Starting Young: Sexual Initiation and HIV Prevention in Early Adolescence

Ruth Dixon-Mueller


AIDS and Behavior. 2009;13(1):100-109. 

In This Article

Abstract and Introduction


The rising numbers of new HIV infections among young people ages 15-24 in many developing countries, especially among young women, signal an urgent need to identify and respond programmatically to behaviors and situations that contribute to the spread of HIV and other sexually transmitted infections in early adolescence. Quantitative and qualitative studies of the sexual knowledge and practices of adolescents age 14 and younger reveal that substantial numbers of boys and girls in many countries engage in unprotected heterosexual vaginal intercourse-by choice or coercion-before their 15th birthdays. Early initiation into male-male or male-female oral and/or anal sex is also documented in some populations. Educational, health, and social programs must reach 10-14-year-olds as well as older adolescents with the information, skills, services, and supplies (condoms, contraceptives) they need to negotiate their own protection from unwanted and/or unsafe sexual practices and to respect the rights of others.


The development of cognitive, emotional, and social capacities during early adolescence and the emergence of sexual feelings and curiosity occur at a time of intense socialization into gendered sexual attitudes and behaviors (Barker 2000; Breinbauer and Maddaleno 2005; Patton and Viner 2007). By the time of their 15th birthdays, a substantial number of boys and girls in some developing countries have already engaged in risky sexual activities, including but not limited to unprotected heterosexual vaginal intercourse. Learning what 10-14-year-olds know, feel, believe, and do (or are encouraged or forced to do) with respect to their bodies and their sexuality is crucial for designing realistic HIV prevention programs that respond to their needs and protect their sexual health and rights.


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