Using information from two national surveys, researchers from Johns Hopkins Medicine and the Guttmacher Institute have found that in some metropolitan areas, more than a quarter of young, African American men reported having sexual intercourse before age 13, and for about 45 percent of them, the sex was either unwanted or experienced with “mixed feelings.”

The researchers caution that while self-reporting surveys have limitations, they say similar results drawn from multiple data sources suggest that rates of underage male sex in metropolitan areas are substantially higher than previously estimated using only national data.

They also find that race, ethnicity and location play a larger than appreciated role.

The researchers say their study, described in the April 8 issue of JAMA Pediatrics, points to the need for better and much earlier access not only to sex education, but also sexual health clinics, family planning and parenting services, and mental health counseling services for inner city male youth, particularly if they have experienced unwanted sex.

“Young men having sex before age 13 usually haven’t received the appropriate sex education and services, and we need a better system to respond to their needs,” says Arik Marcell, M.D., M.P.H., senior author of the study and associate professor of pediatrics at the Johns Hopkins University School of Medicine and Johns Hopkins Children’s Center. “The cultural double standard about sexual behavior in the United States, in which it is OK for young boys, but not girls, to be sexually active, has prevented us from effectively addressing male adolescents’ vulnerabilities and their healthy sexual development,” Marcell adds.

Currently, 24 states and the District of Columbia mandate sex education at some level. Although most adolescents receive some form of sex education between grades six and 12, with some as early as grades four or five, the researchers say what they learn is highly dependent on their region, school and parents’ decisions to allow them in the classes. In 2014, fewer than half of high schools and only 20 percent of middle schools delivered sex education covering all 16 critical sexual education topics identified by the CDC, according to the Guttmacher Institute.

“I have heard boys and adolescents talking about their first sex encounters in a way that suggests they didn’t anticipate, understand or know what was happening or what’s appropriate and what’s not,” says Marcell, “I was concerned that such early sex experiences happening to boys could be unwanted and influence their future health. We used the data available to us in these surveys to attempt a better look at the scale and pattern of this problem across the nation.”

Young men who reported in the national family growth survey that they first had sex before age 13 described a range of attitudes about this experience. Only 55 percent said that their first sexual experience was wanted, while 8 percent said it was unwanted and 37 percent said they had mixed feelings about it.

The investigators underscored the importance of recognizing young people’s perspectives, and also noted that reports of whether a first sexual experience was wanted may be influenced by gender and race expectations, stereotypes, peer pressure and coercion.

“Too often, the sexual health needs of young men are overlooked,” says Guttmacher Institute researcher Laura Lindberg. “Outdated attitudes and harmful gender stereotypes leave many young men without needed information and services.”

Researchers say the study looked only at age at reported first sex, and that further efforts are needed to look at behaviors over time and how this affects their future sexual experiences.

The study was funded by a grant from The JPB Foundation and the Guttmacher Center for Population Research Innovation and Dissemination, under National Institute of Child Health and Human Development of the National Institutes of Health (Grant 5 R24 HD074034).

The researchers declare no conflicts of interest.

This press release is modified from a press release prepared by Guttmacher Institute, a nonprofit research institute focused on reproductive health and policy, which has offices in Washington, D.C., and New York.

On the Web:

• Report Outlines ‘Must-Have’ Sexual Health Services for Men
   
• No Increased Risk of Infection for Long-Term Sex Partners of People with HPV-Related Oral Cancers
   
• As Circumcision Wounds Heal, HIV-Positive Men May Spread Virus To Female Partners, Study Shows
   
• Fact Sheet: American Adolescents’ Sources of Sexual Health Information
   
• Research Article: Adolescents’ and Young Adults’ Reports of Barriers to Confidential Health Care and Receipt of Contraceptive Services
   
• Report: Sexual Behavior and Contraceptive and Condom Use Among U.S. High School Students, 2013–2017
   
• State Laws and Policies: Minors’ Access to Contraceptive Services