Cross-National Trends in Early Sexual Initiation Among 15-Year-Old Adolescents, 2002–2022

Objectives: We examined how the proportion of adolescents who engaged in early sexual intercourse (before the age of 14) changed between 2002 and 2022 across 37 countries. Methods: Data of 15-year-old adolescents participating in the 2002, 2006, 2010, 2014, 2018, and 2022 survey rounds of the Health Behaviour in School-aged Children study were analysed (N = 312,702). We used uni- and multivariate multilevel binary logistic regression models to test whether rates of early sexual initiation changed over time. Country, gender, family affluence, parental support and the clustering effect of school were incorporated in the statistical models; linearity was tested by cubic and quadratic terms in the multivariate models. Results: A significant but very small decline over time was found in early sexual initiation across survey years. Girls and less affluent adolescents had lower odds of early initiation. Parental support (and its interaction with time) also had a significant but small protective role. Conclusion: Despite a small decrease over time, still 4% of participants reported early sexual initiation in 2022. Concerted and sustained efforts are needed to support adolescent sexual health.