Palmer Melissa J, Clarke Lynda, Ploubidis George B, Wellings Kaye
Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK.
Department of Social Science, UCL Institute of Education, University College London, London, UK.
BMJ Sex Reprod Health. 2019 Jan 14;45(2):127-37. doi: 10.1136/bmjsrh-2018-200160.
A greater understanding of the circumstances of first sexual intercourse, as opposed to an exclusive focus on age at occurrence, is required in order that sexual health and well-being can be promoted from the onset of sexual activity.
We used data from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3) conducted in Britain. Participants were categorised as 'sexually competent' at first heterosexual intercourse if the following self-reported criteria applied to the event: contraceptive use, autonomy of decision, both partners 'equally willing', and occurrence at the perceived 'right time'. We examined the prevalence of 'sexual competence', and its component parts, by age at first intercourse among 17-24-year-olds. Using multivariable logistic regression, we explored associations between sexual competence and potential explanatory factors.
Variation in 'sexual competence' and its component parts was associated with, but not fully explained by, age at first sex: 22.4% and 36.2% of men and women who had first sex at age 13-14 years were categorised as 'sexually competent', rising to 63.7% and 60.4% among those aged ≥18 years at first intercourse. Lack of sexual competence was independently associated with: first intercourse before the age of 16 years, area-level deprivation (men only), lower educational level, black ethnicity (women only), reporting 'friends' as main source of learning about sex (women only), non-'steady' relationship at first sex, and uncertainty of first partner's virginity status.
A substantial proportion of young people in Britain transition into sexual activity under circumstances incompatible with positive sexual health. Social inequalities in sexual health are reflected in the context of first intercourse.
为了从性活动开始就促进性健康和幸福，需要更深入地了解首次性交的情况，而不是仅仅关注发生时的年龄。
我们使用了在英国进行的第三次全国性态度和生活方式调查（Natsal-3）的数据。如果以下自我报告的标准适用于首次异性性交事件，则参与者被归类为“性能力合格”：使用避孕措施、自主决定、双方“同样愿意”以及在认为的“合适时间”发生。我们研究了17至24岁人群中按首次性交年龄划分的“性能力合格”及其组成部分的患病率。使用多变量逻辑回归，我们探讨了性能力合格与潜在解释因素之间的关联。
“性能力合格”及其组成部分的差异与首次性行为的年龄有关，但不能完全由其解释：13至14岁首次发生性行为的男性和女性中，分别有22.4%和36.2%被归类为“性能力合格”，在首次性交年龄≥18岁的人群中这一比例上升至63.7%和60.4%。性能力不合格与以下因素独立相关：16岁之前首次性交、地区层面的贫困（仅男性）、教育水平较低、黑人种族（仅女性）、报告“朋友”是了解性知识的主要来源（仅女性）、首次性交时处于非“稳定”关系以及对第一个性伴侣的处女身份不确定。
英国相当一部分年轻人在与积极的性健康不相容的情况下开始性活动。性健康方面的社会不平等在首次性交的背景中得到体现。
