Publications: Data Visualisations

Sexual behaviour

Early sexual activity, initiated while young people are still developing emotionally and cognitively, may increase the risk of unwanted and unplanned pregnancy or sexually transmitted infections (STIs), mainly owing to the misuse or non-use of condoms or other contraceptives. Previous research has shown that early sexual activity is associated with risk factors such as substance use, lower academic achievement and poor mental health.

Prevalence rates for experiences of sexual intercourse vary considerably across countries and cultures, as do gender differences. In many countries and regions, boys are still more likely to report sexual intercourse, but this is reversed in a few northern and western European countries.

Condom use remains inconsistent, and is influenced by factors such as self-efficacy, perceived attitudes of peers and assertiveness. Not using a condom has been associated with a range of other risky sexual behaviours, such as the early onset of sexual activity, having multiple partners and engaging in substance use before sexual intercourse.

Policy Reflections

Negative outcomes related to sexual health among young people can be reduced if initiatives aim to:

• ensure that young people do not engage in sexual relationships before they are developmentally ready to do so

• enable effective use of contraceptives

Integrated programmes involving school, community and health care settings are most likely to be effective in reaching these goals.

Early implementation of comprehensive education on sex and relationships is recommended, as it is more likely to be effective if delivered before young people start sexual activity. Communication and negotiation skills to handle how and when to first engage in sexual relationships may form an important part of effective sex and relationships education, as these skills can enable young people to refrain from engaging before they are ready.

Inequity in service provision based on age may prevent young people from seeking contraceptive advice before engaging in sexual activity, leaving them at risk. Services providing help and advice on the use of contraception should be available to young people of all ages; the services should be accessible, affordable and confidential, with staff trained to meet the specific needs of adolescents.

In addition to comprehensive sex and relationships education and the provision of adolescent-friendly services, broad youth development programmes that target social exclusion by developing self-esteem and providing educational support and vocational preparation are effective in countering potentially the negative outcomes of early sexual initiation.

Related publications

• Factors associated with early sexual initiation in girls: French data from the international HBSC survey (Gynécologie, Obstétrique & Fertilité)

• The effect of adolescent virginity status on psychological well-being (Journal of Health Economics)

• Contraceptive use by 15-year-old students at their last sexual intercourse: results from 24 countries (Archives of Pediatrics & Adolescent Medicine)

• Condom use self-efficacy: effect on intended and actual condom use in adolescents (Journal of Adolescent Health)

• How well protected are sexually active 15-year-olds across Europe and Canada? Data from the 2006 WHO HBSC study (International Journal of Public Health)

• Global strategy for the prevention and control of sexually transmitted infections, 2006−2015. Breaking the chain of transmission. (World Health Organization)

• Young people, pregnancy and social exclusion: A systematic synthesis of research evidence to identify effective, appropriate and promising approaches for prevention and support (EPPI-Centre)