Racial Differences in Time-Varying Effect of Age of Sexual Debut on Sexual Risk Behavior in Young Adulthood

Introduction: Black Americans bear the most severe burden of HIV in the United States; the rates of new HIV infections in Blacks are 8 times that of their White counterparts. Racial disparities in sexual risk may begin early in adolescence, as Black adolescents can be exposed to a wider variety of risk factors earlier in their development and have fewer resources to learn from early sexual experiences and change course to healthier sexual behavior. A new method, the time-varying effect model (TVEM), can help researchers identify ages during which interventions are most strongly indicated. This study uses TVEM to examine the relationship between age of sexual debut and probability of risky sexual behaviors in young adulthood, and how these time-varying relationships may differ in Black and White adolescents.

Methods: Data are a subsample of participants (N = 4,024) from Wave 4 of the National Longitudinal Study of Adolescent to Adult Health (ages 24 to 34). Participants reported on the age at which they first had sexual intercourse and their sexual behaviors in the past year. Participants were included in the analysis if they had sex for the first time before age 24, had been sexually active in the past year, and identified as either non-Hispanic White or non-Hispanic Black/African American. Logistic TVEMs were run separately by race to model the probability of condom use, multiple partners, and paying/being paid for sex in the past year as a continuous function of age of sexual debut.

Results: Blacks had sex for the first time on average one year earlier (M = 15.7) than whites (M = 16.7). Blacks were overall more likely than whites to use condoms, but they were also more likely to have had multiple sexual partners and engaged in paid sex. The time-varying relationship between age of sexual debut and risky behavior differed by race. The probability of paid sex and multiple sexual partners decreased steadily as age of sexual debut increased from 10 to 24 for Blacks, but increased between age 10 and 15 before decreasing again for Whites. The probability of condom use remained the same for Black adults regardless of age of sexual debut, but increased steadily from age 10 to age 24 for Whites.

Discussion. Findings suggest that for both Black and White adolescents, the period of early adolescence may be a crucial time to intervene to prevent sexual risk behavior.  This period may be especially important for White adolescents for certain kinds of sexual risk behavior, given the peak of the relationship between age of sexual debut and risk behavior in early adolescence for this population.