{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T02:30:25Z","timestamp":1787884225708,"version":"build-2784847793"},"reference-count":39,"publisher":"BMJ","issue":"11","license":[{"start":{"date-parts":[[2022,11,4]],"date-time":"2022-11-04T00:00:00Z","timestamp":1667520000000},"content-version":"unspecified","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["2019R1I1A3A01062786"],"award-info":[{"award-number":["2019R1I1A3A01062786"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2022,10,7]]},"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Sexual activity is an important integrative behaviour that interacts with biological, psychological and social factors among various changes in adolescence. However, starting sex at an early age is associated with adverse outcomes. Thus, this study aimed to investigate the factors associated with adolescents\u2019 sexual experience based on the biopsychosocial model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A cross-sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>The participants were selceted through a complex sample design at high schools and middle schools nationwide in Korea.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>We employed 4-year data (2017\u20132020) of the cross-sectional Korea Youth Risk Behavior Web-based Survey. In total, 234567 participants attending middle school and high school were analysed. Sexual experience was defined as having had sexual intercourse (oral, anal or vaginal) in their lifetime. To identify variables associated with adolescents\u2019 sexual experiences, we used a biopsychosocial model. Logistic regression analysis was performed to identify the variables associated with sexual experience.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>3.4% of boys and 1.6% of girls attending middle school had sexual experiences, showing a significant difference. A total of 10.4% of boys and 5.1% of girls attending high school had sexual experiences (p&lt;0.001). Among the biological factors of the biopsychosocial model, age and gender were significantly associated with sexual experiences in adolescents. Regarding the psychological factors, suicidal thoughts were a significant risk factor associated with sexual experience. Furthermore, social factors including drinking, smoking and family structure were associated with sexual experience in adolescents. Particularly, a significantly higher sexual experience was found in the three groups living with a single parent, step-parents and no parents compared with the group living with both parents in family structure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study demonstrated the factors associated with adolescents\u2019 sexual experience based on the biopsychosocial model. Further research and policy strategies that consider supporting family communication and mental health and preventing substance use are required to prevent adolescents\u2019 sexual health.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2022-066307","type":"journal-article","created":{"date-parts":[[2022,11,4]],"date-time":"2022-11-04T11:44:56Z","timestamp":1667562296000},"page":"e066307","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Factors associated with adolescents\u2019 sexual experience based on the biopsychosocial model: a cross-sectional study using the Korea Youth Risk Behavior Web-based Survey (KYRBS)"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3705-6449","authenticated-orcid":false,"given":"Ka Young","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Nursing, College of Nursing, Gachon University, Incheon, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5353-8897","authenticated-orcid":false,"given":"Hye Young","family":"Shin","sequence":"additional","affiliation":[{"name":"Department of Nursing, Gangseo University, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,11,4]]},"reference":[{"key":"2025121514030379000_12.11.e066307.1","doi-asserted-by":"crossref","first-page":"70","DOI":"10.4103\/0974-1208.158594","article-title":"Understanding normal development of adolescent sexuality: a bumpy ride","volume":"8","author":"Kar","year":"2015","journal-title":"J Hum Reprod Sci"},{"key":"2025121514030379000_12.11.e066307.2","unstructured":"Korea Disease Control and Prevention Agency . Korea youth risk behavior web-based survey statistics, 2020. Available: https:\/\/www.kdca.go.kr\/yhs\/ [Accessed 31 Oct 2022]."},{"key":"2025121514030379000_12.11.e066307.3","doi-asserted-by":"crossref","DOI":"10.4178\/epih.e2020008","article-title":"Prevalence of sexual experience among Korean adolescent: age-period-cohort analysis","volume":"42","author":"Jee","year":"2020","journal-title":"Epidemiol Health"},{"key":"2025121514030379000_12.11.e066307.4","unstructured":"Centers for Disease Control and Prevention . Youth Risk Behavior Surveillance system(YRBSS). 2019 YRBS results. Available: https:\/\/www.cdc.gov\/healthyyouth\/data\/yrbs\/index.htm [Accessed 31 Oct 2022]."