Adolescent sexual debut, risk factors, protective factors, and health risk behaviors: Rural, suburban, and urban differences

Problem. Adolescents in the United States experience early sexual debut. This is the beginning of the trajectory leading either to healthy sexual behaviors, or to problematic behaviors resulting in pregnancy and STDs. The total cost to society in actual medical dollars spent, as well as the multiple social costs such as missed life opportunities, infertility, drug and alcohol treatment, incarceration, social and financial support of children produced, and premature deaths are difficult to quantify, but certainly substantial monetarily, psychologically, and socially.; Purpose. The first purpose was to analyze the differences in risk factors and protective factors associated with age at sexual debut among rural, suburban, and urban adolescents. The second purpose was to evaluate the relationship between age at sexual debut and health risk behaviors among rural, suburban, and urban adolescents.; Methods. A secondary analysis of the 2003 YRBS data set, split by gender, tested the model for factors affecting age at sexual debut among urban, suburban, and rural adolescents. Multifactor ANOVAs analyzed the relationships between protective factors, risk factors, and health risk behaviors while controlling for location of residence.; Findings. Location of residence was a factor in age at sexual debut. Rural students were oldest at sexual debut, suburban adolescents were younger, and urban students were youngest. Gender also affected age at sexual debut, with males younger at sexual debut than females. Adolescents with protective factors had an older age at sexual debut than those without. The presence of risk factors and health risk behaviors was associated with a younger age at sexual debut.; Conclusions. Adolescents deserve appropriate interventions aimed at changing behaviors in order to meet Healthy People 2010 goals. Interventions to modify factors affecting age at sexual debut hold the potential to increase the percent of adolescents who abstain from intercourse and to increase condom use among those adolescents who are sexually active. Both of those actions will also help to meet the Healthy People 2010 objective of decreasing the rate of new AIDS cases among adolescents and adults.