Respondents aged 15 to 24 are asked whether or not they have ever had sexual intercourse and, if yes, they are asked: How old were you when you first had sexual intercourse for the first time?  Countries where very few young people have sex before the age of 15 might opt to use an alternative indicator: percentage of young women and men aged 20–24 who report their age at sexual initiation as under 18 years. The advantage of using the reported age at which young people first had sexual intercourse (as opposed to the median age) is that the calculation is simple and provides for clear trend comparisons. The denominator is easily defined because all members of the survey sample contribute to this measure (PEPFAR, 2009). The indicator should be presented as separate percentages for males and females, and should be disaggregated by the age groups 15–19 and 20–24 years (UNAIDS, 2009).

Data Source(s):

Population-based surveys, such as Demographic and Health Survey, AIDS Indicator Survey, Multiple Indicator Cluster Survey or other representative survey

Purpose:

This indicator allows assessment of progress in increasing the age at which young women and men aged 15 to 24 years first have sex, and is an important parameter for informing the design and modifications of country- and setting-specific programs.  A major goal in many countries is to delay the age at which young people first have sex and discourage premarital sexual activity because it reduces young people’s potential exposure to HIV. There is also evidence to suggest that first having sex at a later age reduces susceptibility to infection per act of sex, at least for women (UNAIDS, 2009).

Issue(s):

It is difficult to monitor change in this indicator over a short period because only individuals entering the group, i.e. those aged under 15 at the beginning of the period for which the trends are to be assessed, can influence the numerator (PEPFAR, 2009). If the indicator is assessed every two to three years, it may be better to focus on changes in the levels for the 15–17 age group. If it is assessed every five years, the possibility exists of looking at the 15–19 age group. In countries where HIV-prevention programs encourage virginity or delaying of first sex, young people’s responses to survey questions on this issue may be biased, including a deliberate misreporting of age at which they first had sex.  Also, if the first sexual experience before the age of 15 was forced, both men and women may be reluctant to report that experience.

Gender Implications:

There may be reporting biases based cultural gender norms about adolescent sexual activity.  Young women may be expected to not engage in sexual intercourse at early ages and may tend to underreport sex before age 15.  Whereas, young men may want to meet perceived expectations that males are sexually active at early ages and overreport having sex before age 15.

References:

PEPFAR, 2009, The President’s Emergency Plan for AIDS Relief: Next Generation Indicators Reference Guide, Washington, DC: USAID/PEPFAR.  https://www.k4health.org/toolkits/igwg-gender/president%E2%80%99s-emergency-plan-aids-relief-next-generation-indicators-reference