Characterizing women's first intercourse as simply voluntary or nonvoluntary is inadequate. Measures that take into account degrees of wantedness may help elucidate relationships between sexual initiation, contraceptive use and teenage pregnancy. The fact that substantial numbers of young women voluntarily participated in a first sexual experience about which they felt ambivalent or negative deserves the attention of program planners and service providers.

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Over the past decade, considerable legal and policy discussion has emerged about sexual activity between young teens and older individuals. This discussion has been prompted by the growing awareness of the personal and societal costs of this activity. Sex between young teens and older individuals is linked with risky sexual behaviors that could lead to unintended pregnancy and childbearing, as well as to sexually transmitted infections. Among sexually experienced teens, having sex with someone who is older has been associated with reduced and inconsistent use of contraception, 1-3 including reduced use of condoms, 4 and a greater risk of a teen pregnancy. 5 More than one in four babies born to mothers between the ages of 15 and 17 were fathered by someone who was five or more years older. 6 On average, young teens who have sex with an older individual report a larger number of sexual partners during the high school years and higher levels of drug and alcohol use than do other sexually experienced teens. 7,8 Some studies of male and female middle school and high school teens also have found that those who were dating an older individual were more likely than were those who were dating a similar-aged individual to engage in sexual intercourse in that relationship. 9-11 And early sexual activity, in itself, is linked to a host of negative outcomes, including having a greater number of sexual partners, a reduced likelihood of using contraception, and a greater likelihood of getting pregnant and giving birth during the teen years. 12 Some research on adolescent brain development provides a larger context for these patterns; this research suggests that young teens are not prepared cognitively to make significant life decisions, including decisions about sex and contraception. 13

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