Dating a mexican vs white girl

Abstract

Introduction

The importance of culturally specific interventions to promote positive sexual decision making among adolescents has been well-documented.^1-3 In order to design the most effective interventions, we need to go beyond looking at differences in vaginal intercourse and begin investigating the whole range of sexual behaviors. A landmark study found that patterns of sexual behavior differ by race/ethnicity. While white adolescents progressed through a predictable pattern of non-coital sexual behaviors of kissing, above the waist touching, and below the waist touching before engaging in coitus, black adolescents engaged in very little non-coital behaviors before advancing to coitus.⁴ This initial examination of the sequence of adolescent sexual behaviors did not examine oral and anal sex behaviors. Follow-up studies comparing black and white young adults have indicated that oral and anal sexual behaviors are less frequent among blacks than whites and that blacks have been found to initiate oral sex at a later age than whites despite having initiated vaginal sex at an earlier age.^{5, 6} One adolescent-specific study that compared prevalence of oral sex across white versus non-white adolescent boys and girls ages 12 to 16 years found no differences. The non-white group was comprised of varies ethnicities, including African-American, Asian-American, Latinos, and other ethnicity, thus perhaps masking the effects of race on prevalence rates for oral sex.⁷ Given the paucity of adolescent research examining the relationship of race/ethnicity to oral and anal sex behavior, the present study sought to investigate racial/ethnic differences in oral and anal sexual behaviors among an ethnically diverse sample enrolled in a microbicide acceptability study.

The objectives were to:

1. Identify rates of oral and anal sex behaviors and assess for differences in rates across race/ethnicity;

2. Determine if there were racial/ethnic differences in the number of oral and anal sex partners;

3. Determine the ages at which this sample first engaged in oral, anal, and vaginal sexual behaviors and assess whether there were differences in ages of initiation by race/ethnicity and differences in length of time between ages of initiation for the different sexual behaviors by race/ethnicity;

4. Determine whether oral and anal sexual behaviors were predictive of STI history and pregnancy history.

Materials and Methods

Results

The mean age of the sample was 18.2 years (sd = 1.93). Twenty-six percent (n = 53) were white, 43% (n = 86) was African-American, and 31% (n = 63) Hispanic. White girls (mean = 18.9 years, sd = 1.80) were significantly older than the African-American (mean = 18.1 years, sd = 1.96) and Hispanic girls (mean = 17.7 years, sd = 1.83) (F = 6.00, p < .01).

Descriptive data for sexual history by race/ethnicity are presented in Table 1. When controlling for age, African-American girls were .07 (CI .03, .18) times as likely as white girls and .28 (.13, .58) times as likely as Hispanic girls to have given oral sex. Hispanic girls were .25 (CI .10, .64) times as likely as white girls to have given oral sex. After controlling for age, African-American girls had a decreased odds of having received oral sex than both white (OR .27; CI .11, .67) and Hispanic (OR .41; .20, .87) girls. White and Hispanic girls did not differ from each other with regard to ever having received oral sex. With respect to anal sex, there were no significant differences across race/ethnicities (Wald chi-square = 2.84, p = 24).

Table 2 presents Chi-square analysis of types of sexual behaviors by race/ethnicity. All girls who had anal sex had also had oral sex and thus there were no girls who had only vaginal and anal sex. As can be seen in Table 2, a significantly lower percentage of white girls (9%) had only engaged in vaginal sex compared to that of African-American girls (41%) and Hispanic girls (29%).

Age and race/ethnicity were included as covariates in logistic regression models assessing the relationship between type of sexual behavior (e.g., ever having given oral sex) and history of an STI because they both were significantly related to the outcomes of interest. Age significantly predicted STI and pregnancy history. Older girls were 1.34 (CI 1.13, 1.58) times more likely than younger girls to report having an STI in the past and 1.25 (CI 1.07, 1.45) times more likely than younger girls to report having been pregnant. When controlling for age, African-Americans were 3.58 (CI 1.53, 8.37) times more likely than whites and 2.16 times (CI 1.01, 4.64) more likely than Hispanics to have had an STI in the past. Whites and Hispanics were not significantly different from each other with regard to STI history (OR .60; CI .24, 1.56). African-Americans were 2.64 times (CI, 1.24, 5.64) more likely than whites to have been pregnant but were not significantly different than Hispanics in pregnancy history (OR 1.47, CI .74, 2.89). White and Hispanic girls did not differ from each other with regard to pregnancy history (OR .55; CI .25, 1.25).