},{"key":"2025121514030379000_12.11.e066307.5","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1016\/j.jadohealth.2019.11.310","article-title":"Adolescent sexual activity, contraceptive use, and pregnancy in Britain and the U.S.: a Multidecade comparison","volume":"66","author":"Scott","year":"2020","journal-title":"J Adolesc Health"},{"key":"2025121514030379000_12.11.e066307.6","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1007\/s10508-014-0265-7","article-title":"Sexual initiation and emotional\/behavioral problems in Taiwanese adolescents: a multivariate response profile analysis","volume":"44","author":"Chan","year":"2015","journal-title":"Arch Sex Behav"},{"key":"2025121514030379000_12.11.e066307.7","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2008.133785"},{"key":"2025121514030379000_12.11.e066307.8","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2458-13-295","article-title":"Substance use, risky sexual behaviors, and their associations in a Chinese sample of senior high school students","volume":"13","author":"Li","year":"2013","journal-title":"BMC Public Health"},{"key":"2025121514030379000_12.11.e066307.9","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0257529","article-title":"Barriers and strategies for cervical cancer screening: what do female university students know and want?","volume":"16","author":"Shin","year":"2021","journal-title":"PLoS One"},{"key":"2025121514030379000_12.11.e066307.10","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1080\/00224499.2019.1695098","article-title":"Relating gender to sex: gendered attitudes, sexual double standard, sexual intentions and behaviors in two Chinese adolescent samples","volume":"58","author":"Wu","year":"2021","journal-title":"J Sex Res"},{"key":"2025121514030379000_12.11.e066307.11","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1111\/j.1471-6712.2012.00989.x","article-title":"Early onset of sexual intercourse is an indicator for hazardous lifestyle and problematic life situation","volume":"27","author":"Makenzius","year":"2013","journal-title":"Scand J Caring Sci"},{"key":"2025121514030379000_12.11.e066307.12","unstructured":"Kwon MY , Jeong S . The effects of individuals, families, and school factors on sexually transmitted infections in Korean adolescents: using data from the 10~12th (2014~2016) Korea youth risk behavior web-based survey. J Korean Soc Sch Health 2018;31."},{"key":"2025121514030379000_12.11.e066307.13","doi-asserted-by":"publisher","DOI":"10.1097\/MOP.0000000000000578"},{"key":"2025121514030379000_12.11.e066307.14","unstructured":"CDC . Cdc fact sheet: information for teens and young adults: staying healthy and preventing STDs: centers for disease control and prevention, 2021. Available: https:\/\/www.cdc.gov\/std\/life-stages-populations\/stdfact-teens.htm [Accessed 11 Oct 2021]."},{"key":"2025121514030379000_12.11.e066307.15","first-page":"S3\/52","article-title":"Chapter 6: epidemiology and transmission dynamics of genital HPV infection","volume":"24 Suppl 3","author":"Burchell","year":"2006","journal-title":"Vaccine"},{"key":"2025121514030379000_12.11.e066307.16","doi-asserted-by":"crossref","DOI":"10.5534\/wjmh.210012","article-title":"Changing trends in sexual Debut age in the Korean Internet sexuality survey","volume":"40","author":"Park","year":"2022","journal-title":"World J Mens Health"},{"key":"2025121514030379000_12.11.e066307.17","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1159\/000367857","article-title":"Sexuality development in adolescence and beyond","volume":"57","author":"Moshman","year":"2014","journal-title":"Hum Dev"},{"key":"2025121514030379000_12.11.e066307.18","doi-asserted-by":"publisher","DOI":"10.1126\/science.847460"},{"key":"2025121514030379000_12.11.e066307.19","doi-asserted-by":"publisher","DOI":"10.1037\/0012-1649.39.2.349"},{"key":"2025121514030379000_12.11.e066307.20","doi-asserted-by":"crossref","first-page":"193","DOI":"10.3109\/10253890.2014.891102","article-title":"The biopsychosocial model of stress in adolescence: self-awareness of performance versus stress reactivity","volume":"17","author":"Rith-Najarian","year":"2014","journal-title":"Stress"},{"key":"2025121514030379000_12.11.e066307.21","doi-asserted-by":"publisher","DOI":"10.1177\/1359105310377812"},{"key":"2025121514030379000_12.11.e066307.22","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1111\/j.1744-6171.2011.00312.x","article-title":"Biopsychosocial model of hypersexuality in adolescent girls with bipolar disorder: strategies for intervention","volume":"25","author":"Basco","year":"2012","journal-title":"J Child Adolesc Psychiatr Nurs"},{"key":"2025121514030379000_12.11.e066307.23","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1007\/s11199-016-0618-x","article-title":"The double standard at sexual debut: gender, sexual behavior and adolescent peer acceptance","volume":"75","author":"Kreager","year":"2016","journal-title":"Sex