title: Factors Associated With Early Sexual Experience Among American Indian and Alaska Native Youth.
abstract: OBJECTIVE
  American Indian and Alaska Native (AI/AN) youth experience disparities associated with sexual and reproductive health, including early age of sexual initiation. Identifying factors that are most proximally related to early sexual intercourse and that are modifiable through health promotion interventions may help to reduce these disparities. Using a multisystem approach, we assessed individual (biological, psychological, and behavioral), familial, and extrafamilial (peer behavioral) factors associated with lifetime sexual experience among AI/AN early adolescents living in three geographically dispersed U.S. regions.
  
  
  METHODS
  We analyzed cross-sectional data from 537 AI/AN youth aged 12-14 years, recruited from 27 study sites in Alaska, Arizona, and the Pacific Northwest. We used multilevel logistic regression models to estimate associations between independent variables and lifetime sexual intercourse (oral and/or vaginal sex) individually, within discrete systems, and across systems.
  
  
  RESULTS
  The analytical sample was 55.1% female, with a mean age of 13.2 years (standard deviation = 1.06 years); 6.5% were sexually experienced. In the final model, we found that lower next-year intentions to have oral or vaginal sex (psychological factors), avoidance of risky situations, and nonuse of alcohol (behavioral factors) were associated with lower odds of lifetime sexual intercourse (all p ≤ .01). No other variables were significantly associated with lifetime sexual intercourse.
  
  
  CONCLUSIONS
  Interventions that reduce sexual intentions, exposure to risky situations, and alcohol use may help to delay sexual initiation among AI/AN early adolescents.
authors: Center for Health Promotion & Prevention Research, The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas. Electronic address: Christine.Markham@uth.tmc.edu.
authors: Christine M
authors: CM
authors: Markham
authors: Northwest Portland Area Indian Health Board, Portland, Oregon.
authors: Stephanie
authors: S
authors: Craig Rushing
authors: Alaska Native Tribal Health Consortium, Division of Community Health Services, Anchorage, Alaska.
authors: Cornelia
authors: C
authors: Jessen
authors: Inter Tribal Council of Arizona, Inc., Phoenix, Arizona.
authors: Travis L
authors: TL
authors: Lane
authors: Inter Tribal Council of Arizona, Inc., Phoenix, Arizona.
authors: Gwenda
authors: G
authors: Gorman
authors: Northwest Portland Area Indian Health Board, Portland, Oregon.
authors: Amanda
authors: A
authors: Gaston
authors: Alaska Native Tribal Health Consortium, Division of Community Health Services, Anchorage, Alaska.
authors: Taija Koogei
authors: TK
authors: Revels
authors: Center for Health Promotion & Prevention Research, The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas.
authors: Jennifer
authors: J
authors: Torres
authors: Alaska Native Tribal Health Consortium, Division of Community Health Services, Anchorage, Alaska.
authors: Jennifer
authors: J
authors: Williamson
authors: Center for Health Promotion & Prevention Research, The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas.
authors: Elizabeth R
authors: ER
authors: Baumler
authors: Center for Health Promotion & Prevention Research, The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas.
authors: Robert C
authors: RC
authors: Addy
authors: Center for Health Promotion & Prevention Research, The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas.
authors: Melissa F
authors: MF
authors: Peskin
authors: Center for Health Promotion & Prevention Research, The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas.
authors: Ross
authors: R
authors: Shegog
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000208:ethnology* / Q000523:psychology*; D000413:Alaska; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D007198:Indians, North American / Q000523:psychology*; D016015:Logistic Models; D008297:Male; D060728:Reproductive Health; D012309:Risk-Taking; D012725:Sexual Behavior / Q000208:ethnology* / Q000523:psychology*; D000066608:Underage Drinking / Q000523:psychology
keywords: Adolescent behavior; Alaska Native; American Indian; HIV; Sexually transmitted diseases; Teen pregnancy