Selected risk and protective factors associated with two or more lifetime sexual intercourse partners and non-condom use during last coitus among U.S rural high school students

This analysis determined the association between 13 selected health risk and protective factors and reporting two or more lifetime sexual intercourse partners and non-condom use for last coitus among sexually experienced U.S rural high school students. The sample was 569 sexually experienced adolescent females and 561 sexually experienced adolescent males who participated in the national 1999 Youth Risk Behavior Survey and who attended rural high schools. For females, coital debut before age 15, forced sexual intercourse, physical abuse, and marijuana use were associated with having two or more lifetime sexual intercourse partners. Coital debut before 15, binge drinking, and marijuana use were associated with having two or more sexual intercourse partners for males. Coital debut before age 15, forced sexual intercourse, and regular cigarette smoking were associated with non-condom use at last coital episode for females. Forced sexual intercourse and cocaine use were associated with non-condom use at last coital episode for males. A greater number of correlates were identified for females as opposed to males. The findings suggest that rural adolescents who initiate sexual activity at an early age are at markedly greater risk of engaging in subsequent sexual risk behaviors, such as having multiple sex partners and non-condom use. Further, substance use and a history of forced sex were also prominent determinants of sexual risk-taking. The findings portend that there is value in delaying the onset of coitus until adolescents are older. Thus, risk reduction programs should encourage the postponement of sexual initiation. Finally, the findings suggest that programs that address the key role of substance use and the psychological sequelae of sexual abuse might be more effective at reducing sexual risk-taking among rural adolescents.