Over the past three decades, most research on adolescent sexual behavior has focused on vaginal intercourse and related behaviors, including contraception and unintended pregnancy. In this study, we describe the prevalence and correlates of vaginal, oral, and anal sex in an epidemiologically defined population in Baltimore, Maryland. Young adults (ages 18–24), who had been enrolled in a behavioral intervention trial during elementary school, were interviewed by telephone between 1998 and 2002 to assess their sexual behavior. Of 1679 respondents interviewed, 70.8% were Black and 55% were women. Overall, 93% of the young adults reported vaginal intercourse, 78% reported receiving oral sex, 57% reported performing oral sex, and 10% reported receptive anal intercourse. Among men, 27% reported insertive anal intercourse. Blacks initiated vaginal intercourse at an earlier age than Whites; White women performed oral sex earlier than Black women. Significant interactions were observed between age of first vaginal partner and both gender and race/ethnicity. Blacks with older partners initiated sex at an earlier age than both Blacks with a partner the same age or younger and Whites. We also observed a relationship between older female sex partners and earlier vaginal sex initiation among men. We conclude that older sex partners play an important role in sexual initiation among young adults. In light of the rates of oral and anal sex, sexual education and intervention programs should address the risk for unintended consequences of these behaviors.
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Alexander, E., & Hickner, J. (1997). First coitus for adolescents: Understanding why and when. Journal of the American Board of Family Practice, 10, 96–103.
Andersson-Ellström, A., Forssman, L., & Milsom, I. (1996). Age of sexual debut related to life-style and reproductive health factors in a group of Swedish teenage girls. Acta Obstetricia et Gynecologica Scandinavica, 75, 484–489.
Bartholow, B. N., Doll, L. S., Joy, D., Douglas, J. M., Bolan, G., Harrison, J. S., et al. (1994). Emotional, behavioral and HIV risks associated with sexual abuse among adult homosexual and bisexual men. Child Abuse and Neglect, 18, 747–761.
Begley, E., Crosby, R. A., DiClemente, R. J., Wingood, G. M., & Rose, E. (2003). Older partners and STD prevalence among pregnant African American teens. Sexually Transmitted Diseases, 30, 211–213.
Bettinger, J. A., Adler, N. E., Curriero, F. C., & Ellen, J. M. (2004). Risk perceptions, condom use, and sexually transmitted diseases among adolescent females according to social network position. Sexually Transmitted Diseases, 31, 575–579.
Billy, J. O., Tanfer, K., Grady, W. R., & Klepinger, D. H. (1993). The sexual behavior of men in the United States. Family Planning Perspectives, 25, 52–60.
Brooks-Gunn, J., & Furstenberg, F. F. (1989). Adolescent sexual behavior. American Psychologist, 44, 249–257.
Centers for Disease Control and Prevention. (1996). Youth risk behavior surveillance–United States, 1995. Morbidity and Mortality Weekly Report, 45[SS-4], 1–84.
Centers for Disease Control and Prevention. (1998). Trends in sexual risk behaviors among high school students–United States, 1991–1997. Morbidity and Mortality Weekly Report, 47, 749–752.
Centers for Disease Control and Prevention. (2000). Youth risk behavior surveillance–United States, 1999. Morbidity and Mortality Weekly Report, 49, 1–32.
Centers for Disease Control and Prevention. (2002a). Trends in sexual risk behaviors among high school students–United States, 1991–2001. Morbidity and Mortality Weekly Report, 51, 856–859.
Centers for Disease Control and Prevention. (2002b). Youth risk behavior surveillance–United States, 2001. Morbidity and Mortality Weekly Report, 51, 1–64.
Coles, R., & Stokes, G. (1985). Sex and the American teenager. New York: Harper & Row.
Coutlée, F., Trottier, A. M., Ghattas, G., Leduc, R., Toma, E., Sanche, G., et al. (1997). Risk factors for oral human papillomavirus in adults infected and not infected with human immunodeficiency virus. Sexually Transmitted Diseases, 24, 23–31.
Crosby, R. A., DiClemente, R. J., Wingood, G. M., Salazar, L. F., Harrington, K., Davies, S. L., et al. (2003). Identification of strategies for promoting condom use: A prospective analysis of high-risk African American female teens. Prevention Science, 4, 263–270.
Darroch, J. E., Landry, D. J., & Singh, S. (2000). Changing emphases in sexuality education in U.S. public secondary schools, 1988–1999. Family Planning Perspectives, 32, 204–211, 265.
DiClemente, R. J., Wingood, G. M., Crosby, R. A., Sionean, C., Cobb, B. K., Harrington, K., et al. (2002). Sexual risk behaviors associated with having older sex partners: A study of black adolescent females. Sexually Transmitted Diseases, 29, 20–24.
Dolan, L. J., Kellam, S. G., Brown, C. H., Werthamer-Larsson, L., Rebok, G. W., Mayer, L. S., et al. (1993). The short-term impact of two classroom-based preventive interventions on aggressive and shy behaviors and poor achievement. Journal of Applied Developmental Psychology, 14, 317–345.
