African-American adolescent girls' initiation of sexual activity: survival analysis

Abstract

Purpose: African-American adolescent females tend to initiate participation in sexual activity at an earlier age than Caucasian adolescent females. Early initial participation in sexual activity is associated with increased risk of HIV infection. However, limited prospective data are available on the rate at which African-American adolescent females delay their initial participation in sexual activity. The purpose is to determine low-income, inner-city, African-American adolescent females' survival or continued nonparticipation in sexual activity over a 20-month period and to determine predictors associated with survival.

Methods: A longitudinal, quasi-experimental research design with multiple data collection points was used. The convenience sample consisted of 396 African-American females with a mean age of 12.4 years (SD = 1.1 years) and their mothers. The adolescents completed questionnaires assessing perceptions of maternal monitoring, HIV transmission knowledge, self-efficacy to refuse sex, intention to refuse sex, and age. Their mothers completed questionnaires assessing perception of maternal monitoring, safer sex self-efficacy, marital status, and educational level. At baseline, the adolescents reported nonparticipation in sexual activity. Survival analysis was conducted to determine the timing and predictors of sexual activity initiation for these adolescents.

Findings: Of the 396 adolescents, 28.5% did not survive; they participated in sexual activity within the 20-month period. Predictors of non-survival were the adolescents' age, perception of maternal monitoring, and intention to refuse sex.

Conclusion: Findings suggest interventions that increase maternal monitoring and adolescents' intentions to refuse sex could be beneficial in delaying sexual activity.

Figure 1

Distribution of survival from sex initiation over 20 months for African American adolescent females (product-limit estimate curve). Panel A: Survival probabilities for the entire sample (N=396). Panel B: Survival probabilities by age at T1.