Abma J, Driscoll A, Moore K
Reproductive Statistics Branch, National Center for Health Statistics, Hyattsville, MD, USA.
Fam Plann Perspect. 1998 Jan-Feb;30(1):12-8.
While policymakers and researchers alike often seem to believe that young women's decision to initiate sexual intercourse is conscious and free of ambiguity, the actual degree of control that such young women exert over first intercourse has rarely been explicitly examined.
The 1995 National Survey of Family Growth asked all women who had experienced intercourse to rate, on a 1-10 scale, the wantedness of their first intercourse; they were then asked whether the experience was voluntary. Logistic regression analysis of data for women aged 15-24 who had experienced first premarital intercourse was performed to test the effect of background factors and wantedness scores on contraceptive use at voluntary first intercourse.
Twenty-four percent of women aged 13 or younger at the time of their first premarital intercourse report the experience to have been nonvoluntary, compared with 10% of those aged 19-24 at first premarital intercourse. About one-quarter of respondents who reported their first intercourse as voluntary chose a low value (1-4) on the wantedness scale. Women whose first partner was seven or more years older than themselves were more than twice as likely as those whose first partner was the same age or younger to choose a low value (36% vs. 17%). Women whose partner had been seven or more years older were also less likely than other women to have used contraceptives at first intercourse. After the introduction of controls for demographic and background factors, partner age discrepancy and relationship status, wantedness of voluntary first intercourse was not independently related to the odds of contraceptive use at that intercourse.
Characterizing women's first intercourse as simply voluntary or nonvoluntary is inadequate. Measures that take into account degrees of wantedness may help elucidate relationships between sexual initiation, contraceptive use and teenage pregnancy. The fact that substantial numbers of young women voluntarily participated in a first sexual experience about which they felt ambivalent or negative deserves the attention of program planners and service providers.
虽然政策制定者和研究人员似乎常常认为年轻女性开始性行为的决定是有意识的且不存在模糊性，但这类年轻女性对首次性行为的实际掌控程度却很少得到明确研究。
1995年全国家庭成长调查要求所有有过性行为的女性用1至10分对其首次性行为的意愿程度进行评分；随后询问她们该经历是否是自愿的。对15至24岁有过首次婚前性行为的女性数据进行逻辑回归分析，以检验背景因素和意愿程度评分对自愿首次性行为时避孕措施使用情况的影响。
在首次婚前性行为发生时年龄为13岁或更小的女性中，24%报告该经历为非自愿，而在首次婚前性行为发生时年龄为19至24岁的女性中这一比例为10%。约四分之一将首次性行为报告为自愿的受访者在意愿程度量表上选择了较低分值（1至4分）。首次性伴侣比自己大七岁或更多的女性选择较低分值的可能性是首次性伴侣年龄相同或更小的女性的两倍多（36%对17%）。伴侣比自己大七岁或更多的女性在首次性行为时使用避孕措施的可能性也低于其他女性。在引入对人口统计学和背景因素以及伴侣年龄差异和恋爱关系状况的控制变量后，自愿首次性行为的意愿程度与该次性行为时使用避孕措施的几率并无独立关联。
将女性的首次性行为简单地描述为自愿或非自愿是不够的。考虑意愿程度的措施可能有助于阐明性开始、避孕措施使用和青少年怀孕之间的关系。大量年轻女性自愿参与了她们感到矛盾或消极的首次性经历，这一事实值得项目规划者和服务提供者关注。
