Sex across the life course: An examination of social influences on adolescent sexual attitudes and associations between sexual behavior patterns and young adult health

In this dissertation I use data from the National Longitudinal Study of Adolescent to Adult Health (Add Health) to explore important questions tied to adolescent sexual attitudes, life course sexual behavior, and young adult health. In the first analytic chapter, I examine adolescents’ key social relationships (i.e., parents, friends, and school-level attitudes) and their association with adolescents’ perceptions of sexual intercourse. The results document significant associations between adolescents’ perceptions of sex and their parents, peers, and normative school attitudes surrounding sexual intercourse. Adolescents’ who perceive higher levels of parental support for engaging in sexual intercourse report more positive perceptions of sex. Similarly, adolescents’ who were more likely to perceive that their friends will have more respect for them if they engage in sexual intercourse also held more positive sexual attitudes. Finally, school-level normative attitudes were associated with adolescent sexual perceptions. In schools where students reported an overall higher average on the sexual attitudes scale, adolescents were more likely to report more positive sexual attitudes. In the second and third analytic chapters, I examine the associations between life course sexual patterns and young adult mental and physical health. I document significant associations between sexual behavior patterns and young adult health, especially among young women. Young women who engage in early sexual debut and have a higher number of sexual partners have increased odds of depression diagnosis relative to young women with no early debut and a lower number of sexual partners. Similarly, for young women, early sexual debut is significantly associated with lower odds of higher self-rated health when compared to women who did not debut early and had the same or lower number of sexual partnerships. Taken together, this dissertation reveals important association between adolescents’ primary social relationships and their sexual attitudes and important associations between sexual behavior patterns and young adult health. These findings yield important considerations for sexual education programs and policy implications for supporting healthy sexual behavior practices