Search

The ability of the opportunity cost framework to predict the risk of a teen birth is tested by analyzing the relationship between adolescents 'perceptions of opportunity and the odds of a teen birth across levels of community opportunity. Patterns of this relationship are compared across African American, Latina, and White teens and across socioeconomic status (SES) level. High educational expectations protect Whites, Latinas, and low-SES teens from low-opportunity communities from a teen birth. [ABSTRACT FROM AUTHOR]

CONTEXT: Most U.S. teenage pregnancies are unintended, partly because of inconsistent or no use of contraceptives. Understanding the factors associated with contraceptive use in teenagers' most recent relationships can help identify strategies to prevent unintended pregnancy. METHODS: Data on 1,468 participants in Waves 1 and 2 of the National Longitudinal Study of Adolescent Health who had had two or more sexual relationships were analyzed to assess factors associated with contraceptive use patterns in teenagers' most recent sexual relationship. Odds ratios were generated through logistic regression. RESULTS: Many relationship and partner characteristics were significant for females but nonsignificant for males. For example, females' odds of ever, rather than never, having used contraception in their most recent relationship increased with the duration of the relationship (odds ratio, 1.1); their odds were reduced if they had not known their partner before dating him (0.2). The odds of consistent use (vs. inconsistent or no use) were higher for females in a "liked" relationship than for those in a romantic relationship (2.6), and for females using a hormonal method instead of condoms (4.5). Females' odds of consistent use decreased if the relationship involved physical violence (0.5). Among teenagers in romantic or "liked" relationships, the odds of ever-use and of consistent use were elevated among females who had discussed contraception with the partner before their first sex together (2.9 and 2.1, respectively), and the odds increased among males as the number of presexual couple-like activities increased (1.2 for each). CONCLUSIONS: Teenagers must use contraception consistently over time and across relationships despite pressure not to. Therefore, they must learn to negotiate sexual and contraceptive decisions in each relationship. [ABSTRACT FROM AUTHOR]

CONTEXT: Teenagers have a high unintended pregnancy rate, in part because of inconsistent use or nonuse of contraceptives. It is important to determine how partner and relationship characteristics are related to contraceptive use and consistency within adolescents' first sexual relationships. METHODS: Logistic and multinomial logistic regression analyses of data from 1,027 participants in the first two waves of the National Longitudinal Study of Adolescent Health examined the influence of relationship and partner characteristics on ever-use and consistent use of contraceptive methods during teenagers' first sexual relationships. RESULTS: Teenagers who had waited a longer time between the start of a relationship and first sex with that partner, discussed contraception before first having sex or used dual contraceptive methods had significantly increased odds of ever or always using contraceptives. Adolescents who had taken a virginity pledge, had an older partner, had a greater number of close friends who knew their first partner, or reported having a relationship that was not romantic but that involved holding hands, kissing and telling their partners they liked or loved them had decreased odds of contraceptive use or consistency. As relationship length increased, teenagers were more likely to ever have used a method, but less likely to always have used a method. CONCLUSIONS; Parents and programs should encourage teenagers to delay sexual intercourse, discuss contraception with partners before initiating sex and be vigilant about contraceptive use, particularly in long-term sexual relationships and in relationships with older partners. [ABSTRACT FROM AUTHOR]

Context: The teenage birthrate rose sharply in the late 1980s and early 1990s, and then declined in the 1990s. Attempts to explain these changes have failed to account for the changing environment in which adolescents live. Methods: Data from the 1995 cycle of the National Survey of Family Growth are used to compare the experiences of three cohorts of teenage females in the 1980s and 1990s. A life-course framework is used to examine trends in characteristics of adolescents and adolescent mothers over time, and event-history analyses are conducted to determine which characteristics are associated with the risk of a teenage birth in each cohort. A comparison of the predicted probabilities from hazard analyses shows how changes in the context of adolescence across the cohorts help explain changes in the probability of a teenage birth over time. Results: Factors associated with the increase in the teenage birthrate in the 1980s include Negative changes in family environments (such as increases in family disruption) and an increase in the proportion of teenagers having sex at an early age. Factors associated with the recent decline in the teenage birthrate include positive changes in family environments (such as improvements in maternal education), formal sex education programs and discussions with parents about sex, stabilization in the proportion of teenagers having sex at an early age and improved contraceptive use at first sex. Sexually experienced teenagers in the mid- 1990s were younger, on average, at first sex than were their counterparts in the 1980s, and thus are at an increased risk of a teenage birth. Partner factors, including nonvoluntary first sexual experiences, were not associated with the risk of a adolescent birth in any cohort. Conclusions: Programs to further reduce the teenage birthrate should take into account the role of family stability, parent-child communication, sex education programs and engagement in school, as well as attempt to reduce ... [ABSTRACT FROM AUTHOR]