Durbin, M., DiClemente, R. J., Siegel, D., Krasnovsky, F., Lazarus, N., & Camacho, T. (1993). Factors associated with multiple sex partners among junior high school students. Journal of Adolescent Health, 14, 202–207.
Edgardh, K. (2002). Sexual behavior in a low-income high school setting in Stockholm. International Journal of STD and AIDS, 13, 160–167.
Evans, B. A., McCormack, S. M., Kell, P. D., Parry, J. V., Bond, R. A., & MacRae, K. D. (1995). Trends in female sexual behavior and sexually transmitted diseases in London, 1982–1992. Genitourinary Medicine, 71, 286–290.
Fergusson, D. M., Horwood, L. J., & Lynskey, M. T. (1997). Childhood sexual abuse, adolescent sexual behaviors and sexual revictimization. Child Abuse and Neglect, 21, 789–803.
Friedman, S. R., Flom, P. L., Kottiri, B. J., Neaigus, A., Sandoval, M., Curtis, R., et al. (2001). Prevalence and correlates of anal sex with men among young adult women in an inner city minority neighborhood. AIDS, 15, 2057–2060.
Gates, G. J., & Sonenstein, F. L. (2000). Heterosexual genital sexual activity among adolescent males: 1988 and 1995. Family Planning Perspectives, 32, 295–297, 304.
Gregson, S., Nyamukapa, C. A., Garnett, G. P., Mason, P. R., Zhuwau, T., Carael, M., et al. (2002). Sexual mixing patterns and sex-differentials in teenage exposure to HIV infection in rural Zimbabwe. Lancet, 359, 1896–1903.
Gross, M., Holte, S. E., Marmor, M., Mwatha, A., Koblin, B. A., & Mayer, K. H. (2000). Anal sex among HIV-seronegative women at high risk of HIV exposure. The HIVNET Vaccine Preparedness Study 2 Protocol Team. JAIDS Journal of Acquired Immune Deficiency Syndromes, 24, 393–398.
Jeannin, A., Konings, E., Dubois-Arber, F., Landert, C., & Van Melle, G. (1998). Validity and reliability in reporting sexual partners and condom use in a Swiss population survey. European Journal of Epidemiology, 14, 139–146.
Kaestle, C. E., Morisky, D. E., & Wiley, D. J. (2002). Sexual intercourse and the age difference between adolescent females and their romantic partners. Perspectives on Sexual and Reproductive Health, 34, 304–309.
Kellam, S. G., & Rebok, G. W. (1992). Building developmental and etiological theory through epidemiologically-based preventive intervention trials. In J. McCord & R. E. Tremblay (Eds.), Preventing antisocial behavior: Interventions from birth through adolescence (pp. 162–195). New York: Guilford Press.
Kellam, S. G., Rebok, G. W., Ialongo, N., & Mayer, L. S. (1994). The course and malleability of aggressive behavior from early first grade into middle school: Results of a developmental epidemiologically-based preventive trial. Journal of Child Psychology and Psychiatry, 35, 259–281.
Kellam, S. G., Werthamer-Larsson, L., Dolan, L. J., Brown, C. H., Mayer, L. S., Rebok, G. W., et al. (1991). Developmental epidemiologically based preventive trials: Baseline modeling of early target behaviors and depressive symptoms. American Journal of Community Psychology, 19, 563–584.
Kelly, R. J., Gray, R. H., Sewankambo, N. K., Serwadda, D., Wabwire-Mangen, F., Lutalo, T., et al. (2003). Age differences in sexual partners and risk of HIV-1 infection in rural Uganda. JAIDS Journal of Acquired Immune Deficiency Syndromes, 32, 446–451.
Koenig, A. L., Ialongo, N., Wagner, B. M., Poduska, J., & Kellam, S. (2002). Negative caregiver strategies and psychopathology in urban, African-American young adults. Child Abuse and Neglect, 26, 1211–1233.
Kraner, J. C., McCoy, D. J., Evans, M. A., Evans, L. E., & Sweeney, B. J. (2001). Fatalities caused by the MDMA-related drug paramethoxyamphetamine (PMA). Journal of Analytical Toxicology, 25, 645–648.
Laumann, E. O., Gagnon, J. H., Michael, R. T., & Michaels, S. (1994). The social organization of sexuality: Sexual practices in the United States. Chicago: University of Chicago Press.
Lodico, M. A., & DiClemente, R. J. (1994). The association between childhood sexual abuse and prevalence of HIV-related risk behaviors. Clinical Pediatrics, 33, 498–502.
Marín, B. V., Coyle, K. K., Gomez, C. A., Carvajal, S. C., & Kirby, D. B. (2000). Older boyfriends and girlfriends increase risk of sexual initiation in young adolescents. Journal of Adolescent Health, 27, 409–418.
