Abstract
Background
Previous studies have examined timing of sexual initiation in the United States, but
little is known about rural–urban differences in age at first sex.
Methods
We used female respondent data from the National Survey of Family Growth (n = 29,133; 2006–2010 and 2011–2017) to examine age at first vaginal sex with a male
partner. We used the Kaplan-Meier estimator and Cox proportional hazard analyses to
assess differences in age at first sex by rural–urban residence, overall and stratified
by 5-year birth cohorts (1968–1997). Models were adjusted for respondent characteristics
and accounted for complex survey design.
Results
Overall, rural women experienced first sex earlier compared with urban women (hazard
ratio [HR], 1.20; 95% confidence interval [CI], 1.12–1.29). By age 18, 62% of rural
women had experienced first sex, compared with 54% of urban women. After adjustment
for respondent characteristics, HRs were attenuated, but rural women were still more
likely to have experienced first sex compared with urban women (HR, 1.07; 95% CI,
1.01–1.13). In unadjusted models, rural women were more likely to have experienced
first sex compared with urban women for most birth cohorts (HRs ranged from 1.14 to
1.32); for only one cohort (1988–1992) was this association found in the adjusted
analysis (HR, 1.23; 95% CI, 1.09–1.39).
Conclusions
Women living in rural areas were generally more likely to report first sex at an earlier
age compared with urban women, suggesting that delivery of sexual education and reproductive
health services for women in the United States may need to take into account rural–urban
residence.
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Biography
Jaclyn A. Janis, BSN, RN, is an MPH candidate at the University of Southern Maine, Muskie School of Public Service. Her research interests include reproductive health, health disparities, and health services use.
Biography
Katherine A. Ahrens, MPH, PhD, is an epidemiologist and assistant research professor in the Public Health Program at the University of Southern Maine, Muskie School of Public Service. Her research interests include maternal and child health, with a focus on family planning.
Biography
Erika C. Ziller, PhD, is director, Maine Rural Health Research Center, and assistant professor and chair of Public Health at the University of Southern Maine, Muskie School of Public Service. Her research interests include rural health care access and health insurance coverage.
Article info
Publication history
Published online: August 20, 2019
Accepted:
July 17,
2019
Received in revised form:
July 9,
2019
Received:
February 9,
2019
Footnotes
Disclosure: The authors report no financial or other disclosures of conflict of interest.
Financial support: K.A.A. is supported by a faculty development grant from the Maine Economic Improvement Fund. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Presented at the annual meeting of the New England Rural Health Association, Newry, Maine, November 7–8, 2018.
Identification
Copyright
© 2019 Jacobs Institute of Women's Health. Published by Elsevier Inc.
