P3.B030: Early sexual debut and childhood experiences: Assessing the effects of adverse and benevolent childhood experiences occurring during adolescence.

Background: In the US, adolescents are disproportionally more vulnerable than adults to sexually transmitted infections (STI), with over half of STI cases in 2018 occurring among those between ages 15 and 24. Prior research indicates that early age at first sex is associated with increased likelihood of STI infection in adolescence. Adverse Childhood Experiences (ACEs) have been identified as risk factors associated with increased early-age sexual experimentation. The purpose of this study is to observe the relationship between ACEs and early sexual debut (ESD) and compare it to the effect of benevolent childhood experiences (BCEs) occurring in adolescence. Following the theoretical underpinnings of the Childhood Resiliency Theory, we will also test for a reduced ACEs effect on the likelihood of ESD between those with high and low BCE scores.

Methods: ACE and BCE measures were measured in a sample of 500 adolescents in the US for five years. Ten years after baseline, participants were asked their age of first sex. Two separate logistic regression models were constructed to assess the relationship between cumulative ACE and BCE scores and the likelihood of having a sexual debut before or after their fifteenth birthday. A third model added an interaction term to the logistic regression model for ACEs and ESD to test for significant difference in the relationship between ACEs and ESD between those with low (7 or fewer) and high (8 or more) BCEs.

Results: We used data from 326 participants that reported being sexually active 10 years after the onset of the study. The relationships between ACEs and BCEs with ESD were significant and opposite in direction. The addition of each ACE occurring in an adolescent’s life was associated with a 43% increase in the odds of ESD (OR: 1.43, 95% CI: 1.22, 1.70). Conversely, each additional BCE event in an adolescent’s life was associated with a 28% reduction in the likelihood of ESD (OR: 0.72, 95% CI: 0.57, 0.90). The odds ratio for the relationship between ACE and ESD was 1.53 (95% CI: 1.11, 2.11) among those with low BCE scores, and 1.30 (95% CI: 1.10, 1.64), though this difference was not significant.

Conclusion: This study demonstrates a clear connection between ACEs and ESD, and the potentially protective effect of BCEs. While the theorized ability of positive events to negate the effects of negative ones was not significant, the strong negative association between BCEs and ESD is promising. It is difficult to target and address at-home risk factors aimed at reducing risk healthy behaviors, but BCEs can act as a stepping off point for designing interventions designed at reducing sexual risk taking among young people. More research needs to be done to clarify the potentially neutralizing effect of BCEs on ACEs.