Arch Sex Behav. 2026 Jan 16. doi: 10.1007/s10508-025-03282-4. Online ahead of print.
ABSTRACT
Understanding trends in age of first sex and first marriage is vital for interventions addressing sexually transmitted infections (STIs/HIV) and youth sexual behavior. Shifts in these milestones affect fertility, contraceptive use, and STI/HIV dynamics. Traditional descriptive statistics often overlook younger populations, leading to inaccurate trend assessments. This study analyzed trends in median age at first sex and first marriage using survival analysis. Data from eight surveys within Magu Health and Demographic Surveillance System (1994-2016) were analyzed, focusing on individuals aged 15-24 years. The accelerated failure time (AFT) model with log-logistic distribution estimated these medians. Results showed an increase in median age at first sex by one year for both sexes and in first marriage by one year for females and two years for males. The AFT model captured gradual increases from 2003-2004 to 2015-2016 for females and 2003-2004 to 2010 for males, while standard descriptive statistics showed no changes in specific periods: age at first sex, 1996-1997 to 2012-2013 (females) and 2003-2004 to 2012-2013 (males); first marriage, 1994-1995 to 2015-2016 (females) and 2003-2004 to 2010 (males). Individuals with no education had lower median age at first sex (males: 17.1 vs. 18.3 years; females: 16.2 vs. 18.2) and first marriage (females: 18.0 vs. 21.3) than those with secondary or higher education. HIV-positive individuals experienced slightly earlier age at first sex and first marriage than negative individuals. Education plays a pivotal role in delaying these events. The AFT model enriches trend assessment.
PMID:41543812 | DOI:10.1007/s10508-025-03282-4