The results of the analyses examining the relationship between STI and pregnancy history adjusting for age and race/ethnicity are presented in Table 3. As can be seen in the table, those girls who had had both oral and vaginal sex were 6 times more likely to report having an STI in the past compared to those who only had vaginal sex. Those with oral, vaginal, and anal sex experience were 3 times more likely to report having an STI in the past compared to those who only had vaginal sex.

Given that oral sex likely was not the cause of all these STI infections, we examined whether oral sex was associated with other risk factors by conducting separate logistic regressions models with oral sex (giving or receiving) as the outcome, age and race/ethnicity as covariates, and each risk factor as a predictor (e.g., frequency of sex in the past three months, use of condoms in the past three months, alcohol or drug use during sex in the past three months, age of sexual initiation, and number of lifetime vaginal sex partners). As can be seen in Table 4, those girls with a higher frequency of sex in the past three months, use of alcohol or drugs during sex in the past three months, and a higher number of lifetime vaginal partners were significantly more likely to have engaged in oral sex than those without these characteristics. Age of vaginal sexual initiation was marginally related (p < .07) to history of having oral sex.

Table 5 presents data on the age of initiation for each sexual behavior. After controlling for age, race/ethnic differences were found with regard to age of initiation of giving oral sex (F = 5.78, p <.01); African-Americans were significantly older than whites and Hispanics when they first gave oral sex. When controlling for age, no significant race/ethnic differences were found for age of initiation of any of the other types of sexual behaviors, receiving oral sex (F = .40, p = .67), having anal sex (F = .77, p = .47), having vaginal intercourse (F = .56, p = 57). After controlling for age and age of initiation of the specific type of sexual behavior (e.g., giving oral sex), there were no significant race/ethnic differences in number of oral-giving (F = 1.26, p = .28), oral-receiving (F = 1.67, p = .19), anal (F = .56, p = .58), or vaginal partners (F = .71, p = .49).

Of note, 54% of the white, 27% of the African-American, and 51% of the Hispanic girls who had initiated oral and vaginal sex did so in the same year. Repeated measures analysis of variance (F = 4.74, p = .01) indicated that the difference between the age of vaginal sexual initiation and the age of oral sex initiation (giving or receiving) significantly varied by race/ethnicity with African-Americans having a greater difference between age of oral sex initiation and vaginal sex initiation (mean = 1.14 years, sd = 1.84) than whites (mean = .27 years, sd = 1.20) and Hispanics (mean = .44 years, sd = 1.29).

Discussion

In this sample of sexually experienced adolescent girls, 71% had engaged in oral sex (either gave or received) and 13% had experienced anal sex. These findings are consistent with the prevalence rates found in previous studies with sexually experienced adolescent/young adult females with the range for oral sex being 67 to 97% (median = 72.5%)^{5, 8-12} and the range for anal sex being 15 to 32% (median = 17.5%).^{5, 10, 11, 13} All the girls in our study who had anal sex also had oral sex.

In the present study, racial/ethnic differences were found for oral sex behaviors but not anal sex behaviors, which is consistent with previous studies.^{14, 15} African-Americans girls in our study were less likely to engage in oral sex than white and Hispanic girls. Also the difference in time between initiation for oral sexual behaviors and initiation of vaginal sexual behaviors was much greater for African-American girls; white and Hispanic girls initiated oral and vaginal sexual behaviors within the same year, while African-American girls typically engaged in oral sex one year later than vaginal intercourse. In another recent study, oral sex was found to precede vaginal sex, and this was felt to be related to the fact that oral sex was viewed by some teens as less deviant and therefore, less guilt-provoking.¹⁶ In our sample, it was difficult to ascertain which occurred first for the white and Hispanic girls although there was less than a year difference, but for the African-Americans, the pattern differed. It is difficult to directly compare the study results because the samples differed in demographic characteristics. The sample in Brady et al.'s study¹⁶ included both males and females whereas the present study's sample consisted of only females. Also their sample was younger than and differed in ethnic distribution (40% white, 19% Latino, 17% Asian or Pacific Islander, 4% Black, and 20% multiethnic), and geographical region of the United States from the sample in the present study. In addition, our sample did not include those who had only engaged in oral sex, which may be a different subgroup of adolescents. However, the studies taken together point to the importance of understanding the complexities of decision-making regarding non-coital behaviors and the timing of initiation among diverse groups of adolescents.

