Effects of out-of-school care on sex initiation among young adolescents in low-income central city neighborhoods

Objective: To examine the association between patterns of out-of-school care over time and the initiation of sex among young adolescents living in low-income urban families. Design: A prospective cohort study (using a 16-month follow-up) examining the predictive value of changes in out-of-school-care arrangements on early sex initiation. Setting and Participants: By using a multistage stratified area probability sampling strategy, we selected 494 subjects aged 11 to 13 years living in low-income central city neighborhoods who did not report having had sexual intercourse by time 1. Main Outcome Measure: Adolescent report of having had sexual intercourse by time 2. Results: Bivariate results suggested that being at home with an adult during out-of-school hours was related to less sex initiation than self-care, care at another person's home, and attendance at an organized/supervised activity. Adjusting for demographic attributes, parental monitoring, parental curfews, and family routines, remaining in out-of-home care or self-care was associated with a 2.5 times (95% confidence interval, 1.3-5.1 times) increase in the likelihood of initiating sexual intercourse when compared with being at home with an adult at both assessment times. Conclusion: Policies and programs that enable young adolescents to spend their out-of-school hours at home with an adult may help reduce the risk of early sex initiation among youth in low-income urban areas.