Before first sex: Gender differences in emotional relationships and physical behaviors among adolescents in the Philippines

Context: Early age at first sex has been identified as a risk factor for unplanned pregnancy and HIV infection. However, the emotional relationships and physical behaviors that precede first intercourse, and how they differ by sex, also may provide important cues about how to prevent sexual risk behavior. Methods: The precoital activities of 2,051 adolescents aged 17-19 in Cebu, Philippines, are examined using 1998-2000 and 2002 data from the Cebu Longitudinal Health and Nutrition Survey. The timing and tempo of emotional relationships and physical behaviors for males and females are described. Cox proportional hazards models are used to identify the characteristics associated with age at first sex. Results: Males engage in precoital physical behaviors and first sex at younger ages than females. Although the standard order in which the two sexes engage in emotional relationships for the first time is the same, males progress through the sequence more quickly than females. After adolescents have progressed through the sequence of emotional relationships, there is a gap of a least a year before they begin to have sex. In the multivariate analysis, rapid progression through the sequence of emotional relationships was associated with initiating sex at a younger age for females (hazard ratio, 1.5), but not for males. Conclusion: The period between first date and first sex experienced by both males and females provides an opportunity to ensure that adolescents have access to the information and services that will allow them to make informed choices about sexual behavior.