Roles"},{"key":"2025121514030379000_12.11.e066307.24","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.91.8.1276"},{"key":"2025121514030379000_12.11.e066307.25","doi-asserted-by":"crossref","DOI":"10.1016\/j.psychres.2019.112564","article-title":"Sexual behavior and suicide attempts among adolescents aged 12-15 years from 38 countries: a global perspective","volume":"287","author":"Smith","year":"2020","journal-title":"Psychiatry Res"},{"key":"2025121514030379000_12.11.e066307.26","doi-asserted-by":"crossref","first-page":"144","DOI":"10.3390\/sexes2010012","article-title":"Effectiveness of sex education in adolescents","volume":"2","author":"Cort\u00ednez-L\u00f3pez","year":"2021","journal-title":"Sexes"},{"key":"2025121514030379000_12.11.e066307.27","first-page":"126","article-title":"The effects of sex education on the risky sexual behaviour of school going adolescents: a case study of Mbenjere secondary, Ntaja and Nsanama community day secondary schools","volume":"28","author":"Rashid","year":"2016","journal-title":"Psycho Dev Soc"},{"key":"2025121514030379000_12.11.e066307.28","first-page":"120","article-title":"Effect of sex education programme on at-risk sexual behaviour of school-going adolescents in Ilorin, Nigeria","volume":"8","author":"Esere","year":"2008","journal-title":"Afr Health Sci"},{"key":"2025121514030379000_12.11.e066307.29","doi-asserted-by":"crossref","first-page":"159","DOI":"10.4069\/kjwhn.2012.18.3.159","article-title":"A study on knowledge, attitudes, and need for sex education in high school students","volume":"18","author":"Yang","year":"2012","journal-title":"Korean J Women Health Nurs"},{"key":"2025121514030379000_12.11.e066307.30","doi-asserted-by":"crossref","first-page":"274","DOI":"10.24171\/j.phrp.2019.10.5.03","article-title":"Interaction between smoking cigarettes and alcohol consumption on sexual experience in high school students","volume":"10","author":"Kim","year":"2019","journal-title":"Osong Public Health Res Perspect"},{"key":"2025121514030379000_12.11.e066307.31","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-020-08655-z","article-title":"The association of family structure with health behavior, mental health, and perceived academic achievement among adolescents: a 2018 Korean nationally representative survey","volume":"20","author":"Park","year":"2020","journal-title":"BMC Public Health"},{"key":"2025121514030379000_12.11.e066307.32","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2015-0305"},{"key":"2025121514030379000_12.11.e066307.33","doi-asserted-by":"crossref","DOI":"10.1186\/s12978-015-0069-9","article-title":"Influence of parental factors on adolescents' transition to first sexual intercourse in Nairobi, Kenya: a longitudinal study","volume":"12","author":"Okigbo","year":"2015","journal-title":"Reprod Health"},{"key":"2025121514030379000_12.11.e066307.34","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1016\/j.pcl.2016.11.002","article-title":"Talking to parents about adolescent sexuality","volume":"64","author":"Ashcraft","year":"2017","journal-title":"Pediatr Clin North Am"},{"key":"2025121514030379000_12.11.e066307.35","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.adolescence.2017.02.013","article-title":"Parenting and youth sexual risk in context: the role of community factors","volume":"57","author":"Goodrum","year":"2017","journal-title":"J Adolesc"},{"key":"2025121514030379000_12.11.e066307.36","doi-asserted-by":"publisher","DOI":"10.1111\/jomf.12181"},{"key":"2025121514030379000_12.11.e066307.37","doi-asserted-by":"crossref","first-page":"S36","DOI":"10.21101\/cejph.a4952","article-title":"Trends in Parent-adolescent communication in the Czech Republic between 2002 and 2014: results of the HBSC study","volume":"25 Suppl 1","author":"Vok\u00e1\u010dov\u00e1","year":"2017","journal-title":"Cent Eur J Public Health"},{"key":"2025121514030379000_12.11.e066307.38","doi-asserted-by":"crossref","first-page":"1003","DOI":"10.1007\/s10964-016-0457-7","article-title":"Family structure, maternal dating, and sexual debut: extending the conceptualization of instability","volume":"45","author":"Zito","year":"2016","journal-title":"J Youth Adolesc"},{"key":"2025121514030379000_12.11.e066307.39","unstructured":"Statistics Korea . Marriage and divorce, 2021. Available: http:\/\/kostat.go.kr\/portal\/eng\/pressReleases\/8\/11\/index.board [Accessed 31 Oct 2022]."}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2022-066307","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T22:03:10Z","timestamp":1765836190000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2022-066307"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11]]},"references-count":39,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2022,11,4]]},"published-print":{"date-parts":[[2022,11]]}},"alternative-id":["10.1136\/bmjopen-2022-066307"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2022-066307","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11]]}}}