Advancing Sexual and Reproductive Health and Rights
Perspectives on Sexual and Reproductive Health
Volume 43, Number 1, March 2011


The “obesity epidemic” and its health effects on U.S. youth receive no shortage of research attention. Less well studied, however, are its effects on young people’s socioemotional development. But in this issue of Perspectives on Sexual and Reproductive Health (see article), Yen-hsin Alice Cheng and Nancy S. Landale explore the relationship between adolescents’ weight status and their timing of first sex. In analyses of two waves of data from the National Longitudinal Study of Adolescent Health (Add Health), they find that overweight youngsters are less likely than their normal-weight peers to begin having sex and that social alienation in peer relationships appears to drive the delay. The overall association holds for females and whites, but not for males or members of other racial and ethnic groups. Cheng and Landale stress that overweight teenagers “who delay sex well beyond the ages when intimate relationships become normative might also be facing [social] issues that hinder healthy sexual development.” Therefore, they urge programs and educators to take steps “to create an environment in which overweight youths feel physically, psychologically and socially accepted.”

Also in This Issue

• Also using Add Health data, Abigail A. Haydon and colleagues tackle another understudied issue: the relationship between maltreatment during childhood and STD risk in young adulthood (see article). They report that young adult women who experienced sexual abuse, physical abuse, physical neglect or supervision neglect as children had elevated odds of saying that they have recently had an STD; those who had been physically neglected also were more likely than others to test positive for an STD when surveyed at ages 18–26. No such associations were found for males in adjusted analyses. The findings, the authors write, “underscore the need to consider childhood experiences that may contribute to elevated STD risk later in life.”

• In a sample of young family planning clinic clients seeking oral contraceptives, Angela R. Dempsey and coinvestigators found that those who considered the pill’s advantages important and were confident that they could use the method even if they encountered obstacles had elevated odds of continuing use for six months (see article). Women’s perceptions of the pill’s disadvantages were not linked to continuation. Nor were their demographic characteristics, which have been significant in other work. According to the researchers, these findings are important because demographic variables are not modifiable, but a woman’s perceptions of the pill’s advantages and her self-confidence may be. The attitudinal variables derive from the transtheoretical model of health behavior change, and the findings, the authors contend, argue for exploring the model’s application in studies of continuation of other methods.

• Parents may help their teenage children avoid sexual risk by imparting particular values or communicating particular messages about sex. In addition, through day-to-day parenting processes not specifically focused on sex, they may foster their children’s ability to have positive early sexual relationships, as Alison Parkes and colleagues found in their study of Scottish adolescents (see article). Parental supportiveness, for example, was positively associated with teenagers’ feelings of sexual autonomy and, for those who were not yet sexually experienced, with the expectation that first sex would occur within the context of a relationship. These and other findings lead the authors to conclude that parents’ role in their children’s sex education should not be framed “solely in terms of advocating delayed sex.”

• After declining for more than a decade, the incidence of abortion in the United States remained essentially stable between 2005 and 2008, according to Rachel K. Jones and Kathryn Kooistra, who analyzed data collected in a census of facilities that provided abortions in 2007 and 2008 (see article). Some states, however, registered changes. Nationwide, the abortion rate increased by 1% from 2005 to 2008, and the number of providers showed no change; in both years, nine in 10 U.S. counties had no abortion provider, and one-third of women of reproductive age lived in those counties. The researchers urge policymakers to ensure the widespread availability of family planning services, to reduce the numbers of unintended pregnancies and abortions.

• Using data from three waves of the National Survey of Adolescent Males, spanning the period 1988–1995, Jacinda K. Dariotis and colleagues found that black men and Latinos were more likely than whites to maintain a high level of sexual risk and to increase their level of sexual risk over time (see article). Blacks were the most likely to have a history of STDs, and this disparity persisted even when socioeconomic characteristics and level of sexual risk were controlled for. The researchers suggest that understanding these disparities might require exploration of social context, to identify environmental or social network differences among racial and ethnic groups, as well as examination of the availability of sexual and reproductive health services, to assess gaps in access.

• In a survey of women attending adolescent health clinics in low-income Boston-area neighborhoods, Jay G. Silverman and coinvestigators found that the experience of intimate partner violence was common and was associated with a wide range of sexual risk factors (page 60). The two-fifths of the sample who had experienced abuse had elevated odds of reporting both standard risk behaviors (e.g., multiple partners) and risk involving coercion or deception by a male partner (e.g., partner infidelity and fear of requesting condom use). “These findings,” the authors remark, “highlight the need to expand understanding of STD risk factors to include behaviors not under women’s control.”

—The Editors