Neighborhood context and sexual behaviors among adolescents: findings from the national longitudinal study of adolescent health.

CONTEXT Adolescent sexual behaviors are a significant public health concern because of the risks of STDs and the negative social consequences of teenage pregnancies. Associations between neighborhood characteristics and adolescents' initiation of sex and contraceptive use are poorly understood. METHODS Multilevel logistic regression analyses of data from 14,151 adolescents in grades 7-12 in Wave 1 of the National Longitudinal Study of Adolescent Health examined the relationships between four neighborhood dimensions (socioeconomic characteristics, norms and opportunity structure, social disorganization, and racial and ethnic composition) and the initiation of sex and contraceptive use at first and most recent sex. Individual- and household-level covariates were family income, parental education, race and ethnicity, age and family structure. Multivariate analyses were stratified by gender. RESULTS All four dimensions of neighborhood context were independently associated with sexual initiation. For females, living in a neighborhood with a greater concentration of youth who were idle or black residents was associated with increased odds of sexual initiation, whereas a greater concentration of married households or Hispanic residents was associated with decreased odds of initiation. Higher initiation among males was associated with a higher concentration of poverty or idle youth, while lower initiation was found with a higher concentration of affluent households or working women. The sole association with contraceptive use was that females in neighborhoods with more idle youth had a reduced likelihood of having used contraceptives at first sex. CONCLUSIONS Neighborhood context appears to be modestly associated with the sexual initiation of adolescents. However, little support was found for neighborhood influence on contraceptive use, suggesting that other factors may play a more important role in shaping adolescents' contraceptive behaviors.