Lifestyle and risk of premature sexual activity in a high school population of Seventh-Day Adventists: Valuegenesis 1989

Adolescence, Summer, 1996 by Miriam L.M. Weinbender, Annette MacKay Rossignol

In the past twenty years, sexually transmitted diseases (STDs), including human immunodeficiency virus infection and acquired immunodeficiency syndrome (HIV/AIDS), as well as the physical, psychological, and economic difficulties associated with unwanted pregnancy, have increased steadily among American adolescents. It has been demonstrated that early initiation of sexual activity is associated with an increased risk for STDs (Centers for Disease Control, 1992b). The morbidity from teenage STDs over time poses serious health risks for youth who are sexually active. Further, should unwanted pregnancy occur, babies of teen parents are at higher risk both physically and psychologically than are infants born to older women (McAnarney & Hendee, 1989).

Recently, the risk of HIV exposure has added urgency to concerns about adolescent sexual activity. Several sources have noted that adolescents are among the high risk groups for HIV/AIDS in the United States (CDC, 1989; Stall, McKusick, Wiley, Coates, & Ostrow, 1986). The Centers for Disease Control (1992a) reported that the 15- 29-year age group has the third highest incidence of new cases of HIV infection. Because the average time between exposure to HIV and diagnosis of AIDS is approximately ten years, AIDS identified in individuals ages 20-29 years ordinarily represents exposure during the teen years.

In January 1992, the CDC (1992b) estimated the percentage of sexually active high school students in the United States to be 54.2%. The percentage increased with grade level, ranging from 39.6% for ninth graders to 71.9% for twelfth graders and was significantly higher in males than in females (48% versus 60.8%, respectively).

By contrast, a 1989 study of Seventh-Day Adventist youth in private Adventist secondary schools (the "Valuegenesis Study") found that, overall, only 21.6% of males and females in grades nine through 12 reported being sexually active (Benson & Donahue, 1990). The National Health Objectives for the year 2000 include reduction of the proportion of adolescents who are sexually active to [less than or equal to] 15% for 15-year-olds and [less than or equal to] 40% for 17-year-olds (CDC, 1992b). In light of this goal, the lower than average proportion of sexually active adolescents identified by the Valuegenesis data is of particular interest.

A subset of the Valuegenesis study was analyzed in order to identify lifestyle factors associated with adolescent sexual intercourse and thus also with an increased risk of both teen pregnancy and sexually transmitted diseases including HIV/AIDS. The objective was to identify possible "transition-marking behaviors" (behaviors that represent significant points in the transition from adolescence to adulthood) associated with early sexual activity (Jessor & Jessor, 1975).

METHOD

The study is based on a subset of the Valuegenesis study data. In that study, a 20% random sample of Adventist elementary schools (grades six through eight), all Adventist high schools in North America, and teachers, parents, and pastors were invited to participate by completing a questionnaire (Search Institute, 1989). The questionnaire probed specific behaviors, beliefs, feelings, and attitudes as part of an evaluation of the strength of faith and Adventist belief evidenced by youth enrolled in Seventh-day Adventist private schools in North America. North American Division leaders of the Seventh-day Adventist Church, in cooperation with Searle Institute (Minneapolis, Minnesota), designed the questionnaire, selecting nearly 500 from a total of approximately 1,500 questions previously used by Search Institute in other, similar studies of other denominations.

Search Institute directed the data collection, designating a test administrator in each participating school who was responsible for planning and organization prior to administration of the questionnaire and for the data collection. Questionnaires at each school were completed during a two-week period in September 1989. During this period, each potential responder was given two opportunities to complete the questionnaire. Because it was felt that adolescent respondents would answer with greater honesty if they had confidence in the privacy of their responses, youth were tested in different test sites than were the other respondents (parents, teachers, and pastors), and all questionnaires were treated as confidential documents. After data collection, completed questionnaires were returned to Search Institute for initial data analysis and storage (Search Institute, 1989).

The present study is based on a subset of respondents and questions from the student questionnaires. The subset was comprised only of students who indicated on the questionnaire that they were Seventh-day Adventists and who were in high school (grades nine through 12); 8,321 students from 58 high schools participated in the study (response rate = 79% of all students in the targeted grades and schools). A preliminary analysis of the data indicated statistically significant differences between behaviors associated with early sexual activity for high school students compared with younger students, and differences in the proportions of students who had experienced sexual intercourse; thus the study was restricted to high school students. The subset of questions analyzed for the study consisted of 40 questions which, based on the behavioral risk-taking literature, appeared most likely to be associated with high-risk health behaviors in this population (Donavan & Gassier, 1985; Jessor & Jessor, 1975; Orr, Beiter, & Ingersoll, 1991). These behaviors included both legal and illegal drug use, social activities and dating practices, level of physical activity, and popular entertainment. In addition, a set of behaviors discouraged by a large percentage of Adventists, particularly by more conservative members, such as wearing jewelry and watching a movie at a theater, or participating in competitive sports was analyzed. (The Seventy-day Adventist denomination is a distinct subculture whose beliefs include "healthful living," that is, the belief that sound thinking depends on good physical health, and that spirituality depends on sound thinking. One requirement for membership in the Adventist denomination is public commitment to refrain from the use of tobacco, alcohol, and nonprescription drugs. Many Adventists participate in other healthful behaviors such as regular exercise and eating a largely vegetarian diet. In addition, strong family life is encouraged by children's attendance at denominational schools and by regular church attendance.)