title: Patterns of vaginal, oral, and anal sexual intercourse in an urban seventh-grade population.
abstract: BACKGROUND
  This study examines the prevalence of vaginal, oral, and anal intercourse among a population of urban, public middle school students, the characteristics of early sexual initiators, and the sequence of sexual initiation. Such data are limited for early adolescents.
  
  
  METHODS
  A total of 1279 seventh-grade students (57.3% female, 43.6% black, and 41.8% Hispanic), mean age 12.5 years (SD = 0.63) from 10 middle schools in a large southeastern US public school district completed a cross-sectional survey using audio computer-assisted self-interviews. Main outcomes included lifetime and past 3-months' experience of vaginal, oral, and anal sex; condom use; age of initiation; and number of lifetime partners.
  
  
  RESULTS
  Overall, 12.0% of students had engaged in vaginal sex, 7.9% in oral sex, and 6.5% in anal sex. Among students who had initiated intercourse, approximately two thirds were currently sexually active and one quarter reported > or =4 lifetime partners. Six percent had engaged in 1 type of intercourse, 4% in 2 types of intercourse, and 4% in all 3 types of intercourse; vaginal sex was typically initiated at an earlier or at the same age as other types of intercourse. Only 2% had engaged in oral sex without engaging in vaginal sex. Although black students were significantly more likely to have initiated sex compared to other racial/ethnic groups, Hispanic students who had initiated each type of intercourse were more likely to be currently sexually active and to have engaged in recent unprotected sex.
  
  
  CONCLUSIONS
  A small percentage of early adolescents are engaging in multiple sexual behaviors. These findings have implications for early adolescent school-based sexual health education.
authors.affiliation: Center for Health Promotion and Prevention Research, University of Texas Health Science Center at Houston, 7000 Fannin, 26th Floor, Houston, TX 77030, USA. christine.markham@uth.tmc.edu
authors.forename: Christine M
authors.initials: CM
authors.lastname: Markham
authors.forename: Melissa
authors.initials: M
authors.lastname: Fleschler Peskin
authors.forename: Robert C
authors.initials: RC
authors.lastname: Addy
authors.forename: Elizabeth R
authors.initials: ER
authors.lastname: Baumler
authors.forename: Susan R
authors.initials: SR
authors.lastname: Tortolero
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000208:ethnology; D001741:Black or African American; D017677:Age Distribution; D002648:Child; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D016017:Odds Ratio; D015995:Prevalence; D017678:Sex Distribution; D012725:Sexual Behavior / Q000208:ethnology / Q000706:statistics & numerical data*; D015144:Southeastern United States / Q000453:epidemiology; D014505:Urban Population; D044465:White People