| Summary: | 碩士 === 國立臺灣大學 === 流行病學與預防醫學研究所 === 106 === Background. Previous studies showed that early sexual initiation was associated with negative sexual health outcomes. However, most studies were conducted in Western populations and did not examine the role of illicit drugs in the pathway. This study aims to (1) examine the associations between early sexual initiation and risky sexual practices in Taiwan and (2) the mediation effects through drugs before sex in the above associations.
Methods. Participants were recruited from regular alcohol- and tobacco-using young adults (aged 18-50) in the Taipei metropolitan area through respondent-driven sampling (N = 1115). Respondents completed a computer-assisted self-interview covering a variety of questions on substance use and sexual experiences, among others. We analyzed a sexually experienced subsample of 916 participants. Multivariable logistic regression analyses examined the associations between early sexual initiation (before age 16) and four risky sexual practices, respectively – multiple sexual partners (≥ 8 partners in lifetime), casual sex, group sex, and inconsistent condom use (sometimes/seldom/never). Interaction terms of early sexual initiation and gender were applied to the logistic regression models to examine moderation effects of being male on the associations between early sexual initiation and the four risky sexual practices. Causal mediation analyses examined if and to what extent drugs before sex (yes/no in lifetime) mediated these associations.
Results. Around 9% reported early sexual initiation and the prevalence of risky sexual practices ranged from 7% (group sex) to 47% (inconsistent condom use). Early sexual initiation was positively associated with multiple sexual partners, casual sex, and group sex. The odds ratio of early sexual initiation with multiple sexual partners or casual sex was greater for females than males. Significant mediation effects through drugs before sex were found between early sexual initiation and the three risky sexual practices, with the proportions mediated ranging from 17% to 22%.
Conclusions. Early sexual initiators among alcohol- and tobacco-using young adults were more likely to engage in risky sexual practices and drugs before sex partially explained this relationship. Attention should be given to the sexual health of this population in Taiwan and more generally in East Asia.
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