A sample of high school age mothers was followed from 1988 to 1994 in order to examine factors associated with having a second teen birth or a closely spaced second birth. The study incorporates a life-course perspective. Factors associated with postponing a subsequent birth include characteristics measured prior to the first birth, at the time of the first birth, and after the first birth. Analyses suggest that a combination of young teen mothers staying in school, living at home with their parents, and (among older teen mothers) being engaged in educational or work activities might help reduce the risk of a second untimely birth. Those teenage mothers who were able to complete their high school diploma, or even their GED, were less likely to have a second teen birth. [ABSTRACT FROM AUTHOR]

This article analyzes the reform in England and Wales that changed the secondary school system from a selective type (with grammar and secondary modern schools) to a comprehensive type during the period 1965-74. It presents evidence of two possible middle-class tactics: resistance to the reform and using the reform to protect the middle-class advantage. Resistance took the forms of keeping grammar schools from being transformed into comprehensives and maintaining high middle-class enrollments in grammar schools and in private schools. Organizing the comprehensive system to the advantage of the middle class involved establishing some comprehensives without sixth forms and making it less likely that middle-class children would attend them. Enrollment patterns of a national sample are used to show how the middle class retained an advantage even as the types of schools were being changed. [ABSTRACT FROM AUTHOR]

The article presents information on a study that examines the fertility patterns of daughters of teenage mothers in Great Britain. This study uses data from the British National Child Development Study to explore intergenerational patterns in teen motherhood. Specifically, it tests whether daughters of teen mothers have different fertility patterns than other teens and whether or not they are more likely to become teen mothers themselves. The study uses several mechanisms to help explain how early motherhood is reproduced across generations, including an earlier inherited age of menarche, poor family and educational environments, and an early ideal age of childbearing among daughters of teen mothers. Despite support for several intergenerational hypotheses, the model used in this study shows a significantly higher rate of fertility among daughters of teen mothers. The study found that even after controlling for family, school, and individual factors, daughters of teen mothers were more likely to have a birth in their teens and into their early 20s.

Many sexual health programs transitioned to virtual implementation during the COVID-19 pandemic. Despite its devastation, the pandemic provided an opportunity to learn about virtual compared to in-person implementation of a sexual health promotion program—El Camino. This study assessed differences in program attendance, engagement, quality, and student ratings for virtual versus in-person implementation of El Camino as part of a rigorous evaluation in high schools with high Latino populations in Maryland. Drawing on positive youth development practices, El Camino helps participants identify personal goals and learn about sexual reproductive health and healthy relationships. This mixed-methods study incorporates data from performance measures, baseline and post-intervention participant surveys, observations, monthly implementation reports, and debriefs with facilitators to describe and compare virtual and in-person program implementation. At baseline, participants were an average of 16.2 years old; between 8 and 12th grade; 61% female; 79% Hispanic, Latino, or of Spanish origin; and 54% spoke mostly Spanish at home. Recruitment and retention of students outside of school classes were challenging for both forms of implementation. However, attendance was higher during in-person implementation and in schools where the organization implementing El Camino had a strong presence before the pandemic. Findings indicate high fidelity, excellent quality ratings, and positive student perceptions of the program and facilitators in both the virtual and in-person cohorts, which suggest that both forms of implementation were comparable and furthermore highlight the strength of the virtual adaptation of the El Camino program. [ABSTRACT FROM AUTHOR]

ABSTRACT: BACKGROUND: Teen Prevention Education Program (PEP) is a school‐wide, peer‐led comprehensive sexuality education program currently implemented in more than 50 schools across 2 states. Many teen pregnancy prevention researchers and practitioners view peer‐led programs as a promising approach for reducing teen pregnancy and associated sexual risk behaviors. However, prior research on the effectiveness of these programs indicates mixed results. METHODS: We randomly assigned schools to implement Teen PEP immediately (intervention group) or on a delayed schedule (comparison group) and used propensity score matching to improve the comparability of the study groups. We surveyed students at baseline and about 6 months after the program ended. RESULTS: Teen PEP did not significantly impact rates of sexual activity or unprotected sex; however, the program led to improvements in exposure to information about sexual health topics and knowledge of preventing pregnancy and transmission of sexually transmitted infections. CONCLUSIONS: Teen PEP succeeded in accomplishing some of its most proximal goals, increasing students' access to information and knowledge. However, we found little evidence that the program affects sexual risk‐taking within 6 months of its conclusion. Future research will examine the program's longer‐term impacts on sexual risk behaviors. [ABSTRACT FROM AUTHOR]

