Sexual health of young adults and age at first intercourse

Interest in the timing of first sexual intercourse has increased in recent years because of public health, social, and political concerns. Using a life-course theoretical perspective, I examined the connection between timing of first sexual intercourse and later sexual behavior and health outcomes by analyzing data from Waves I through III of the National Longitudinal Study of Adolescent Health (Add Health). The majority of respondents with a current sexual relationship engaged in combinations of various types of sexual behaviors. Almost 80% of these respondents included cunnilingus and fellatio as well as vaginal intercourse in the sexual repertoire of their current relationship, with over 20% engaging in these three sexual activities plus anal sex. Earlier age at first intercourse was associated with engaging in oral sex with a current partner for females, and with anal sex with a current partner for males and females. Early first intercourse was associated with higher odds of testing positive for chlamydial infection, gonorrhea, and trichomoniasis among adolescents, but the association was not significant among young adults. By young adulthood, an older age at first intercourse was no longer protective against these sexually transmitted infections; young adults who had started having sex recently had similar levels of sexually transmitted infection as those who had been having sex through most of adolescence. Furthermore, timing of first intercourse was not associated with sexual coercion victimization or perpetration with a current partner. Reports of sexual coercion in current relationships indicated substantial levels of male victimization and female perpetration. This work expands upon the current understanding of first sexual intercourse and later sexual behavior and health, and carries important implications for health promotion education and policy.