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April 8, 2019

Early Sexual Initiation Among Boys: What Should We Do?

Author Affiliations
  • 1Department of Pediatrics, Columbia University Medical Center, New York, New York
  • 2Heilbrunn Department of Population & Family Health, Columbia University Medical Center, New York, New York
JAMA Pediatr. 2019;173(6):522-523. doi:10.1001/jamapediatrics.2019.0469

In the United States, the average age at first sexual intercourse, among both males and females, is approximately 17 years.1 Prior studies have found that, among female and male adolescents, early sexual initiation (before age 13 years) is associated with increased sexual risks, including multiple sexual partners2 and sexually transmitted diseases,3 and co-occurring risks, including binge drinking.2 In studies in the United States and in other countries, early sexual initiation co-occurs with negative factors, including substance use, dating violence, and low school attachment, but the temporality of these associations is limited by cross-sectional study designs.4 The effects of early sexual initiation have also been shown to persist into adulthood, adversely affecting long-term sexual health,5 substance use behaviors (nicotine), and physical health (obesity).6 Given these links, national surveillance surveys among high school students in the United States track early sexual initiation as a key indicator of adolescent wellness. Understanding the causes, correlates, and contexts of early sexual initiation, particularly among young men, whose health needs are specific and often overlooked,7 can inform clinical and public health approaches to address and mitigate the consequences of early sexual initiation.

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