CONTEXT Although expanding research has found that relationship characteristics can shape contraceptive use among young adults, limited research has examined how relationship characteristics intersect to form distinct types of relationships and how relationship types are linked to contraceptive use. METHODS Data from the 2002-2005 rounds of the National Longitudinal Survey of Youth 1997 cohort were used to examine contraceptive use in 3,485 young adult dating relationships. Latent class analysis was employed to develop a typology of relationships using measures of relationship structure (duration) and quality (intimacy, commitment and conflict). Multinomial logistic regression analyses were used to estimate associations between relationship type and contraceptive use and method choice at last sex. RESULTS Four types of relationships were identified, two shorter term and two longer term, differentiated by levels of intimacy, commitment and conflict. Young adults in longer term relationships with greater conflict and lower intimacy and commitment were less likely than those in other long-term relationships to use hormonal and dual methods versus no method (relative risk ratios, 0.6-0.7). Hormonal method use, versus no method use or condom use, was more prevalent in short-term relationships with greater intimacy and commitment and lower conflict than in other short-term relationships (1.7 and 1.9, respectively). CONCLUSIONS Classifying short-term relationships as 'casual' or long-term ones as 'serious' may ignore heterogeneity within these categories that may have implications for contraceptive use. Future qualitative research could provide a better understanding of relationship types and couples' fertility intentions and access to and use of contraceptives. [ABSTRACT FROM AUTHOR]

Using data from the National Longitudinal Study of Adolescent Health, the authors examine the association between contraceptive use patterns in teens' first sexual relationships and their knowledge of, perceptions of, and motivations for contraception and pregnancy prevention. Results from logistic regression analyses show that knowledge, perceptions, and motivations surrounding sexual activity and contraception are indeed important predictors of contraceptive outcomes, and they influence males and females differently. For both genders, perceived ease of access to contraceptives is associated with increased odds of ever using contraception and using contraception consistently. For males, greater perceived condom knowledge is associated with increased odds of ever using contraception. For females, higher levels of actual reproductive health knowledge is associated with increased odds of ever using contraception, and holding negative views of pregnancy and having greater contraceptive self-efficacy are both associated with increased odds of consistent contraceptive use. [ABSTRACT FROM AUTHOR]

Introduction: Adolescent sexual health interventions are increasingly incorporating content that is inclusive of LGBTQIA+ youth (lesbian, gay, bisexual, transgender, queer/questioning, intersex, asexual, and other marginalized sexualities and genders). Evaluations of such programs must also be inclusive to enhance the validity of evaluation results and avoid further marginalization. We present strategies for increasing LGBTQIA+-inclusivity based on our evaluation of SafeSpace, a sexual health curriculum., Methods: To design an LGBTQIA+-inclusive program evaluation, we leveraged LGBTQIA+ research staff's insights, pursued a parental consent waiver, developed an inclusive recruitment plan, and crafted demographic and sexual behavior survey measures with input from youth and equity experts. We conducted a pilot study with 42 youth ages 14-17 to assess the feasibility and efficacy of our strategies., Results: We obtained a parental consent waiver and recruited a majority LGBTQIA+ pilot study sample (62%). Using themes from cognitive interviews with youth and experts regarding inclusive framing and use of plain language, we refined demographic measures and expanded sexual behavior measures., Conclusion: Findings suggest that the strategies used to enhance LGBTQIA+-inclusivity in our evaluation of SafeSpace were effective in respectfully and more accurately capturing a fuller range of experiences and identities of LGBTQIA+ and cis-straight youth. The strategies and survey measures developed for this study can be applied to increase LGBTQIA+-inclusivity in other adolescent sexual health program evaluations., Competing Interests: MC works at the organization that developed the Real Talk app and was involved in developing the SafeSpace curriculum. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2024 Balén, Pliskin, Cook, Manlove, Steiner, Cervantes, Garrido, Nuñez-Eddy and Day.)

