| Summary: | 碩士 === 國立成功大學 === 公共衛生研究所 === 98 === Objectives：In regard to the data structure of large-scale sample survey of retrospective issue, we pointed out the lack of traditional method and proposed more appropriate model, multi-level discrete time survival model, to analysis. Through the model, we hoped to get the more accurate results about the risk and protective factors for the age at the first sexual intercourse and contraceptive use.
Design：It is a multi-stage cross-sectional survey and a secondary data analysis.
Participants：The data were obtained from a high school survey of sexual knowledge, attitude and behavior conducted by the Bureau of Health Promotion in 2000. The total sample of 7336 students aged 15-19 years.
Main Outcome Measures and Statistical Method：The dependent variable is dose teenagers use contraception measures or not at first sexual intercourse. The relationship of person, family, and school factors to age at first sexual and contraceptive use were estimated by multinomial logit model with random effects.
Results：9.8% of boys and 8.2% of girls were sexually experienced. Among the boys and girls who had sexual behavior, there were 58.8% of boys and 55.4% of girls had used of contraception at the first sexual intercourse. Both boys and girls, the common significant risk factors for the age at debut of sexual intercourse were believing that they can engage in premarital sex, Current smokers, and having friends who were sexually experienced. The significant risk factors for contraceptive use at the initiation of sexual intercourse for boys were believing that they can engage in premarital sex (Z-statistics＝-2.54，P-value＝0.01), and thinking that family love and care about their (Z-statistics＝-1.96，P-value＝0.03). On the other hand, having abused drugs (Z-statistics＝1.91，P-value＝0.03), and mother felt premarital sex can occur (Z-statistics＝1.82，P-value＝0.04) were protective factors. Among girls, risk factors were looking at pornography (Z-statistics＝-1.66，P-value＝0.05), thinking that family love and care about their (Z-statistics＝-1.80，P-value＝0.04), fathers’ neutral attitude towards premarital sex (Z-statistics＝-2.00，P-value＝0.02), and studying in alternative high schools (Z-statistics＝-1.61，P-value＝0.05). Protective factors were watching pornographic films or videos (Z-statistics＝3.17，P-value＜.01), good relationship with their fathers (Z-statistics＝2.77，P-value＜.01), and did not wish to continue their studies (Z-statistics＝2.03，P-value＝0.02).
Conclusions：Peer relations and parent-child interaction were the two main reasons that affected teenager have sex at early age. The factors of peer were not significant for contraceptive use, and the family factors like parent-child communication and parental attitudes about sex were played an important role in contraceptive use at the debut of sexual intercourse. It is highlight the importance of family education. In addition, the occurrence of sexual intercourse at early age and contraceptive use were not different for boys in the different schools, but greatly different for girls. Hence, we looked forward that school education could enhance care and advocacy for different characteristics of students.
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