A substantial minority of young adults in Britain were not prepared for their first sexual activity in terms of consent, autonomy, contraceptive use and readiness, so it often occurred in circumstances “incompatible with positive sexual health”, according to a large study* from the London School of Hygiene and Tropical Medicine. The researchers reported in BMJ Sexual & Reproductive Health that adverse circumstances of first sexual intercourse were associated with socioeconomic status, educational level, source of sex education, and relationship with, and virginity status of, the first partner. They called for a greater focus on reducing these disparities rather than on young age alone.
The team analysed data from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3) conducted in Britain in 2010-12, to consider whether a subgroup of 2,825 participants, aged 17-24 years, had been ‘sexually competent’ at the time of first heterosexual intercourse. They categorised participants as ‘sexually competent’ if the following self-reported criteria applied to the event: contraceptive use, autonomy of decision, both partners ‘equally willing’, and occurrence at the perceived ‘right time’.
They found that age at first sex was associated with, but could not fully account for, variation in ‘sexual competence’ and its component parts: 22.4% of men and 36.2% of women who had first sex at age 13-14 years were categorised as ‘sexually competent’, rising to 63.7% and 60.4% respectively among those who had been at least 18 years old at first intercourse. Lack of sexual competence was independently associated with: first intercourse before the age of 16 years; area-level deprivation (men only); lower educational level; black ethnicity (women only); reporting ‘friends’ as main source of learning about sex (women only); ‘non-steady’ relationship at first sex; and uncertainty of first partner’s virginity status.
They noted: “The finding that age at first sex does not explain all of the variation observed in sexual competence, and nor does it account for the associations found with other antecedent factors, suggests that this measure is not merely a function of age at first sex, but rather tapping into a distinct dimension of the experience in itself.”
They pointed out that previous research has suggested that the experience of first sexual intercourse can have implications for sexual health status later in life; and analyses of Natsal-3 data have identified lack of sexual competence at first intercourse to be a risk factor for poor subsequent sexual health among young people, independently of their age at first sex.
They commented: “Therefore, it is possible that targeted interventions aimed at enabling at-risk young people to have a more positive and healthy first sexual experience may result in improvements in sexual health that continue into adulthood.”
*Palmer ML, Clarke L, Ploubidis GB, et al. Prevalence and correlates of ‘sexual competence’ at first heterosexual intercourse among young people in Britain. BMJ Sex Reprod Health Published Online First 14 January 2019. doi:10.1136/bmjsrh-2018-200160.