The COVID-19 pandemic introduced urgent and unique challenges to family planning providers and staff in ensuring continued access to high-quality services, particularly for groups who experience greater barriers to accessing services, such as women with systemically marginalized identities and adolescents and young adults (AYA). While research has documented key adaptations made to service delivery during the early phase of the pandemic, limited studies have used qualitative methods. This paper draws on qualitative interview data from family planning providers and staff in Title-X-funded clinics and school-based clinics-two settings that serve populations that experience greater barriers to accessing care-to (a) describe the adaptations made to service delivery during the first year of the pandemic and (b) explore provider and staff experiences and impressions implementing these adaptations. In-depth interviews were conducted with 75 providers and staff between February 2020 and February 2021. Verbatim transcripts were analyzed via inductive content analysis followed by thematic analysis. Four key themes were identified: (1) Title-X- and school-based staff made multiple, concurrent adaptations to continue family planning services; (2) providers embraced flexibility for patient-centered care; (3) school-based staff faced unique challenges to reaching and serving youth; and (4) COVID-19 created key opportunities for innovation. The findings suggest several lasting changes to family planning service delivery and provider mindsets at clinics serving populations hardest hit by the pandemic. Future studies should evaluate promising practices in family planning service delivery-including telehealth and streamlined administrative procedures-and explore how these are experienced by diverse patient populations, particularly AYA and those in areas where privacy or internet access are limited.

Objective: Person-centered contraceptive care is associated with positive reproductive health outcomes. Our objective was to analyze patients' ratings on the newly developed Person-Centered Contraceptive Counseling scale (PCCC) to provide distributions for a nationally representative population and to assess differences by sociodemographic characteristics., Study Design: Using data from 2017 to 2019 National Survey of Family Growth (NSFG), we analyzed ratings across the four PCCC items among 2242 women who received contraceptive counseling in the past year. Items measured patients' reports of how providers respected them, let them describe their contraceptive preferences, took their preferences seriously, and adequately informed them about their options. We studied each PCCC item individually as well as the combined scale, distinguishing between ratings of "excellent" versus lower ratings. Bivariate and multivariate logistic regression models assessed how patients' characteristics (age, race/ethnicity and English proficiency, sexual orientation, income, and parity) and provider type were associated with the likelihood of experiencing person-centered care., Results: The majority of women (59%-69%) reported that their family planning provider was "excellent" across the four PCCC items and just over half (51%) reported "excellent" on all items. In multivariate analyses, having a lower income, Black race, non-heterosexual identity, and Hispanic ethnicity combined with low English proficiency were associated with lower PCCC ratings., Conclusions: In a nationally representative sample, the PCCC captured variation in women's experiences with person-centered family planning care by sociodemographic characteristics. Findings highlight the need for contraceptive counseling that centers on clients' preferences and experiences, particularly for patients who belong to groups experiencing health inequities., Implications: Person-centered care is a key component of high-quality family planning services. This analysis highlights sociodemographic disparities in person-centered care by analyzing PCCC ratings. Findings show the value of this new health care performance measure and affirm the need for family planning care that centers individuals' preferences and lived experiences., (© 2022 The Authors.)

Background: Latinx adolescents are at increased risk of teen pregnancy. This study evaluates the impact of Re:MIX, a comprehensive sexuality education program cofacilitated by professional health educators paired with young parent educators implemented with primarily Latinx youth in Texas., Methods: A cluster randomized trial was conducted with students in grades 8-10 in 57 classrooms across three schools. Students completed baseline, post-test, and long-term follow-up surveys to determine the impact of the program on behavioral outcomes-sexual experience and unprotected sex-and on mediating factors including intentions, attitudes, knowledge, and self-efficacy related to sexual activity and contraception., Results: Re:MIX was implemented with fidelity and educators were well-received. At post-test, compared to control students, Re:MIX students were more likely to intend to use hormonal or long-acting contraceptive methods if they had sex, had greater reproductive health knowledge, had more confidence in their ability to ask for and give consent, and were more likely to know where to obtain contraception. Most findings were sustained at the long-term follow-up, but there were no impacts on behaviors., Conclusions: The implementation and impact findings highlight the promising approach of pairing young parent educators with experienced health educators for teen pregnancy prevention among Latinx students., (© 2021 American School Health Association.)

