Middle school youth as young as 12 engaging in risky sexual activity

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Christine Markham, Ph.D., assistant professor of behavioral science at the UT School of Public Health, and colleagues examined sexual risk behaviors among middle school students in a large southeastern U.S. urban public school district.

"This is one of the few school-based studies conducted with this age group to look at specific sexual practices in order to develop more effective prevention programs," Markham said. "This study shows that although most seventh graders are not engaging in sexual risk behaviors, a small percentage are putting themselves at risk."

In the study, Markham and colleagues defined sexual intercourse as vaginal, oral or anal sex. According to their research, by age 12, 12 percent of students had already engaged in vaginal sex, 7.9 percent in oral sex, 6.5 percent in anal sex and 4 percent in all three types of intercourse.

Markham said, "These findings are alarming because youth who start having sex before age 14 are much more likely to have multiple lifetime sexual partners, use alcohol or drugs before sex and have unprotected sex, all of which puts them at greater risk for getting a sexually transmitted disease (STD) or becoming pregnant."

The study found one-third of sexually active students reported engaging in vaginal or anal sex without a condom within the past three months, and one-fourth had four or more partners. The more experienced students in all three types of intercourse were more likely to be male and African-American.

"We need to develop prevention programs that address the needs of students who are not yet sexually active in order to promote skills and attitudes to help them wait until they are older to have sex," Markham said. "And we need to provide skills and knowledge related to condoms and contraception for youth who are already sexually active."

The study recommends that sexually active students also need to receive accurate and factual information and services related to STDs and pregnancy testing, as well as skills for future abstention and risk reduction for those who intend to remain sexually active.

More than one-third of youth in the study reported engaging in precoital touching behaviors. Among the students who engaged in precoital behavior, 43 percent reported having engaged in sexual intercourse.

According to the Centers for Disease Control and Prevention (CDC), 80 percent of the 435,427 births to mothers ages 15 to 19 were the result of unintended pregnancies. According to the National Vital Statistics Report, birth rates among Hispanic and black teens remain higher than other racial/ethnic groups, including rates among those ages 10 to 14.

In 2000, youth between the ages of 15 and 24 accounted for 9.1 million or 48 percent of all new STD cases, according to a report by the CDC. Minority youth also are disproportionately affected. The CDC's 2006 STD Surveillance Report stated that minority racial and ethnic populations had higher rates of STDs when compared to whites and, although black teens represent only 17 percent of U.S. teenagers, they account for 70 percent of HIV/AIDS cases reported among teens. "We need more research to develop effective interventions, in particular for youth of color living in underserved areas," Markham said.

"A common misperception among adolescents is that oral or anal intercourse is not as risky for STD transmission," said Markham. "But transmission of non-viral and viral STDs can occur through all three types of intercourse when condoms are not used."

These findings clearly indicate the need for open discussion about sexual health at the middle school level, Markham said. "It is critical that health education teachers and school nurses feel comfortable addressing these issues with their students and that their efforts are supported by parents and the school administration," she added.

The University of Texas School of Public Health