Abstract
INTRODUCTION: Sexuality is a component of health and well-being for all women, including adolescents. Yet relationships between young women's health perceptions and sexual behavior are unclear. AIM: We examined associations between perceived health and lifetime sexual experiences among young U.S. women. METHODS: We used data from 4,413 young women ages 15-24 years in the National Survey of Family Growth, 2002-2008. Descriptive, bivariate, and multivariate statistics estimated relationships between categories of perceived health and types of lifetime sexual experience. MAIN OUTCOME MEASURES: A self-rated health Likert item and sexual history questions were administered with a computer-assisted survey instrument. RESULTS: Young women reported excellent (30%), very good (41%), good (23%), and fair-poor (6%) health. Sexual experiences included vaginal (64%), oral (64%), and anal (20%) sex. Negative experiences included involuntary sex (11%) and sexually transmitted infection (STI) history (8%). In multivariate logistic regression models, lower perceived health ("good" rather than "excellent") was positively associated with vaginal (odds ratio [OR] 1.5, confidence interval [CI] 1.1-2.1, P = 0.02), oral (OR 1.5, CI 1.1-2.1, P = 0.005), and anal (OR 1.4, CI 1.0-2.0, P = 0.03) sex. In models stratified by age, point estimates for vaginal (OR 1.8, CI 1.2-2.6, P = 0.002) and oral (OR 1.9, CI 1.4-2.6, P < 0.001) sex were higher among adolescents ages 15-19 years, but associations were insignificant among young adults ages 20-24 years. When controlling for negative sexual experiences, point estimates were stable in models including STI history but statistically insignificant when including involuntary sexual experience. Other characteristics associated with sexual experiences varied by type of experience and included age, race/ethnicity, employment situation, poverty level, insurance status, childhood family situation, religious service participation, cohabitation/marital experience, and body mass index. CONCLUSIONS: Further investigation is warranted to disentangle potentially negative relationships between perceived health (as well as response bias and more objective health outcomes), sociodemographic factors, and diverse sexual experiences among young women in the United States.