title: Sexual intercourse among adolescents maltreated before age 12: a prospective investigation.
abstract: OBJECTIVE
  To examine whether child maltreatment (physical, emotional, and sexual abuse, and neglect) predicts adolescent sexual intercourse; whether associations between maltreatment and sexual intercourse are explained by children's emotional distress, and whether relations among maltreatment, emotional distress, and sexual intercourse differ according to gender.
  
  
  METHODS
  The Longitudinal Studies of Child Abuse and Neglect was a multisite, longitudinal investigation. Participants ranged from at-risk to substantiated maltreatment. Maltreatment history was assessed through Child Protective Service records and youth self-report at age 12. Youth reported emotional distress by using the Trauma Symptom Checklist at the age of 12 years and sexual intercourse at ages 14 and 16. Logistic and multiple regressions, adjusting for gender, race, and site, were used to test whether maltreatment predicts sexual intercourse, the explanatory effects of emotional distress, and gender differences.
  
  
  RESULTS
  At ages 14 and 16, maltreatment rates were 79% and 81%, respectively, and sexual initiation rates were 21% and 51%. Maltreatment (all types) significantly predicted sexual intercourse. Maltreated youth reported significantly more emotional distress than non-maltreated youth; emotional distress mediated the relationship between maltreatment and intercourse by 14, but not 16. At 14, boys reported higher rates of sexual intercourse than girls and the association between physical abuse and sexual intercourse was not significant for boys.
  
  
  CONCLUSIONS
  Maltreatment (regardless of type) predicts sexual intercourse by 14 and 16. Emotional distress explains the relationship by 14. By 16, other factors likely contribute to intercourse. Maltreated children are at risk for early initiation of sexual intercourse and sexually active adolescents should be evaluated for possible maltreatment.
authors.affiliation: University of Maryland School of Medicine, Department of Pediatrics, Baltimore, MD 21201, USA. mblack@peds.umaryland.edu
authors.forename: Maureen M
authors.initials: MM
authors.lastname: Black
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Oberlander
authors.forename: Terri
authors.initials: T
authors.lastname: Lewis
authors.forename: Elizabeth D
authors.initials: ED
authors.lastname: Knight
authors.forename: Adam J
authors.initials: AJ
authors.lastname: Zolotor
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Litrownik
authors.forename: Richard
authors.initials: R
authors.lastname: Thompson
authors.forename: Howard
authors.initials: H
authors.lastname: Dubowitz
authors.forename: Diana E
authors.initials: DE
authors.lastname: English
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D002649:Child Abuse / Q000706:statistics & numerical data*; D003075:Coitus; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies