Research Division, Lifespring, Panthapath, Dhaka, Bangladesh.
School of Population Health, UNSW Sydney, New South Wales, Australia.
J Adolesc Health. 2022 Apr;70(4):607-616. doi: 10.1016/j.jadohealth.2021.10.027. Epub 2021 Dec 10.
This study aimed to investigate the regional and sex differences in the prevalence of early sexual initiation and its correlates among school-going adolescents in 50 countries.
We used data from the Global School-based Health Survey from 50 countries in 2009-2015 for 124,091 adolescents (53.5% girls) aged 12-15 years. Using meta-analysis with random effects, we estimated the prevalence of early sexual initiation (i.e., having first sexual intercourse at ≤14 years) by sex, region, and country income classification. Multilevel mixed-effect logistic regressions including a random intercept for countries were used to investigate the correlates of early sexual initiation.
Overall, 14.2% (95% confidence interval: 12.1-16.2) of adolescents aged 12-15 years had early sexual initiation, with boys reporting much higher than girls (19.7%, 16.9-22.5 vs. 8.9%, 7.6-10.3). The prevalence of early sexual initiation was the highest in the region of the Americas (18.4%, 15.2-21.5) and the lowest in the South-east Asia region (5.3%, 2.6-8.0). Adolescents from high-income and lower middle-income countries had the highest (19.5%, 13.5-25.5) and the lowest (7.3%, 5.5-9.0) prevalence, respectively. Older age, anxiety, loneliness, suicidal ideation, being bullied, physical fight, school truancy, smoking, drinking alcohol, illicit drug use, physical activity, and being overweight were associated with higher odds of early sexual initiation, whereas female sex, parental monitoring, and peer support were protective. There was little or no evidence of heterogeneity by sex and across regions for these associations.
Substantial differences in the prevalence are observed by sex and across regions for early sexual initiation among adolescents, whereas its correlates remain relatively similar when examined separately by these characteristics.
本研究旨在调查 50 个国家/地区的在校青少年中早期性启动的区域性和性别差异及其相关因素。
我们使用了 2009-2015 年来自 50 个国家/地区的全球学校健康调查的数据，涉及 124091 名 12-15 岁的青少年（53.5%为女孩）。使用具有随机效应的荟萃分析，我们按性别、地区和国家收入分类估计了早期性启动（即首次性行为发生在 14 岁及以下）的流行率。使用包含国家随机截距的多级混合效应逻辑回归来调查早期性启动的相关因素。
总体而言，12-15 岁的青少年中有 14.2%（95%置信区间：12.1-16.2）发生了早期性启动，男孩报告的发生率明显高于女孩（19.7%，16.9-22.5 与 8.9%，7.6-10.3）。性启动的发生率在美洲地区最高（18.4%，15.2-21.5），在东南亚地区最低（5.3%，2.6-8.0）。来自高收入和中低收入国家的青少年的发生率最高（19.5%，13.5-25.5）和最低（7.3%，5.5-9.0）。年龄较大、焦虑、孤独、自杀意念、被欺凌、打架、逃学、吸烟、饮酒、吸毒、体育活动和超重与早期性启动的可能性增加相关，而女性、父母监督和同伴支持具有保护作用。这些关联在性别和区域之间的异质性很小或没有。
青少年早期性启动的流行率在性别和区域上存在显著差异，而按这些特征分别检查时，其相关因素则相对相似。