Marsiglio, W., & Menaghan, E. G. (1990). Pregnancy resolution and family formation. Understanding gender differences in adolescents' preferences and beliefs. Journal of Family Issues, 11, 313–333.
Miller, K. S., Clark, L. F., & Moore, J. S. (1997). Sexual initiation with older male partners and subsequent HIV risk behavior among female adolescents. Family Planning Perspectives, 29, 212–214.
Mott, F. L., Fondell, M. M., Hu, P. N., Kowaleski-Jones, L., & Menaghan, E. G. (1996). The determinants of first sex by age 14 in a high-risk adolescent population. Family Planning Perspectives, 28, 13–18.
Mott, F. L., & Haurin, R. J. (1988). Linkages between sexual activity and alcohol and drug use among American adolescents. Family Planning Perspectives, 20, 128–136.
National Center for Health Statistics. (1997). Fertility, family planning, and women's health: New data from the 1995 National Survey of Family Growth (Rep. No. 23(19)). Hyattsville, MD: U.S. Department of Health and Human Services.
Newcomer, S. F., & Udry, J. R. (1985). Oral sex in an adolescent population. Archives of Sexual Behavior, 14, 41–46.
Paul, C., Fitzjohn, J., Herbison, P., & Dickson, N. (2000). The determinants of sexual intercourse before age 16. Journal of Adolescent Health, 27, 136–147.
Pearson, J. L., Ialongo, N. S., Hunter, A. G., & Kellam, S. G. (1994). Family structure and aggressive behavior in a population of urban elementary school children. Journal of the American Academy of Child and Adolescent Psychiatry, 33, 540–548.
Pless, I. B., & Miller, J. R. (1979). Apparent validity of alternative survey methods. Journal of Community Health, 5, 22–27.
Ramrakha, S., Caspi, A., Dickson, N., Moffitt, T. E., & Paul, C. (2000). Psychiatric disorders and risky sexual behavior in young adulthood: Cross sectional study in birth cohort. British Medical Journal, 321, 263–266.
Rosenbaum, E., & Kandel, D. B. (1990). Early onset of adolescent sexual behavior and drug involvement. Journal of Marriage and the Family, 52, 783–798.
Santelli, J. S., Lowry, R., Brener, N. D., & Robin, L. (2000). The association of sexual behaviors with socioeconomic status, family structure, and race/ethnicity among U.S. adolescents. American Journal of Public Health, 90, 1582–1588.
Schwartz, I. M. (1999). Sexual activity prior to coital initiation: A comparison between males and females. Archives of Sexual Behavior, 28, 63–69.
Singh, S., & Darroch, J. E. (1999). Trends in sexual activity among adolescent American women: 1982–1995. Family Planning Perspectives, 31, 212–219.
Smith, C. A. (1997). Factors associated with early sexual activity among urban adolescents. Social Work, 42, 334–346.
Staples, R. (1973). The Black woman in America. Chicago: Nelson Hall.
Starkman, N., & Rajani, N. (2002). The case for comprehensve sex education. AIDS Patient Care and STDs, 16, 313–318.
Sturdevant, M. S., Belzer, M., Weissman, G., Friedman, L. B., Sarr, M., & Muenz, L. R. (2001). The relationship of unsafe sexual behavior and the characteristics of sexual partners of HIV infected and HIV uninfected adolescent females. Journal of Adolescent Health, 29, 64–71.
United States Congress. (December 29, 2000). Richard B. Russel National School Lunch Act. 42 U.S.C., 1751–1769.
Warren, C. W., Kann, L., Small, M. L., Santelli, J. S., Collins, J. L., & Kolbe, L. J. (1997). Age of initiating selected health-risk behaviors among high school students in the United States. Journal of Adolescent Health, 21, 225–231.
Weeks, M. F., Kulka, R. A., Lessler, J. T., & Whitmore, R. W. (1983). Personal versus telephone surveys for collecting household health data at the local level. American Journal of Public Health, 73, 1389–1394.
Wilsnack, S. C., Vogeltanz, N. D., Klassen, A. D., & Harris, T. R. (1997). Childhood sexual abuse and women's substance abuse: National survey findings. Journal of Studies on Alcohol, 58, 264–271.
Wilson, P. M. (1986). Black culture and sexuality. Journal of Social Work and Human Sexuality, 4, 29–46.
Wyatt, G., Durvasula, R. S., Guthrie, D., LeFranc, E., & Forge, N. (1999). Correlates of first intercourse among women in Jamaica. Archives of Sexual Behavior, 28, 139–157.
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Ompad, D.C., Strathdee, S.A., Celentano, D.D. et al. Predictors of Early Initiation of Vaginal and Oral Sex Among Urban Young Adults in Baltimore, Maryland. Arch Sex Behav 35, 53–65 (2006). https://doi.org/10.1007/s10508-006-8994-x
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DOI: https://doi.org/10.1007/s10508-006-8994-x