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J Epidemiol Community Health 2009;63:39 doi:10.1136/jech.2009.096719m
  • Thursday 10 September, Parallel session B
  • Adolescents

Comparison of teenagers’ early same sex and heterosexual behaviour in the UK: data from the share and RIPPLE studies

  1. A. Parkes1,
  2. V. Strange2,
  3. D. Wight1,
  4. M. Henderson1,
  5. K. Buston1
  1. 1
    Medical Research Council Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
  2. 2
    Institute of Education, University of London, London, UK

      Objectives

      To compare the sexual experiences of UK teenagers who have same-sex partners with those who have exclusively opposite-sex partners, in terms of context, quality and risk involved. Pupils’ background and attitudes were explored to suggest reasons for differences.

      Studies

      Self-complete, anonymised questionnaires were administered at ages 13/14 and 15/16 years to pupils in two school-based RCTs of sex education programmes in Scotland (SHARE) England (RIPPLE), giving a combined eligible sample of 10 250 for this study.

      Main Measures

      “First sex” (FS) reported at age 15/16 was defined for a same-sex partner as any genital contact, and for an opposite-sex partner as vaginal intercourse. Teenagers were classified according to gender of sexual partner(s) as reporting exclusively heterosexual, exclusively homosexual, or bisexual behaviour. Additional information was collected on circumstances of, and feelings after, first hetero- and homosexual sex; and on heterosexual risk behaviours (age at FS, condom use, number of partners and pregnancy).

      Methods

      Regression models of quality of FS and of sexual risk on sexual group adjusted for age, arm of trial and gender, and took account of clustering by school.

      Results

      Four in ten teenagers (39%, N = 3565) reported heterosexual intercourse and no same-sex genital contact. Same-sex FS was reported by 2.5% (N = 201) teenagers. Bisexual (BS) behaviour was reported by most (72%) of teenagers in the homosexual behaviour group. Girls were more likely than boys to report heterosexual intercourse (43% vs. 35%), but were no different in reporting same-sex genital contact. First same-sex genital contact was more likely than first heterosexual intercourse to be at a younger age, unplanned, involve alcohol or drugs and no prior romantic relationship with partner. These contextual factors helped to account for lower autonomy reported for first same-sex genital contact, compared to first heterosexual intercourse. Boys and teenagers with exclusively same-sex partners were more likely than girls and teenagers with opposite-sex partners to report worse feelings after sex. Heterosexual risk was greater among teenagers who had partners of both sexes than among teenagers with exclusively opposite-sex partners. To some extent, this difference was mediated by attitudinal factors including poorer condom attitudes, as well the context of sexual behaviour.

      Discussion

      Lower autonomy and greater risk-taking found among teenagers with same-sex partners echo the findings of research elsewhere (mainly the US). Further research on underlying psychosocial factors is required.

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