Factors Associated to the Occurrence of the First Intercourse in Adolescents Authors: Prof. Dr. Jorge Pelaéz Mendoza Dr. Orlando Rodríguez Pons Dr. Raúl

Factors Associated to the Occurrence of the First

Intercourse in Adolescents

Authors:

Prof. Dr. Jorge Pelaéz MendozaDr. Orlando Rodríguez PonsDr. Raúl Bermúdez Sánchez

JPM/SIJ.SCOG/1999

Factors Associated to the Ocurrence of the First Intercourse in Adolescents

JPM/SIJ.SCOG/1999

• Today’s adolescent are affected by a disproportionately high prevalence of unplanned pregnancies, sexually transmitted diseases, including AIDS, and other serious problems that affect their reproductive health.

• A risky sexual behaviour is considered responsible of all of this problems


JPM/SIJ.SCOG/1999

• Precocious first intercourse.

• Poor recognition of the risks involved in relationships held in inappropriate circumstances and places.

• Frequent changes of couples.

• Ignorance about sexuality.

• Birth control is not considered as a couple’s problem.

• Lack of essential knowledge and use of contraceptive methods.

• Insufficient knowledge about STD and their prevention.

Risky Sexual Behaviour

Factors Associated to the Occurrence of the First Intercourse in Adolescents

JPM/SIJ.SCOG/1999

Defined as the first coitus seen as an intimate experience of communication of desires, affections and instincts between two human beings, which could take part voluntarily or involuntarily.

Sexual Initiation:


JPM/SIJ.SCOG/1999

It is considered as a sexual relationship that begins before the adolescent’s arrival to the consolidation stage, between ages 17 and 19 (Bloss & Erickson 1989)

Precocious Sexual Initiation:


JPM/SIJ.SCOG/1999

Adolescent Psychosexual Development:

S t a g e A g e M o t i v a t i o n M a n i f e s t a t i o n

I s o l a t i o n 1 2 - 1 3 P r o f o u n d p u b e r a lc h a n g e s

M a l e : t e n d e n c y t o w a r d s s a m e s e x ,j o k e s a g g r e s s io n .F e m a l e : t e n d e n c y t o w a r d s o p p o s i t es e x , i n d e p e n d e n c e f r o m p a r e n t s ,m a s t u r b a t i o n

U n c e r t a i n l y 1 4 - 1 5 R e l a t iv e c o n t r o l o v e rp u b e r a l c h a n g e s ,s e a r c h f o r p a r e n t a lp a t t e r n s

I d e a l iz a t io n i n t im a t e f r ie n d .C a n a l i z a t i o n o f e r o t i c i s s u e s t h r o u g hc o n f id e n c e s , m a s t u r b a t i o n , o c c a s io n a lh o m o s e x u a l r e la t i o n s

Adapted from Bloss and Erickson


JPM/SIJ.SCOG/1999

Adolescent Psychosexual Development:

S t a g e A g e M o t i v a t i o n M a n i f e s t a t i o n

O p e n i n g t oh e t e r o -s e x u a l i t y

1 6 - 1 7 A f f i r m a t i o n o fs e x u a l i d e n t i t y ,s t r o n gn a r c i s s i s m

I n t e n s e a n d a m b i v a l e n tr e l a t i o n s h i p s b e t w e e n b o t hs e x e s , l a c k o f c o m p r o m i s e ,e p h e m e r a l

C o n s o l i d a -t i o n

1 8 - 1 9 A c h i e v e di d e n t i t y , s i n g l el o v e o b j e c t

G r e a t e r e m o t i o n a l s t a b i l i t y

Adapted from Bloss and Erickson


JPM/SIJ.SCOG/1999

Commitment in a couple does not end in the mutual preoccupation about sexual pleasure, but extends up to include the reciproque responsability on birth control and the results of such union, in other words, pregnancy.Master and Jhonson, 1989


JPM/SIJ.SCOG/1999

• Frustrating experiences favouring sexual dysfunction.

• Continuous changes of couple resulting in a risky sexual behaviour.

• Increased risk of STD, genital infections and their sequels(CIN-PID).

• Higher risk of abortion.

• Unplanned pregnancies and their consequences.

• Higher risk to suffer from PID and its medium & long term consequences (infertility/ectopic pregnancy).

• Increased reproductive risk.

Precocious sexual initiation, consequences:


JPM/SIJ.SCOG/1999

1.To know the frequency of adolescents attending secondary school that have initiated intercourse.

2.To determine the causes that lead them to have a precocious intercourse.

3.To study the adolescent’s environment to establish risk and protective factors for precocious intercourse.

4.To know the characteristics and motivation for the first intercourse.

Objectives of the study:


JPM/SIJ.SCOG/1999

• Eight junior high, technical and high school institutions from Havana City were randomly selected.

• A self responded and anonymous questionnaire was applied to the totality of students who went to classes on the day established by the study.

• Four multidisciplinary teams were created who were responsible for the application of the questionnaire.

