D, Rigby J. Factors associated with PAP testing in adolescents in northern Nova Scotia. Can J Public Health. 2006;97:183–86. doi: 10.1007/BF03405580. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 14.Landry DJ, Forrest JD. How old are U.S. fathers? Fam Plann Perspect. 1995;27:159–65. doi: 10.2307/2136260. [DOI] [PubMed] [Google Scholar]
- 15.Millar WJ, Wadhera SA. A perspective on Canadian teenage births, 1992–94: Older men and younger women? Can J Public Health. 1997;88:333–36. doi: 10.1007/BF03403901. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 16.Langille D, Curtis L. Factors associated with sexual intercourse before age 15 in Nova Scotia female adolescents. Can J Hum Sexual. 2002;11:91–99. [Google Scholar]
- 17.Langille D, Hughes J, Tomblin Murphy G, Rigby JA. Socio-economic factors and adolescent sexual activity and behaviour in Nova Scotia. Can J Public Health. 2005;96:313–18. doi: 10.1007/BF03405173. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 18.Civic D. The association between characteristics of dating relationships and condom use among heterosexual young adults. AIDS Educ Prev. 1999;11:343–52. [PubMed] [Google Scholar]
- 19.Poulin C, Graham L. The association between substance use, unplanned sexual intercourse and other sexual behaviours among adolescent students. Addiction. 2001;96:607–21. doi: 10.1046/j.1360-0443.2001.9646079.x. [DOI] [PubMed] [Google Scholar]
- 20.Langille DB, Hughes J, Tomblin Murphy G, Rigby JA. Contraception among young women attending high school in rural Nova Scotia. Can J Public Health. 2002;93:461–64. doi: 10.1007/BF03405040. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 21.Langille DB, Tomblin Murphy G, Hughes J, Rigby JA. Nova Scotia high school students’ interactions with physicians for sexual health information and services. Can J Public Health. 2001;92:219–22. doi: 10.1007/BF03404310. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 22.Rucklos Hampton M, Smith P, Jeffery B, McWatte B. Sexual experience, contraception and STI prevention among high school students: Results from a Canadian urban centre. Can J Hum Sexual. 2001;10:111–26. [Google Scholar]
- 23.Maticka-Tyndale E, Barrett M, McKay A. Adolescent sexual and reproductive health in Canada: A review of national data sources and their limitations. Can J Hum Sexual. 2000;9:41–65. [Google Scholar]
- 24.Darroch JE, Landry DJ, Oslak S. Age differences between sexual partners in the United States. Fam Plann Perspect. 1999;31:160–67. doi: 10.2307/2991588. [DOI] [PubMed] [Google Scholar]
- 25.DiClemente RJ, Wingood GM, Crosby RA, Sionean C, Cobb BK, Harrington K, et al. Sexual risk behaviors associated with having older sex partners: A study of black adolescent females. Sex Transm Dis. 2002;29:20–24. doi: 10.1097/00007435-200201000-00004. [DOI] [PubMed] [Google Scholar]
- 26.Miller KS, Clark LF, Moore JS. Sexual initiation with older male partners and subsequent HIV risk behavior among female adolescents. Fam Plann Perspect. 1997;29:212–14. doi: 10.2307/2953397. [DOI] [PubMed] [Google Scholar]
- 27.Kissinger P, Clayton JL, O’Brien ME, Kent C, Whittington WL, Oh MK. Older partners not associated with recurrence among female teenagers infected with Chlamydia trachomatis. Sex Transm Dis. 2002;29:144–49. doi: 10.1097/00007435-200203000-00004. [DOI] [PubMed] [Google Scholar]
- 28.Rainey DY, Stevens-Simon C, Kaplan DW. Are adolescents who report prior sexual abuse at higher risk for pregnancy? Child Abuse and Neglect. 1995;19:1283–88. doi: 10.1016/0145-2134(95)00088-P. [DOI] [PubMed] [Google Scholar]
- 29.Boyer D, Fine D. Sexual abuse as a factor in adolescent pregnancy and child maltreatment. Fam Plann Perspect. 1992;24:4–11. doi: 10.2307/2135718. [DOI] [PubMed] [Google Scholar]
- 30.Stock JL, Bell MA, Boyer D, Connell FA. Adolescent pregnancy and sexual risk-taking among sexually abused girls. Fam Plann Perspect. 1997;29:200–203. doi: 10.2307/2953395. [DOI] [PubMed] [Google Scholar]