Purpose: Black and Latinx women aged 18-20 years have high rates of unplanned pregnancy. Furthermore, this age group is less likely than school-aged youth to be served by pregnancy prevention programs typically administered in schools. The study's purpose was to assess the effectiveness of a new app-based teen pregnancy prevention program created for this population using an online- and texting-only recruitment and evaluation approach., Methods: The study design was a randomized controlled trial with individual-level assignment of 1,304 women aged 18-20 years recruited online. Seventy-six percent of participants were black or Latinx. Women were randomized to the Pulse reproductive health app or a general health app and received regular text messages with program content and reminders to view the app. An intention-to-treat approach was used for analyses, and significance tests were adjusted to account for permuted block random assignment and multiple hypothesis testing. Linear probability models controlling for the baseline measure of each outcome, whether the participant reported ever having vaginal sex, age, and race/ethnicity, assessed program impacts for 1,124 participants 6 weeks after randomization., Results: Participants who received the intervention were 7.6 percentage points less likely (p = .001) to report having had sex without a hormonal or long-acting contraceptive method. Intervention participants also scored 7.1 percentage points higher on contraceptive knowledge (p = .000) and were 5.7 percentage points more likely to be confident that they can use birth control during every sexual intercourse (p = .027)., Conclusions: Impacts at 6 weeks are promising, particularly for a self-led intervention with no direct contact with study staff., (Copyright © 2019 Society for Adolescent Health and Medicine. All rights reserved.)

Context: Intimate partner violence is one dimension of relationships that may influence condom use, yet few studies have examined male- and female-initiated violence in efforts to understand variation in condom use., Methods: Power dynamics and relationship conflict approaches were employed to examine the association between relationship violence and condom use. In a latent class analysis of 8,599 dating relationships from Wave 3 (2001-2002) of the National Longitudinal Study of Adolescent to Adult Health, when the respondents were aged 18-25, relationship violence was characterized by the severity and frequency of violence and the perpetrator's gender. Random-effects logistic regression analyses assessed the association between violence classes and condom use., Results: One in five young adult dating relationships involved violence in the past year. Four violence classes were identified: one male-dominant class (3% of relationships), in which many relationships had reciprocal violence; two female-dominant classes, differentiated by the frequency and severity of violence (2% low-intensity, 4% medium-intensity); and one class with limited or no violence (91%). Male-perpetrated violence was reported less frequently but was more severe than female-perpetrated violence. Respondents in relationships in the male-dominant/high-intensity and the female-dominant/medium-intensity classes were less likely to report condom use than those in relationships in the no/low-violence class (odds ratios, 0.4-0.5)., Conclusions: This work expands on research focusing only on male-perpetrated violence and highlights the importance of capturing relationship violence in national data sets. Future surveys that collect information about violence from both partners can inform efforts to prevent violence and to support victims., (Copyright © 2019 by the Guttmacher Institute.)

Objective: To assess whether young men's reports of hormonal and long-acting contraceptive methods match their female partner's reports., Study Design: We analyzed a sample of 1096 heterosexual couples (aged 18-26) from the National Longitudinal Study of Adolescent to Adult Health Romantic Pair subsample. We compared male and female partner reports of hormonal/long-acting method use using class of method (hormonal/long-acting) rather than type (e.g., intrauterine device). Regression analyses linked men's reports of individual and relationship characteristics with alignment of reporting., Results: Sixteen percent of young men reported hormonal/long-acting method use at last sex differently than their female partner, that is, had a mismatched report. Men who had fewer lifetime sexual partners, had greater relationship satisfaction, believed their partner was monogamous and had a matched report of condom use at last sex were more likely to match their partner's report of hormonal/long-acting contraceptive use. Men living with children (from either partner) were less likely to have a matched report. Hispanic men were more likely to have a matched report than black men., Conclusions: Men are an increasingly important part of pregnancy prevention efforts. Pregnancy prevention and healthy relationship programs that incorporate communication skills may also indirectly improve young men's knowledge of their partner's contraceptive use and engagement in contraceptive decision making., Implications: Analyses showed that nearly two thirds of the 16% of young men that did not accurately report their partner's hormonal/long-acting method use at last sex underreport method use. Men at increased risk of misreporting may benefit the most from targeted pregnancy prevention programs., (© 2019 The Authors.)

