Differences in Reproductive Health Knowledge, Attitudes, and Intentions among Adolescents by Pre-Sexual Experience
Despite significant declines in teen pregnancy since the mid-1990s, the United States still has the highest rate of teen pregnancy among industrialized nations, with especially high rates of unintended pregnancies among black and Latinx teens. Teen pregnancy prevention programs aim to reduce pregnancies among adolescents through reduced sexual activity and/or improved contraceptive use. Programs often target younger adolescents, introducing them to pregnancy prevention programming before they reach the average age of first sexual intercourse (17 years). These programs generally aim to delay sexual initiation and prepare teens with the knowledge and skills to avoid pregnancy should they become sexually active.
Whether teens have “pre-sexual experience”—usually defined as having engaged in sexual touching or oral sex, but not vaginal sex—is an important consideration for teen pregnancy prevention program implementors and evaluators working with younger adolescents. Some previous research has found that adolescents with pre-sexual experience are more likely to initiate vaginal sex than those with no sexual experience. Understanding the knowledge, attitudes, and intentions of adolescents with differing levels of sexual experience can help programs target their message to students.
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In this research brief, we examine students who participated in a teen pregnancy prevention program, Re:MIX. The study participants were mostly Latinx students in grades 8 to 10. We present findings on (1) students’ differing baseline levels of sexual experience (no sexual experience, pre-sexual experience, vaginal sex); (2) whether pre-sexual experience at baseline predicts vaginal sex at 12-month follow-up; and (3) how the knowledge, attitudes, and intentions of students who had pre-sexual experience at baseline compared to those who had no sexual experience or those who had vaginal sex at baseline. Findings highlight the importance of understanding these distinct groups for program implementors and evaluators.
Key findings
- At baseline, about 2 in 10 Re:MIX students (22%) had pre-sexual experience, 9 percent had had vaginalsex, and the remaining 69 percent had no sexual experience.
- Among control participants, students who had pre-sexual experience at baseline were more likely than those who had no sexual experience to have vaginal sex within the next 12 months (26% vs. 6%).
- Students with pre-sexual experience were more likely to intend to have sex in the next year than students with no sexual experience, but less likely to intend to have sex in the next year than students who had had vaginal sex. They also had more accepting attitudes toward having sex in early adolescence than students with no sexual experience, but less accepting attitudes than students who had had vaginal sex.
- Students with pre-sexual experience believed they were less likely to get pregnant (or get someone pregnant) between now and age 20 than those who had had vaginal sex.
- Students with pre-sexual experience were more knowledgeable about condoms and birth control efficacy and more likely to know where to get birth control than students with no sexual experience.
- Students with pre-sexual experience reported that they were less likely to be able to avoid unwanted sex and sexual contact than those with no sexual experience.
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