{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:46:52Z","timestamp":1788482812788,"version":"build-2803163510"},"reference-count":32,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2017,5,2]],"date-time":"2017-05-02T00:00:00Z","timestamp":1493683200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of School Health"],"published-print":{"date-parts":[[2017,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Previous research on associations between early sexual debut and other health risk behaviors has not examined the effect of forced sexual intercourse on those associations.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>We analyzed data from a nationally representative sample of 19,240 high school students in the United States, age \u226516 years, to describe the effect of forced sexual intercourse on associations between early sexual debut and other health risk behaviors using adjusted prevalence ratios (APR).<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Early sexual debut and forced sexual intercourse were simultaneously and independently associated with sexual risk\u2010taking, violence\u2010related behaviors, and substance use. For example, even after controlling for forced sexual intercourse and race\/ethnicity, students who experienced their first sexual intercourse before age 13 years were more likely than students who initiated sexual intercourse at age \u226516 years to have had \u22654 sexual partners during their lifetime (girls, APR = 4.55; boys, APR = 5.82) and to have not used a condom at last sexual intercourse (girls, APR = 1.74; boys, APR = 1.47).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Associations between early sexual debut and other health risk behaviors occur independently of forced sexual intercourse. School\u2010based sexual health education programs might appropriately include strategies that encourage delay of initiation of sexual intercourse, and coordinate with violence and substance use prevention programs.<\/jats:p><\/jats:sec>","DOI":"10.1111\/josh.12512","type":"journal-article","created":{"date-parts":[[2017,5,2]],"date-time":"2017-05-02T16:22:27Z","timestamp":1493742147000},"page":"435-447","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Effect of Forced Sexual Intercourse on Associations Between Early Sexual Debut and Other Health Risk Behaviors Among US High School Students"],"prefix":"10.1111","volume":"87","author":[{"given":"Richard","family":"Lowry","sequence":"first","affiliation":[{"name":"Division of Adolescent and School Health US Centers for Disease Control and Prevention, 1600 Clifton Road, N.E., Mailstop E\u201075  Atlanta GA 30329"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leah","family":"Robin","sequence":"additional","affiliation":[{"name":"Research Application and Evaluation Branch, Division of Adolescent and School Health US Centers for Disease Control and Prevention, 1600 Clifton Road, N.E. 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