Context: Contraceptive decision making occurs in the context of relationships. Although many individual-level characteristics have been linked to youths' contraceptive use, less is known about associations between contraceptive use and relationship-level characteristics., Methods: Data from the 2001-2002 romantic pair subsample of the National Longitudinal Study of Adolescent Health were used to describe characteristics of 322 dating relationships and 406 cohabiting relationships among young adults aged at least 18 years. Logistic regression was employed to assess associations between these characteristics and hormonal or long-acting contraceptive use and condom use. Data from both partners allowed discordance in reports between partners in some measures to be examined., Results: Cohabiting couples were less likely than dating couples to have used condoms (19% vs. 37%) and hormonal or long-acting methods (40% vs. 57%) at last sex. In dating relationships, couples reporting discordant levels of intimacy and couples in which neither partner reported a high level of intimacy had greater odds of condom use than couples in which both partners reported high intimacy (odds ratios, 4.5 and 3.3, respectively); mistrust and male problem drinking were negatively associated with condom use (0.3 for each). For cohabiting couples, frequency of sex was negatively associated with condom use and hormonal method use (0.8 for each)., Conclusions: At least for dating couples, contraceptive use is linked to multiple dimensions of relationships, particularly measures reflecting relationship quality-both positive and negative., (Copyright © 2015 by the Guttmacher Institute.)

Using data from the National Longitudinal Survey of Youth, this article examined how early maternal characteristics, an adolescent's family environment, and the adolescent's own attitudes and behaviors were associated with the odds of a nonmarital teenage birth among youth born to teenage mothers. Multivariate analyses indicated that these domains were closely linked. Early maternal characteristics shaped the later family environment of adolescents (parenting quality and home environment), which, in turn, was associated with the attitudes and behaviors of teens that put them at risk of a nonmarital birth. Notably, there was variation in some of the associations by gender. Increased mother's cognitive ability lowered the risk of a nonmarital birth for boys, but not for girls, whereas fertility expectations were significant for girls, but not for boys. There were no race-ethnic differences in the risk of a teenage birth among girls, although Black boys had a higher risk than White boys., Competing Interests: Declaration of Conflicting Interests The author(s) declared no potential conflicts of interest with respect to the authorship and/or publication of this article.

This article uses a sample of 1,731 fathers aged 16 - 45 from the 2002 National Survey of Family Growth to identify factors associated with multiple-partner fertility. Almost one third of fathers who reported multiple-partner fertility did so across a series of nonmarital relationships, and nonmarital-only multiple-partner fertility has been increasing across recent cohorts of men. Being older, having a first sexual experience or a first child at a young age, and fathering a child outside of marriage or cohabitation are associated with greater odds of multiple-partner fertility, whereas having additional children with the first birth mother is associated with reduced odds. Black, Hispanic, and young fathers have especially high odds of experiencing multiple-partner fertility across a series of nonmarital relationships.

By using data from the National Longitudinal Study of Adolescent Health, we examine how adolescent relationship characteristics, partner attributes, and sexual relationship histories are associated with contraceptive use and consistency, incorporating random effects to control for respondent-level unobserved heterogeneity. Analyses show that teens' contraceptive use patterns vary across relationships. Teens with more-homogamous partners, with more-intimate relationships, and who communicate about contraception before sex have greater odds of contraceptive use and/or consistency. Teens in romantic relationships, and who are older when engaging in sex for the first time, have greater odds of ever using contraceptives but reduced odds of always using contraceptives. Teens continue habits from previous relationships: teens with experience practicing contraceptive consistency and females who previously have used hormonal contraceptive methods are better able to maintain consistency in subsequent relationships. Also, relationship and partner characteristics are less important for females who previously used hormonal methods.

Context: Limited nationally representative information exists on the characteristics of teenagers who had first sex at an early age with an older partner., Methods: Gender-specific analyses were conducted of 2002 National Survey of Family Growth data from 1,838 females and 1,426 males aged 18-24. Multivariate analyses examined the associations between family and individual characteristics and having a first sexual experience before age 16 with an older partner, and between age and partners' age difference at first sex and contraceptive use and having or fathering a child as a teenager., Results: Sex at a young age with an older partner was associated with not living with a biological parent at age 14 and Hispanic ethnicity for females and males, early menarche and religious attendance for females, and black race for males. Among females and males, first sex by age 16 was negatively associated with contraceptive use at first sex (odds ratios, 0.7 for each) and positively associated with a teenage birth (1.6 and 2.9, respectively); having an older first partner was associated with poor reproductive health outcomes among females. Among females, the combination of young age and an older partner at first sex was positively associated with having a teenage birth. Among males, sex before age 16 with an older partner was associated with more than twice the odds of fathering a child as a teenager compared with the odds among those who had first sex at age 16-17., Conclusions: Interventions should target specific teenage populations, including males, to dissuade them from having sex at a young age and with older partners. Also, prevention efforts should target potential older teenage partners and adult partners of young teenagers.