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Understanding Sexual Health Indicators During Adolescence: A Study to Consider Time Since Sexual Debut When Exploring Multiple Sexual Partners

Abstract

Understanding risky sexual behaviors among adolescents is key in efforts devoted to reducing the health burden related to sexually transmitted infections and unintended or unplanned pregnancies. The aims of this study were to understand the association between number of lifetime sexual partners and time since sexual debut (TSSD) among adolescents and to determine whether sex modified this association. Data were drawn from the 2018–2019 COMPASS-Quebec study, a cohort study conducted in secondary schools in the province of Quebec, Canada. Of 18,467 respondents aged 14 years and older, 6991 (37.9%; mean age 15.3) reported consensual sexual intercourse and answered questions on their age at sexual initiation and number of lifetime sexual partners. Multilevel Poisson regressions with robust standard errors were estimated to adjust for covariates and produce adjusted group mean differences. The adjusted mean number of lifetime sexual partners ranged from 1.5 for those who had recently begun sexual activity (< 12 months) to 4.0 for those who had been active for > 35 months, an average rise of about 0.6 per year. Females-to-males adjusted mean differences showed that males reported more sexual partners than females at all time points, but the differences were only significant at the shorter (< 12 months) and longer (> 35 months) time spans. This study highlights the importance of taking into account TSSD when using and interpreting the number of lifetime sexual partners as risky sexual behavior among adolescents. Sex did not have a significant modifying effect on the relationship between number of lifetime sexual partners and TSSD.

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  1. In the province of Quebec, secondary schools cover five years, Grades 1 to 5, equivalent to Grades 7 to 11 in the USA and the rest of Canada.

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Acknowledgements

The authors wish to thank the Direction régionale de santé publique du CIUSSS de la Capitale-Nationale, the COMPASS team, especially Mireille Desrochers-Couture and Claude Bacque-Dion, the relevant school boards, the administrations of participating schools, and all participants, for their continued confidence in our team.

Funding

The COMPASS study was supported by a bridge grant from the Canadian Institutes of Health Research (CIHR) Institute of Nutrition, Metabolism and Diabetes (INMD) through the “Obesity—Interventions to Prevent or Treat” priority funding awards (OOP-110788; grant awarded to S. Leatherdale) and an operating grant from the Canadian Institutes of Health Research (CIHR) Institute of Population and Public Health (IPPH) (MOP-114875; grant awarded to S. Leatherdale). The COMPASS-Quebec project additionally benefits from funding from the Ministère de la Santé et des Services sociaux of the province of Québec, and the Direction régionale de santé publique du CIUSSS de la Capitale-Nationale. The participation of Yara Barrense-Dias was made possible thanks to a research grant (# IZSEZ0_191187 / 1) granted by the Swiss National Fund for Scientific Research.

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Correspondence to Yara Barrense-Dias.

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Conflict of interest

All authors have indicated they have no potential conflicts of interest to disclose.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or provincial research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. All procedures in the COMPASS study received ethics approval from the University of Waterloo Research Ethics Board (ORE 30118), as well from the Research Ethics Review Board of the Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale [#MP-13–2017-1264] and participating school board review panels.

Informed Consent

The protocol for COMPASS involves active-information passive-consent parental permission procedures. Students could decline to participate at any time.

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Barrense-Dias, Y., Bélanger, R.E., Desbiens, F. et al. Understanding Sexual Health Indicators During Adolescence: A Study to Consider Time Since Sexual Debut When Exploring Multiple Sexual Partners. Arch Sex Behav 51, 1765–1772 (2022). https://doi.org/10.1007/s10508-021-02207-1

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  • DOI: https://doi.org/10.1007/s10508-021-02207-1

Keywords

  • Adolescence
  • Sexual debut
  • Sexual partners
  • Sex differences