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Richard Doty

William Yarber

Last modified: Wednesday, July 31, 2002

IU study of rural adolescents supports delay in sexual activity

An Indiana University national study of sexual activity among rural adolescents supports education programs that advocate postponing sexual activity until a later age.

"Our findings suggest that rural adolescents who initiate sexual activity at an early age are at markedly greater risk of engaging in subsequent sexual risk behaviors, such as having multiple sex partners and not using condoms," said William Yarber, senior director of the Rural Center for AIDS/STD Prevention that is headquartered at the IU School of Health, Physical Education and Recreation. "Substance use and a history of forced sex are also prominent determinants of sexual risk-taking among rural adolescents," Yarber said.

Yarber is the principal author of the national study of 569 sexually experienced rural adolescent females and 561 sexually experienced rural adolescent males who participated in the 1999 Youth Risk Behavior Survey. The survey findings have been published in the current issue of American Journal of Health Education as the first study identifying these associations among a nationally representative sample of rural adolescents.

"Our findings support the belief that there is value in delaying the onset of sexual activity until adolescents are older," Yarber said, "so risk reduction programs should encourage the postponement of sexual initiation. Our findings also suggest that programs that address the key role of substance use and the psychological consequences of sexual abuse might be more effective at reducing sexual risk-taking among rural adolescents."

Sections of the study reported that in rural areas both boys and girls with two or more sexual partners had higher incidents of such behavior as physical abuse by their partners, forced sexual intercourse, binge drinking, use of marijuana and cocaine, cigarette smoking, and drinking alcohol before sexual intercourse. "In some cases, these differences were dramatic," Yarber said. "Females who engaged in sexual intercourse before age 15 were more than five times as likely to have had multiple partners. Males who had intercourse before age 15 were 11 times more likely than males who delayed their coital debut to have multiple partners."

Robin Milhausen, study co-author and an IU doctoral student, said, "These results have important implications for planning risk prevention education for rural adolescents, because engaging in intercourse at a younger age widens the possible time frame for exposure to STDs and pregnancy. Reducing the number of associated risk factors may prevent some of these detrimental sexual outcomes. Comprehensive school health education that focuses on a wide variety of health behaviors may be an effective strategy for reducing rural adolescents' sexual risk behavior." She said this is especially important for females, because the study showed a higher correlation for them than for males in terms of risk factors and risky sexual behaviors.

Assisting Yarber and Milhausen with the report were Richard Crosby and Ralph DiClemente from Emory University. The project was funded by the Rural Center for AIDS/STD Prevention, a joint project of Indiana University, Purdue University and the Texas A&M University School of Rural Public Health.

RCAP, started in 1994, is the only center in the country focusing solely on HIV/STD prevention in rural areas. Funding over the years from the federal government has exceeded $1.5 million.

For more details on this project, contact Yarber at 812-855-7974 or The RCAP Web site is at