Factors that affect Early Sexual Initiation in a Sample of College Students in North-East Tennessee: The Role of Adverse Childhood Experiences, Economic Hardship, Family Structure and Religiosity.

• Main Authors: ROTIMI, Oluyemi R, Dubasi, Hima Bindu, Yadav, Ruby, Maisonet, Mildred
• Format: Others
• Published: Digital Commons @ East Tennessee State University 2018
• Subjects: ACEs; Adolescent; Sexual; Health; Hardship; Epidemiology; Public Health
• Online Access: https://dc.etsu.edu/asrf/2018/schedule/59; https://dc.etsu.edu/cgi/viewcontent.cgi?article=1189&context=asrf

Background Normal adolescent development often involves sexual activity. Early sexual initiation poses a challenge to health and well-being. In 2015, Tennessee had the 9th highest teen birth rate in the country. The structural, social and economic environments of growth define sexual risk taking, with poverty, Adverse Childhood Experiences (ACEs) religiosity and family structure known to affect adolescent and adult health. This study seeks to explore the effect of these factors on early sexual initiation. Methods A sample of college students taking the introductory psychology course participated in the study through the ETSU SONA system. They completed a self-reported web-based survey inquiring about their family structure growing up (between the ages of 5 and 15), exposure to adverse childhood experiences (ACEs), economic hardship, religious attendance at age 14 and sexual risk behaviors such as age of sexual debut and total lifetime number of sexual partners. Early sexual initiation was defined as having sexual intercourse with the opposite sex before 15 years of age. Of 385 students who completed the survey, final analysis included 352 (91.4%) students who were between ages 18-24. We used descriptive statistics to analyze survey responses. Chi square tests were done to determine the association of these exposures with age at sexual initiation. Bivariate logistic regression was used to explore the impact of the structural, social and economic environments while growing up on age at sexual initiation. All analyses were done on SAS 9.4. Results Of 352 included in the analysis, 239 (67.9%) were females, 264 (72.73%) are Non-Hispanic whites and 314 (89.2%) have never been married. About 60% had at least one ACE and 111 (31.53%) had high economic hardship. Mean age at sexual debut was 16.55 (16.56 for females and 16.53 for males). Only 7.1% had sexual initiation before 15. Based on chi square tests, early sexual initiation was associated with higher ACE scores, no / infrequent religious attendance and ‘not always living with biological or adoptive parents from birth to age 18’. Economic hardship was not associated with early sexual initiation. Bivariate logistic regression showed significantly higher chances of early sexual initiation (before 15 years) with one to three ACEs (P-value= 0.03) and ≥ 4 ACEs (P-value= 0.004). Conclusion The social, structural and economic environment of a child’s growth is a major determinant of sexual risk behaviors. Interventions should be aimed at modifying the environment in which children grow to reduce rates of teen pregnancy and sexually transmitted infections and improve health.