Future research should investigate how racial/ethnic differences develop for some sexual behaviors but not for others. Sexual scripting theory postulates that sexual behaviors, beliefs, and meanings attached to sexual behaviors are constructed through the interaction of the individual and his/her social group.¹⁷ It appears that for adolescents, race/ethnicity may be an important “social group” for determining oral sex behaviors. Previous influential writers of black culture have hypothesized that oral sex is less acceptable among black cultures than it is among white cultures,^{18, 19} thereby lending some support to interpreting our findings within sexual scripting theory. The need to examine sexual scripts and their origins separately for each sexual behavior seems relevant, given our findings of race/ethnic differences for oral sex but not anal sex and given that previous research has found that adolescents' attitudes toward different types of sexual behaviors vary.²⁰

Both oral sex and anal sex were associated with an increased risk of reporting an STI history; the odds of having had an STI increased by a factor of 6 for those who had oral sex and vaginal sex only but only by a factor of 3 for those who had oral, vaginal, and anal sex. Thus, having a history of anal sex did not confer any greater risk for an STI than having a history of oral sex alone among our sample of non-virgin adolescent girls. We believe that the relationship found between oral sex behavior and STI history in the present study is consistent with Problem Behavior Theory, which suggests that problem or non-conventional behaviors cluster together.^{21, 22} In other words, oral sex experience represented a non-conventional behavior that clustered with other risk-taking behaviors. Indeed, girls in our study who had oral sex reported more frequent vaginal sex within the past 3 months, a higher number of lifetime vaginal sex partners, and more frequent use of alcohol or drugs during sex in the past three months than girls without oral sex experience. Thus, sexual behaviors should not be considered in isolation, but rather as a pattern of behaviors that constitute a “sexual lifestyle.”²² It should be noted that those adolescents who had only engaged in oral sex were not included in this sample. It is possible that these adolescents would constitute a group with a different “sexual lifestyle” and thus, they could have a different cluster of risk behaviors. Previous research has found that adolescents who have had oral sex only compared to those who have had oral and/or vaginal sex reported a lower rate of STIs.¹⁶ It may be that the relationships found in the present study would not hold for all adolescent populations. However, it is still important for us as clinicians to identify and address patterns of adolescent sexual behavior.

The present study had several limitations. First, the findings were based on a convenience sample of girls from Galveston, Texas. Thus, the results may not generalize to girls from other geographical regions. Also, our sample only included girls with vaginal sexual experience. Thus, these results are not reflective of those adolescents who have had only oral or anal sex but no vaginal sex. The sample size was relatively small and the study not designed to evaluate racial/ethnic differences in sexual behaviors. Thus, more in-depth studies with larger sample sizes are needed to further understand patterns of sexual behaviors and cultural norms. The data regarding recent sexual history (last three months) were based on retrospective report, and thus, there may be some biases in what girls chose to remember or report. We did not collect information with regard to other non-coital behaviors such as kissing, breast-touching, or outer course (e.g., masturbation of or by a partner) and thus were not able to examine where oral and anal sex fits in with these behaviors. For girls who reported first engaging in certain sexual behaviors at the same age (e.g., oral and vaginal sex), we were unable to distinguish which behavior occurred first and could not specifically assess the sequence of sexual behaviors across race/ethnicities. Lastly, when assessing whether the pattern of sexual behaviors differed for the three race/ethnicities, we could not include those girls who would, but had not yet initiated oral or anal sex. However, only 5 (9%) of the white girls and 29% of the Hispanic girls had not had oral sex whereas 41% of the African-American girls had not had oral sex. The reported difference between the age of vaginal sex initiation and oral sex initiation was greater for African American girls than white and Hispanic girls, and these relationships would likely be supported to a greater degree if data were collected at a later age when all participants who would have engaged in oral sex had done so.

Conclusion

We found that adolescent girls engage in a range of sexual behaviors, with cultural differences in their choices of which behaviors to engage in and when. Understanding the influence of cultural/social mechanisms on patterns of sexual behavior, rather than isolated behaviors (i.e., vaginal intercourse) may prove helpful when designing culturally-specific STI prevention efforts. Lastly, although vaginal sex poses a much greatest risk for infection of an STI than oral sex, our findings indicated that sexually experienced girls who engaged in oral sex were likely to be engaging in additional risk behaviors and had greater rates of STIs. Such findings again highlight the importance of examining patterns of adolescent behavior, and viewing sexual behavior within the larger context of the adolescent's life.

Acknowledgements

Footnotes

References