Sexual intercourse, contraception, and risk-taking behavior among unselected French adolescents aged 11-20 years

Abstract

An epidemiological study was carried out among 4,255 adolescents, aged 11-19 years, randomly selected from secondary schools in a northern urban area of France. The questionnaire concerned sexual activity, contraception, health status, licit and illicit drug consumption, and other risk-taking behavior. A total of 31% of the adolescents had had sexual relations (43% of the boys, 20% of the girls). Sexual activity increased with age. A large majority (70%) of the sexually active adolescents used some form of contraception. The study confirms the relationship between smoking, drinking, illicit drug consumption, and sexual activity, but shows that contraceptive behavior is not related to problem behavior.

PIP: Questionnaires from 4255 randomly selected adolescents from 42 schools in the northern district of Arras in France in the winter of 1988/89 were obtained in order to examine 1) the relationship between risk-taking behavior and sexual behavior, and 2) the negative relationship between contraception and risk-taking behavior by age and sex. Questions were based on a tool developed by Choquet and Menke and included measures of sociodemographics, academic standing and difficulties, life style, quality of family and peer relationships, self-perception, sexual activity, contraceptive habits, licit and illicit drug use, and recent health visits. Stepwise logistic regression was used in the analysis of the sexually experienced (SI), who were further grouped into contraceptive users (CTC) or not (NCTC). Relative odds ratio (OR) and logistic regression were used to assess the relative effect of risk-taking behavior on contraceptive use or sexual intercourse. Descriptive results showed 52.3% boys and 47.7 girls. 86.8% of fathers and 51.3% of mothers were employed. Fathers were in a variety of professions: executives (13%), shopkeepers (8%), middle managers (13%), office employees (19%), blue-collar workers (32%), and farmers (6%). 81% of parents were married. 43% of boys and 20% of girls were SIs, of whom 50% were active regularly. 71% of boys and 76% of girls used contraception (p.05) and 50% of boys and 69% of girls used it systematically. SIs increased with age. For boys, each risk behavior at any age was related to sexual activity; proportions of sexually active varied with risk behavior. For girls, similar trends were found, i.e., heavy smoking and regular illicit drug use were correlated the most significantly with sexual activity. There were differences also. CTC and NCTC groups had similar risk-taking behavior. Frequency of contraceptive use was 2.5 times greater in the older boys' age group (OR = 2.45). Smoking (the strongest predictor), drinking (more prevalent among boys), and illicit drug use are all related to sexual activity, but not necessarily contraception. The implications are that contraceptive use would have been lower and sexual activity higher if other populations had been included. For health care providers, it is important that treatment of adolescent sexuality involve the whole person and context, and not as an isolated problem. A weakness was in not including confounding factors such as social class and the lack of detailed questions on topics.