Developmental investigation of age at sexual debut and subsequent sexual risk behaviours: A study of high-risk young black males

Background The purpose of this study was to identify unmediated associations of early sexual debut (ESD) on the current safer sex practices of young Black men (YBM). Methods: A cross-sectional study of YBM (n≤697) attending clinics treating sexually transmissible diseases (STIs) in three cities was conducted. ESD was dichotomised at the age of 13 years and under. A series of regression models were used to test the moderating effects of ESD and perceived parental monitoring (PPM). A regression model also tested the effect of years of sexual experience (YSE) on sexual risk behaviours, while controlling for ESD. Results: Mean age of debut was 13.95 years. ESD results varied with significance for pregnancy (P<0.001), sexual partners (P<0.001), and ever having chlamydia (assessed by self report), but this final association was only found for older males (P≤0.03). PPM held no moderating effect on any of the sexual risk outcomes. YSE was correlated with an increase in recent unprotected vaginal sex (AOR≤1.19, 95%CI≤1.10-1.27) and having a pregnant partner at the time of enrolment (AOR≤1.30, 95%CI≤1.17-1.43). Conclusions: The findings provide mixed evidence for unmediated associations of ESD among young Black males. The study strongly posits that ESD may actually be a mediating variable rather than a causal explanation for sexual risk. The findings also suggest that advancing YSE foster diminishing vigilance in safer sex practices. These outcomes should be utilised to inform intervention development.Journal