Behavioral patterns formed in high school may foreshadow sexual risk-taking in the months after young people leave high school, according to a study of 19-year-olds in the Pacific Northwest.[1] In contrast with literature that associates college attendance and living away from home with increases in risk behaviors, the study shows that in the fall after high school, college attendance predicted a decreased probability of sexual risk behaviors, while living arrangement was not associated with the likelihood of participating in sexual risk behaviors. Academic performance, risky sexual behaviors and drug use during high school, however, were highly associated with post–high school behaviors.

The data came from a longitudinal study of students from 10 public schools in a suburban district. Students were enrolled in the study as first and second graders in 1993, and were interviewed each subsequent year. At baseline, the sample was 47% female and 81% white; no other racial or ethnic group represented more than 7% of the total. The final interview, held in the fall after the 12th grade, was completed by 865 participants, whose average age was 18.4. Data from the 834 unmarried high school graduates in this sample were analyzed.

In the fall after high school, 60% of participants lived with a parent and 45% were attending college. Twenty-five percent lived with a parent and attended college, and 19% did neither. In the month prior to the interview, 63% had been sexually active, 30% had used condoms inconsistently and 23% had engaged in casual sex (defined as having had sex outside of a relationship or with someone they had known for less than two weeks, or having had multiple partners). Eleven percent reported especially high-risk behaviors: sex that was both unprotected and casual, or sex with men who have sex with men, HIV-positive partners or injection-drug users.

The prevalence of each type of sexual risk behavior was significantly lower among participants in college than among those who were not in college. For instance, only 5% of college students had engaged in high-risk sex in the previous month, compared with 16% of those who were not in college. Living with a parent, whether or not the participant also attended college, was not associated with risk behaviors in bivariate analyses. Correlational analysis confirmed these findings and showed that sexual risk behaviors were negatively related to high school grade point average and positively related to having used drugs and having had risky sex in high school.

In an analysis controlling for demographic variables, college status and living situation, college attendance was associated with decreased odds of inconsistent condom use (odds ratio, 0.6), casual sex (0.4) and high-risk sex (0.3). Young people who were in a romantic relationship were more likely than their unattached counterparts to have used condoms inconsistently (6.9), but were less likely to have had casual sex (0.5). Hispanic and black participants were more likely than whites to have had casual sex (2.1 and 2.4, respectively).

In a second multivariate model, the researchers controlled for three additional variables—grade point average, drug use and sexual risk behavior in high school—to determine whether past behavior was associated with correlates of recent sexual risk behaviors. College attendance was no longer associated with condom use or casual sex, but it continued to predict a lower probability of engaging in high-risk sex (odds ratio, 0.5). Living with a parent was insignificant in all cases.

High school behavior, on the other hand, was a powerful predictor of many recent behaviors. The odds of inconsistent condom use and casual sex among participants declined as high school grade point average rose (odds ratios, 0.7 and 0.8, respectively). Having had risky sex in high school was associated with elevated odds of participants’ having performed each of the three sexual risk behaviors—inconsistent condom use (5.1), casual sex (3.0) and high-risk sex (3.4)—after leaving high school. Prior drug use was a strong predictor of casual sex (6.1) and high-risk sex (4.4).

Being in a relationship continued to be positively associated with using condoms inconsistently (6.1) and negatively associated with casual sex (0.3). Race ceased to predict casual sex, while black ethnicity emerged as protective against inconsistent condom use (0.3).

The researchers conclude that the increased freedom young people experience when they leave home or go to college does not necessarily translate into increased sexual risk-taking. In addition, they note that the reduced prevalence of sexual risk behaviors among young people in college is largely explained not by any protective effect of college itself, but by experience with risk and protective behaviors that may have simultaneously influenced sexual behavior and college ambitions. Thus, the researchers contend, "prevention efforts aimed at reducing substance abuse and risky sex and improving academic performance during high school among all youth should result in the reduction of [sexual risk behaviors] in the transition to adulthood." They emphasize the importance of programs that begin early in high school, focus on STD prevention and target non–college-bound youth.

REFERENCE

1. Bailey JA et al., Sexual risk behaviors 6 months post–high school: associations with college attendance, living with a parent, and prior risk behavior, Journal of Adolescent Health, 2008, 42(6):573–579.