Differences by Gender and Sexual Experience in Adolescent Sexual Behavior: Implications for Education and HIV Prevention zy Deborah Nahom, Elizabeth Wells, Mary Rogers Gillmore, Marilyn Hoppe, Diane M. Morrison, Matthew Archibald, Elise Murowchick, Anthony Wilsdon, Laurie Graham ABSTRACT: zyxwvutsrqponml Researchers examined individual characteristics and peer influences related to adolescents’ sexual behavior, taking gender and sexual experience into account. As part of a larger, longitudinal study investigating youth health awareness, 8th, 91h, and 10th graders reported their intentions to engage in sexual activity and use condoms in the next year, the amount of pressure they felt to engage in sexual activiry, and their perceptions about the number of their peers engaging in sexual activity. Findings suggest inten- tions to engage in sexual behavior and use condoms, feelings of pressure to have sex, and perceptions about the number zyxw of friends engaging in sexual intercourse differ by gender and sexual experience status. Implications of these findings for health and sexuality education, as well as HlVprevention programs targeted at adolescents, are discussed (J Sch zyxwvu Health. 2001;71(4): 153-158) zyxw he prevalence of sexual activity, pregnancy, and STDs T among US adolescents has caused some alarm. Researchers have described outcomes associated with adolescent sexual behavior in terms varying from “a public problemL” to a “near epidemic.2” Fear, anxiety, and concern over the life-altering nature of HIV and AIDS also prompted much research on adolescent sexual behavior and contraception use because, according to the Centers for Disease Control and Prevention (CDC), one in five AIDS cases in the United States is diagnosed in the 20-29 year- old age group3 and most of these are likely to have resulted from HIV infections acquired up to 10 years earlier. In response, many AIDS education programs were insti- tuted in US schools. Although researchers have identified characteristics of effective programs (see Kirby et a14for a review), two important variables typically included in research and found to be related to adolescent sexualitys-’ have not been considered when designing these programs: gender and sexual experience of adolescents. Because a relationship exists, these variables should be considered when studying the factors influencing adolescent sexuality and implementing adolescent sexuality education programs. This paper focuses on four factors - intentions to engage in sexual behavior, intentions to use condoms, perceptions of peers’ sexual activity, and peer pressure - that have been shown empirically to influence adolescents’ sexual behav- ior, and discusses differences in these factors by gender and level of sexual experience. BACKCROU N D Intentions, Pressure, and Perceptions Much of the research investigating ways to prevent Deborah Nahom, MS, Prevention Research Trainee, (dnahom@u.wash- ington.edu); zyxwvutsrqpo Elizabeth Wells, PhD, Research Professor, zyxwvutsrq (bwells@u.washington.edu); Mary Rogers Gillmore, PhD, Associate Dean of Research. (maryg@u. washington.edu); Marilyn Hoppe, PhD, Research Scientist, (mjhoppe@u.washington.edu); Diane M. Morrison, PhD, Research Professor, (dmm@ u. washington.edu): Matthew Archibald, MA, Research Analyst, (arch@u.washing:on.edu); Elise Murowchick, PhD, Research Analyst, (elisem@u.washington.edu); Anthony Wilsdon, MS, Research Consultant, (tonyw@u. washington.edu); and Laurie Graham, MS W, Project Director, (deceased). Children’s Health Awareness Project - University of Washington; School of Social Weuare. 927 N. Northlake Way, #210, Seattle, WA 98103-8871. This investigation was supported by the National Institutes of Drug Abuse grant #5ROIDA0747 and by the National Institutes of Health National Research Service Award (MH20010) from the National Institute of Mental Health (Deborah Nahom). This article was submitted May 12. 2000, and revised and acceptedfor publication January 16, 2001. unwanted consequences of sexual behavior among adoles- cents has focused on the identification of factors influenc- ing adolescents’ sexual behavior (ie, sexual intercourse and contraception use). Empirical evidence suggests that inten- tions to engage in sexual behaviors are related to actually engaging in these behavior^,^-^^ and that perceptions of peers’ sexual behavior influence adolescents’ decisions to engage in sexual behavior”-Is more strongly than peers’ actual behavior.16 Though the argument that an individual’s sexual behavior changes as a result of peer pressure has received relatively weak empirical support,17 adolescents do report experiencing peer pressure to engage in sexual activ- ity? and the extent and impact of this pressure seems to vary by age and gender.I3 This evidence underscores the need to consider these four variables when studying adoles- cent sexuality and when subsequently designing sexuality education programs. Differences by Gender Gender is consistently related to intentions to engage in sexual activity and use contraception, perceptions of peers’ sexual activity, and peer pressure. One study found more frequent condom use among males than females ages 12, 13, and 17.19 Others found that females were less likely than males to follow through on intentions to consistently use condoms,12 and that males had more positive intentions to use condoms with steady partners, though not with casual partners.” National survey data suggested that, while the proportions of boys and girls engaging in sexual activity were similar, age of initiation was earlier for males than females.’ In addition, males were more likely to intend to have sex before finishing high school6 or getting married’ than were females. Males also anticipated more partner pressure for sex than did fern ale^.^ Females have been found to be more likely than males to perceive that a larger proportion of their peers were engaging in sex and using birth controls and to perceive less peer pressure for sex and more support for waiting than did males.’ Though evidence suggests important gender differences in these variables, gender is seldom taken into account in sexuality education or AIDS prevention programs aimed at youth. Differences by Sexual Experience The effect of previous adolescent sexual experience is less studied than gender in relation to intentions, perceived peer involvement, and peer pressure. Research typically Journal of School Health Aprll2001, Vol. 71, No. 4 153