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Gender Differences in Risk Behaviors Associated With Forced or Pressured Sex
Lydia A. Shrier, MD, MPH;
Judith Dwyer Pierce, EdD;
S. Jean Emans, MD;
Robert H. DuRant, PhD
Arch Pediatr Adolesc Med. 1998;152:57-63.
Objective To determine whether gender-specific patterns of risk behaviors are associated with a self-reported history of ever having been forced or pressured to have sexual intercourse among sexually active adolescents.
Subjects and Methods In 1995, 21297 eighth- through 12th-grade students in 79 public and private schools in Vermont were anonymously surveyed. Data were analyzed for 7884 sexually active students (3931 girls and 3953 boys). Demographic variables and indicators of violence, suicide, recent substance use, sexual behavior, pregnancy, and weight control behavior were assessed. Data were analyzed with multiple logistic regression.
Results Of the sexually active students, 30.3% of the girls and 9.9% of the boys reported ever being forced or pressured to have sexual intercourse. Among sexually active girls, being in 1 or more physical fights in the past year (odds ratio [OR], 1.65; 95% confidence interval [CI], 1.40-1.94), seriously considering suicide (OR, 1.97; CI, 1.69-2.31), more years of sexual activity (OR, 1.52; CI, 1.43-1.61), not using a condom at last sexual intercourse (OR, 1.28; CI, 1.09-1.49), and having been pregnant more often (OR, 1.40; CI, 1.16-1.69) were associated with having been forced or pressured to have sex. For sexually active boys, seriously considering suicide (OR, 1.64; CI, 1.23-2.20), more years of sexual activity (OR, 1.21; CI, 1.12-1.31), more male partners in the past 3 months (OR, 1.30; CI, 1.14-1.48), more female partners in the past 3 months (OR, 1.09; CI, 1.01-1.18), not using a condom at last sexual intercourse (OR, 1.37; CI, 1.03-1.82), having been involved in more pregnancies (OR, 1.64; CI, 1.29-2.08), and having vomited or used laxatives (OR, 3.44; CI, 2.18-5.43) were associated with having been forced or pressured to have sex.
Conclusions Patterns of risk behaviors differed among sexually active male and female adolescents reporting being forced or pressured to have sex. Having been forced or pressured to have sex was associated with externalizing behavior, such as fighting, among girls and with internalizing behavior, such as bulimia, among boys. These unexpected associations have notable implications for screening adolescents for a history of having been forced or pressured to have sex.
From the Division of Adolescent/Young Adult Medicine, Children's Hospital and Harvard Medical School, Boston, Mass (Drs Shrier, Emans, and DuRant); and the Department of Education, College of Education and Social Service, University of Vermont, Burlington (Dr Pierce). Dr Pierce is now with Research and Development, School Health Programs, Educational Development Center, Newton, Mass. Dr DuRant is now with the Department of Pediatrics, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, NC.
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