Published online October 19, 2009
PEDIATRICS Vol. 124 No. 5 November 2009, pp. e913-e920 (doi:10.1542/peds.2008-2797)
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ARTICLE

Exploring the Relationship Among Weight, Race, and Sexual Behaviors Among Girls

Aletha Yvette Akers, MD, MPHa, Cheryl P. Lynch, MD, MPHb, Melanie A. Gold, DOc, Judy Chia-Chi Chang, MD, MPHa, Willa Doswell, PhD, RNd, Harold C. Wiesenfeld, MD, CMa, Wentao Feng, PhDe and James Bost, PhD, MSf

a Department of Obstetrics, Gynecology and Reproductive Sciences
f Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
b Medical University of South Carolina, Charleston, South Carolina
c Division of Student Affairs, Student Health Services, University of Pittsburgh, Pittsburgh, Pennsylvania
d Department of Health Promotion and Management, University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania
e Novartis Pharmaceutical Corporation, New York, New York

OBJECTIVE: The relationship between weight and sexual behavior among adolescents is poorly understood. We examined this relationship in a nationally representative sample of high school girls.

METHODS: We performed a cross-sectional analysis of self-reported data from 7193 high school girls who completed the 2005 Youth Risk Behavior Surveillance survey. We used multivariate logistic regression to examine associations among 3 weight indices (BMI calculated from self-reported weight and height, perceived weight, and weight misperception) and 6 sexual behaviors (ever had vaginal sex; sex before age 13; ≥4 sexual partners; and alcohol, condom, and oral contraceptive use at last sex) adjusting for age, race/ethnicity, and a history of intimate partner violence.

RESULTS: There were no differences in the likelihood of ever having sex on the basis of BMI or weight perception accuracy; however, girls who perceived themselves as overweight were less likely to have ever had sex. Among sexually active girls, those who had low BMI and perceived themselves as overweight or had overweight misperceptions were less likely to report condom use at last sex. Sexually active girls who perceived themselves as overweight were also more likely to have had sex before age 13. Associations between the 3 weight indices and sexual risk behaviors varied across racial/ethnic groups.

CONCLUSIONS: Sexual risk behaviors may be more common among girls who are underweight or perceive themselves (accurately or not) to be overweight and vary by racial/ethnic group. This suggests that girls at weight extremes and those from different racial backgrounds may have unique sexual health education and prevention needs.

Key Words: body weight • sexual behavior • ethnic groups

Abbreviations: YRBSS—Youth Risk Behavior Surveillance System • CDC—Centers for Disease Control and Prevention • IPV—intimate partner violence

Accepted Jun 4, 2009.


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