An analysis of studies based on a federal survey of adolescent health behavior shows that the risk factors for sexual intercourse among teenagers differ greatly from the factors predicting other major risk behaviors-such as cigarette smoking, drug and alcohol use, weapons-related violence, and suicidal thoughts and attempts. The review, "Recent Findings From the 'Add Health' Survey: Teens and Sexual Activity," by Cynthia Dailard, a senior policy analyst with The Alan Guttmacher Institute, appears in the August 2001 issue of The Guttmacher Report on Public Policy.

The $25 million, federally funded, school-based National Longitudinal Study of Adolescent Health (Add Health survey), conducted in the mid-to-late 1990s, is the first in-depth study designed to identify and assess the various factors that shape adolescents' risk for a host of potentially health-compromising behaviors, ranging from eating disorders to vehicular safety to early sexual activity. One of the key purposes of the Add Health survey is not only to determine the prevalence of sexual intercourse among teenagers, but also to determine the various factors that place adolescents at risk for such activity.

The review shows that whether or not a teen has ever had sexual intercourse is largely influenced by that individual's own sexual history and perceptions about the costs and benefits of having sex, whereas other risky behaviors are shaped more by external influences. The most powerful "protective" factors for many teens are the perceived personal and social costs of having sex, getting pregnant or causing a pregnancy. In addition, teens who have good relationships with their parents are far more likely to delay sexual activity than their peers, are more likely to use contraception when they do become sexually active and are less likely to become pregnant.

Teen's reports of ever having had sexual intercourse increase dramatically with grade level, from 16% among seventh and eighth graders to 60% among 11th and 12th graders. The Add Health survey also examined the effectiveness of virginity pledges and found that although the pledges delay intercourse by an average of 18 months, there are significant limitations-as the proportion of students who pledge rises, the effectiveness of pledging decreases. Teens are attracted to virginity pledges because they offer a shared group identity that sets young people apart from their peers. The pledges lose their allure as they become more normative. The study also found that virginity pledges have the unintended effect of placing some teens at higher risk of unintended pregnancy and STDs, because teens who break the pledge are one-third less likely than nonpledgers to use contraceptives once they do become sexually active.

Add Health researchers are only beginning to understand the factors that place teens at risk for and protect against teenage sexual activity, how these factors interact and what the implications are for future policy development around adolescent sexual health. Sara Seims, president of The Alan Guttmacher Institute said, "What we do know is that the Add Health survey will provide more guidance to parents than to policymakers, because it speaks to the quality of parenting and parent-child communications."