Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
School of Big Data Management, Soochow University, Taipei, Taiwan.
BMC Public Health. 2020 Nov 3;20(1):1647. doi: 10.1186/s12889-020-09777-0.
As early sexual initiation is increasingly common in East Asia, we examined its relations to risky sexual practices in alcohol- and tobacco-using individuals in Taiwan and evaluated whether the associations were mediated through preceding-sex use of illicit drugs.
Participants, recruited from alcohol- and tobacco-using adults aged 18 to 50 in Taipei through respondent-driven sampling (N = 1115), completed a computer-assisted self-interview covering questions on substance use and sexual experiences. In a subsample of 916 participants who had had sexual experience (median age 27), we examined the relations of early sexual initiation (< 16 years) to multiple sexual partners, casual sex, group sex, and rare condom use. Causal mediation analyses were conducted to examine whether illicit drug use preceding sex mediated these associations.
Around 9.3% reported early sexual initiation and the prevalence of risky sexual practices ranged from 7% (group sex) to 47% (rare condom use). Early initiators had a higher prevalence of regular binge drinking, illicit drug use, and risky sexual practices. In the multivariable analyses, higher odds of multiple sexual partners, casual sex, and group sex were consistently associated with early sexual initiation, gender, and their interaction. Mediation through preceding-sex use of illicit drugs was found between early sexual initiation and the three risky sexual practices, with the proportions mediated ranging from 17 to 19%.
Early sexual initiators were more likely to engage in risky sexual practices and preceding-sex use of illicit drugs partially explained this relationship, calling for more attention to this population's sexual health.
由于东亚地区性初潮年龄提前的现象越来越普遍，我们考察了性初潮年龄提前与台湾地区烟酒使用人群中危险性行为之间的关系，并评估了这种关联是否通过之前使用非法药物的性经历来介导。
通过在台北地区对 18 至 50 岁的烟酒使用成年人进行应答者驱动抽样（N=1115），招募参与者完成了涵盖物质使用和性经历问题的计算机辅助自我访谈。在有性经历（中位数年龄 27 岁）的 916 名参与者的子样本中，我们研究了性初潮年龄提前（<16 岁）与多个性伴侣、随意性行为、群交和很少使用避孕套之间的关系。进行了因果中介分析，以检验之前的性行为中使用非法药物是否会中介这些关联。
约 9.3%的人报告性初潮年龄提前，危险性行为的流行率从 7%（群交）到 47%（很少使用避孕套）不等。性初潮提前者更频繁地出现有规律的狂欢饮酒、非法药物使用和危险性行为。在多变量分析中，多个性伴侣、随意性行为和群交的更高可能性与性初潮提前、性别及其相互作用始终相关。在之前的性行为中使用非法药物在性初潮提前和三种危险性行为之间存在中介作用，中介比例从 17%到 19%不等。
性初潮提前者更有可能进行危险的性行为，之前的性行为中使用非法药物部分解释了这种关系，呼吁更多关注这一人群的性健康。
