title: Macro-level age norms for the timing of sexual initiation and adolescents' early sexual initiation in 17 European countries.
abstract: OBJECTIVE
  To examine the relationship between country-level age norms for sexual initiation timing and early sexual initiation (ESI) among adolescent boys and girls.
  
  
  METHODS
  Nationally representative data from 17 countries that participated in the 2006/2007 European Social Survey (ESS-3, n = 33,092) and the 2005/2006 Health Behaviour in School-Aged Children Study (HBSC, n = 27,702) were analyzed. Age norms were measured as the average country-level response to an item asking the age at which ESS respondents believed someone is too young to have sexual intercourse. HBSC respondents (aged 14-16 years) self-reported age at sexual initiation, which we defined as early (<15 years) or not early (≥15 years or no initiation). Control variables included age, family affluence, perceived socioeconomic status, family living arrangement, substance use, school attachment, and country-level legal age of consent. Multivariable three-level logistic models with random intercepts were run separately by sex.
  
  
  RESULTS
  In multivariable analyses, higher overall age norms were associated with reduced likelihood of ESI among girls (AOR .60, 95% CI .45-.79); associations with ESI were stronger for parent cohort (ages 31-65 years) norms (AOR .37, 95% CI .23-.58) than for peer cohort (ages 15-20 years) norms (AOR .60, 95% CI .49-.74). For boys, overall norms were also significantly negatively associated with ESI (AOR .68, 95% CI .46-.99), as were parent cohort norms (AOR .66, 95% CI .45-.96). Peer cohort norms were not significantly related to boys' ESI.
  
  
  CONCLUSIONS
  Macrolevel cultural norms may impact adolescents' sexual initiation timing. Research exploring the sexual health outcomes of early initiators in countries with contrasting age norms is warranted.
authors: Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana. Electronic address: aspriggs@tulane.edu.
authors: Aubrey Spriggs
authors: AS
authors: Madkour
authors: Department of Child and Adolescent Studies, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, The Netherlands.
authors: Margaretha
authors: M
authors: de Looze
authors: Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana.
authors: Ping
authors: P
authors: Ma
authors: Department of Maternal & Child Health, Gillings School of Global Public Health, Chapel Hill, North Carolina.
authors: Carolyn Tucker
authors: CT
authors: Halpern
authors: Prevention Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland.
authors: Tilda
authors: T
authors: Farhat
authors: Department of Interdisciplinary Social Sciences, Utrecht University, Utrecht, The Netherlands.
authors: Tom F M
authors: TF
authors: Ter Bogt
authors: Research Unit on Perinatal Epidemiology and Childhood Disabilities, Adolescent Health, Université de Toulouse III, Toulouse, France.
authors: Virginie
authors: V
authors: Ehlinger
authors: Department of Health Promotion, Áras Moyola, National University of Ireland, Galway, Ireland.
authors: Saoirse
authors: S
authors: Nic Gabhainn
authors: Child and Adolescent Health Research Unit, School of Medicine, North Haugh, St Andrews, United Kingdom.
authors: Candace
authors: C
authors: Currie
authors: Research Unit on Perinatal Epidemiology and Childhood Disabilities, Adolescent Health, Université de Toulouse III, Toulouse, France; Service médical du rectorat de Toulouse, Toulouse, France.
authors: Emmanuelle
authors: E
authors: Godeau
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000328:Adult; D017677:Age Distribution; D000368:Aged; D003075:Coitus; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D004522:Educational Status; D005060:Europe / Q000453:epidemiology; D005191:Family Characteristics; D005260:Female; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010290:Parents; D010379:Peer Group; D012111:Residence Characteristics; D017678:Sex Distribution; D012923:Social Class; D066262:Social Norms / Q000208:ethnology*; D019966:Substance-Related Disorders / Q000453:epidemiology; D055815:Young Adult
keywords: Adolescents; Cross-national comparison; Culture; Europe; Multilevel modeling; Sexual behavior