Predisposing Factors Related to Adolescent Sexuality Among Students in Rural and Urban School-Based Health Centers in Eastern North Carolina

This study examined possible predisposing factors that may contribute to rural adolescents' early sexual behavior. Sexual behaviors, demographics, family structure, history of abuse, sexually active friends, and substance use were analyzed in 410 rural and urban adolescents, aged 10 to 19 years, who were enrolled in a school-based health center in North Carolina between 2005 and 2007. Results indicated that Black students residing in single-parent urban households were more likely to engage in sex earlier than other analyzed ethnic groups (odds ratio [OR] = 5.2; 95% confidence interval [CI] = 1.1-23.6). As age increased, risk of engaging in sex also increased. Rural students reporting history of abuse had a higher risk of engaging in early sexual behaviors than urban students (OR = 2.6; 95% CI = 1.0-6.8) with a similar history. Students residing in a single-or no-parent household had requested more health education services than those residing in a dual-parent household. An inverse association was observed between the amount of parental communication among urban adolescents and engagement in risky sexual behaviors (OR = 0.3; 95% CI = 0.1-0.9). Rural/urban location and student race should be considered as moderators of the relationships between demographic characteristics and sexual behaviors in adolescents enrolled in a school-based health center.