Method:


JPM/SIJ.SCOG/1999

• A total of 2713 students filled the questionnaire.

• Seventy three questionnaires were excluded due to incompleteness or mistakes, totalling 2640 students (1425 males, 1215 females)

• Informed consent was obtained from each individual and Institution.

Method:


JPM/SIJ.SCOG/1999

Adolescents included in the survey by gender

1215

46% 54%

1425

Sources: Adolescent Sexuality Survey Havana 1998


JPM/SIJ.SCOG/1999

Distribution by age


0

100

200

300

400

500

600

700

Ages


JPM/SIJ.SCOG/1999

Sexual initiation by Gender


Initiated Non initiated Total

Male

Female

721 704 1425

995 220 1215

P<0,005


JPM/SIJ.SCOG/1999

Sexual initiation by age and gender


0

50

100

150

200

250

300

Female Male

Ages

P<0,005


JPM/SIJ.SCOG/1999

First Intercourse: Characteristics of the partner.


0

100

200

300

400

500

600

700

boy or girlfriend

Friend Relative Unknow

Female

Male


JPM/SIJ.SCOG/1999

First Intercourse: Causes or motivation.


0

50

100

150

200

250

300

350

400

own will partnerpressure

grouppressure

familypressure

deceit rape others

Male

Female

P<0,005

1301

148 154 194261

582

Initiated No Initiated Ignore

Sexual Initiation

No Sexual Initiation


Sexual Initiation

JPM/SIJ.SCOG/1999

Characteristics of Peers Groups


P<0,005Peers Group

463

63

601

335

652

526

Abortion No Abortion Ignore


Sexual Initiation

Sexual Practices in AdolescentsSexual Initiation

JPM/SIJ.SCOG/1999

Antecedents of abortion in Peers Groups


P<0,005Peers Group


JPM/SIJ.SCOG/1999

Characteristics of the family.


0

100

200

300

400

500

600

700

800

900

Very Good Good Regular Bad Very bad


Sexual Initiation

Relationships

P<0,005


JPM/SIJ.SCOG/1999

Adolescent Convivence.


0

200

400

600

800

1000

1200

Bothparents

Motheronly

Fatheronly

Grands Othersrelative

Others norelative


Sexual Initiation

Convivence

P<0,005


JPM/SIJ.SCOG/1999

First Intercourse: Judgement by Gender


0

100

200

300

400

500

600

Verypleasant

Pleasant Fear-stress Indifferent unpleasant others

Female Male

P<0,005


JPM/SIJ.SCOG/1999

First Intercourse: Use of contraceptive methods


86%

14%Y es

No


JPM/SIJ.SCOG/1999Sources: Adolescent Sexuality Survey Havana 1998

0

100

200

300

400

500

600

700

800

900

1000

Relationnon

planned

Ignore risk underalcohol or

drugseffects

Ignorance fear others

First Intercourse: Reasons given for not use contraceptive


JPM/SIJ.SCOG/1999Sources: Adolescent Sexuality Survey Havana 1998

0

50

100

150

200

250

300

350

400

450

500

Alleys / parks School Partner orfriend house

Own house Party /discotheque

Beach /camping

Motel / Hotel Others

First Intercourse: Where it happened


JPM/SIJ.SCOG/1999

Sexuality information level


0

100

200

300

400

500

600

700

800

900

Very Good Good Regular Bad Very bad


Sexual Initiation

Information level

P<0,005


JPM/SIJ.SCOG/1999

Life Project


Confuse31%

Absence30%

Definite39%


JPM/SIJ.SCOG/1999

Life Project


0

200

400

600

800

1000

1200

Definite Confuse Absence


Sexual Initiation

Life Project

P<0,005


JPM/SIJ.SCOG/1999

• There is a high percentage of adolescent that initiate precociously their sexual relationships, more frequently among males.

• The majority of adolescents start their first intercourse voluntarily, although some of them under some degree of pressure from their counterparts and groups.

• Belong to a group in which the majority have begun sexual relationship, as well as to belong to a dysfunctional family behaved as risk factor of precocious sexual initiation.

Conclusions:

Sexual Practices in Adolescents

Sexual Initiation

JPM/SIJ.SCOG/1999

• A vast majority of adolescents had their first intercourse in inappropriate places and circumstances, did not use contraceptive methods.

• A great percentage of female referred a non-pleasant experience for their first intercourse.

• The convivence with both parents, as well as a clear definition of their life project behaved as a protective factors of the precocious sexual initiation

Conclusions:


JPM/SIJ.SCOG/1999

An intense work should be developed aimed to the elimination, modification or control of reproductive risk factors in adolescents, with special attention to the precocious sexual initiation.

The following aspects should be considered:

•Gender perspectives

•Education in sexual health

•Programs for the development of youth

•Psicologic and social pressures

•Media participation

Recommendations:

Documents

Factors Associated to the Occurrence of the First Intercourse in Adolescents Authors: Prof. Dr. Jorge Pelaéz Mendoza Dr. Orlando Rodríguez Pons Dr. Raúl