Why do sexually experienced girls resume sexual activity after abstinence?

While there has been a significant amount of research on teenagers' initial sexual experiences, the IU study is among the first to examine changes over time in decision-making about sexual abstinence among sexually active teenage girls. This information may help tailor effective counseling to prevent adolescent pregnancy and STDs.

The new findings are reported in the March 2010 issue of Perspectives on Sexual and Reproductive Health.

Characteristics associated with the risk of a teen girl having sex after a period of abstinence differed according to how long she had been abstinent. In the short term, a young woman was more likely to have sex when her relationship with her partner was good, when the girl felt good and when she was interested in having sex. Long term, sexual interest and relationship quality were the two most important predictors of resumption of sex after a period of abstinence.

"Sexuality is an important developmental task for teens. They need to go from childhood to sexually mature adulthood while remaining sexually disease free and without getting pregnant. We conducted this study to better understand the factors that influenced teenage girls who became sexually active again after a period of abstinence. With this new understanding we can better help young women remain healthy and avoid unwanted pregnancy," said study first author Mary A. Ott, M.D., assistant professor of pediatrics at the Indiana University School of Medicine.

Diagnosis of a STD was associated with a reduced risk of subsequent sex for a short time. However having an STD increased risk for sexual activity in the intermediate time period and was unrelated to the decision to have sex in the long run. The study authors hypothesize that the switch may reflect either relationship turmoil after diagnosis of an STD, followed by "make up" sex, or may reflect adherence to Center for Disease Control and Prevention recommendations for a period of abstinence following STD treatment, followed by resumption of previous sexual activity.

"Either way, the findings suggest that counseling only about abstinence after a sexually transmitted infection is insufficient. Clinicians should anticipate resumption of sexual behavior and tailor counseling appropriately," said Dr. Ott.

The researchers also found that, in the short term, girls who characterized themselves as irritable, angry or unhappy were unlikely to return to sexual activity after a period of abstinence. That finding contradicts anecdotal information that depressed individuals are likely to engage in sexual activity.

The researchers evaluated 354 sexually active urban teen girls for up to four and a half years between 1999 and 2006. Study participants were 14 to 17 years old and not pregnant when they enrolled. Sexual experience was not an inclusion criterion, but 81 percent of participants were sexually experienced at enrollment; most of the others had their first sexual experience during the study period.

Participants reported a total of 9,236 abstinence periods, which averaged 31 days.

"Having data from the same group of young women over such a long period of time, as they go through periods of having sex and times when they are not having sex and as they change partners, enables us to understand a complex process of motivation in a way that previous studies have not. What we have established in this study are the major factors associated with the decision to resume sex," said study senior author J. Dennis Fortenberry, M.D., professor of pediatrics.

In addition to Dr. Ott and Dr. Fortenberry, co-authors of "Characteristics Associated with Sex After Periods of Abstinence Among Sexually Experienced Young Women" are Susan Ofner, M.S.; Wanzhu Tu, Ph.D., associate professor of medicine; and Barry P. Katz, Ph.D., professor of medicine. Dr. Tu is a Regenstrief Institute investigator. Dr. Katz is a Regenstrief affiliated scientist.

The study was funded by the National Institutes of Health.