Understanding pre-sexual behaviors can help tailor pregnancy prevention programs to teens

Teen pregnancy prevention programs often target younger teens who are not sexually active, with the goal of delaying their sexual initiation and preparing them with the knowledge and skills to avoid pregnancy and STIs should they become sexually active. Many younger teens engage in pre-sexual behaviors (defined in our study as having engaged in sexual touching or oral sex, but not vaginal sex) that can then lead to vaginal sex. Understanding the knowledge, attitudes, intentions, and subsequent sexual behaviors of abstinent adolescents with pre-sexual experience can help programs tailor their curricula to students.

A recent Child Trends study—based on participant data from an adolescent pregnancy prevention program that targeted predominately Latinx students in grades 8-10 in Texas—found that approximately one-fifth (22%) of students had only pre-sexual experience (9% had had vaginal sex and 69 percent had no sexual experience). Compared to students with no sexual experience, students with pre-sexual experience were:

• More likely to intend to have sex in the next year
• More accepting toward having sex in early adolescence
• More knowledgeable about condoms and birth control efficacy and more likely to know where to get birth control
• Less likely to report being able to avoid unwanted sex and sexual contact

One year after program completion, students with pre-sexual experience were four times more likely to have had vaginal sex than those who had no sexual experience, supporting previous research.

These notable differences in reproductive health knowledge, attitudes, intentions, and behaviors highlight the importance of distinguishing between teens who have had pre-sexual experience and those who have not when tailoring teen pregnancy prevention programs for younger, mostly abstinent, adolescents.

This blog post is adapted from a poster presentation originally planned for the Society for Adolescent Health and Medicine conference in March 2020, which was canceled due to COVID-19 concerns.