The publisher's final edited version of this article is available at Perspect Sex Reprod Health See other articles in PMC that cite the published article. Abstract Context Approximately two-thirds of all sexually experienced teenagers in the United States say they wish they had waited longer to have sexual intercourse for the first time.
Little is known, though, about why such a large proportion of teenagers express disappointment about the timing of their initial experience with sexual intercourse. Methods Using data from a national longitudinal survey of adolescents year olds followed to ages , we tested for a prospective association between exposure to sex on television and the likelihood of regret following sexual initiation, analyzed the mediating role of shifts in sex-related outcome expectancies from pre- to post-initiation, and investigated gender differences in these relationships.
Results Among males but not females , we found that greater exposure to sexual content on television was associated with an increased likelihood of regret following sexual initiation, an association partly explained by a downward shift in males' sex-related outcome expectancies following sexual initiation.
Conclusions These findings, which offer insight into the contextual factors and processes that may foster initiation regret, could be important for advancing critical decision-making by youth about sexual debut.
That is, youth who say they wish they had waited longer to have sex for the first time apparently come to regret their decision to have sex, whether because they felt unprepared for the experience, wish they had shared it with someone else or been at a different point in their relationship, found the sex itself to be unsatisfying, or found that the consequences were not what they hoped or expected they would be.
Only a few studies have investigated the correlates of regretted sexual initiation, 2 - 4 so little is known about why such a large proportion of teenagers feel that the timing of their initial experience with sexual intercourse was wrong. Cotton and colleagues asked sexually experienced females recruited from an adolescent medicine clinic whether they felt they were too young, too old, or neither too young nor too told the first time they had consensual sex.
Variables associated with this response included younger age at first intercourse, lower parental education, and lower parental monitoring. The latter variables indicate that more than just chronological age influences the perception that sex occurred too soon or at too young an age. In addition, study participants who reported that the timing of their first sexual experience was neither too early nor too late were more likely than other participants to say that being in love motivated their decision to have sex for the first time, suggesting that the right relationship partner or right type of relationship may be important to avoiding regret.
A national survey of Irish youth found that teenagers were more likely to think that they should have waited longer to have sex for the first time if the sex was unplanned, not protected, or not within a close relationship. Moreover, if the decision to have sex was instrumental—an investment in the relationship—the duration of the relationship is a measure of how well the investment paid off.
A better understanding of the processes by which adolescents come to regret their first experience with sexual intercourse is needed, as the development of healthy sexuality and the evolution of present and future relationships may be impeded by a negative first sexual experience. After the fact, adolescents may infer that they have made a poor decision about when or with whom to initiate intercourse because the experience fell short of their expectations.
To the extent that adolescent's expectations are shaped by the media, this suggests that media exposure may contribute to the high levels of sexual regret reported by teenagers. In particular, television strongly contributes to youths' sexual socialization and often engenders unrealistic expectations.
In the United States, teenagers watch an average of three hours of television per day. Television typically focuses on the positive possibilities of sex rather than on its potential problems. Television also tends to portray sexual roles in a stereotypic manner that can set up unrealistic expectations. Two recent studies have linked exposure to sex on television with earlier sexual initiation. In another study, the association between exposure to sex on television and the timing of sexual initiation was found to be partially mediated by teenagers' sexual outcome expectancies.
Although this research links exposure to sex on television to early sexual initiation and provides evidence that teenagers' expectations have a role in the relationship, it does not indicate that youth felt disappointed with these initial experiences with sex. If their sexual experiences did not meet their perhaps media-driven expectations, these heavy-viewing teenagers may have experienced regret.
Building on this prior work and theory, we hypothesize that exposure to sex on television among teenage virgins is associated with an increased probability of regret following sexual initiation, i.
We also hypothesize that extensive exposure to sex on television inflates expectations about the positive consequences of having sex to unrealistic levels. Evidence of this may be found after sexual initiation if those who watch greater amounts of sex on television evidence a downward shift in sexual outcome expectancies.
That is, to the extent that heavy viewers of sex on television perceive their actual experience of first intercourse as having not met their expectations, they will shift their expectations downward. This downward shift in sexual outcome expectancies should be greater than any such shift among teenagers who watch less sex on television.
While expectations prior to sexual initiation might be inflated among all youth as a consequence of our sex-focused culture, the covariate-adjusted expectations of youth who view less sex on TV should be less inflated than the expectations of heavy viewers. Thus, we propose that the relationship between television sex exposure and sexual initiation regret is mediated by a perceived disconnect between actual and expected sex-related outcomes, and that evidence of this perceived disconnect can be found in a greater post-intercourse decrease in outcome expectancies among heavier viewers.
We also explore gender differences in this process. Because television's messages about sex are less uniformly positive for females than males, 24 we tentatively predict that a relationship between exposure and regret will be more likely in males. That is, we hypothesize that television's gender-specific sexual messages are more likely to set up heavy-viewing male adolescents than heavy-viewing female adolescents for having unmet sexual expectations.
Methods Sample and Procedure We conducted a national telephone survey in spring T1 and re-interviewed the same group one and three years later, in the springs of T2 and T3. Our sample was recruited from a purchased list of households with a high probability of containing a member aged This list was based on residential telephone listings, supplemented with other sources of information.
We mailed parents in these households an explanation of the study in advance, and obtained verbal consent via telephone from a parent or legal guardian just prior to conducting an interview with a randomly selected adolescent from the household. Youth provided verbal assent. Most adults who refused consent cited time constraints rather than concerns with the sexual content of the survey. Nonresponse and Attrition Weights Without weights, the baseline sample of 2, youth had demographic characteristics similar to those of all teenagers in the U.
A multivariate logistic regression predicting nonresponse at baseline from information provided by the supplier of our sample and a brief nonresponse interview identified higher response rates 1 in census tracts with higher proportions of blacks, 2 among households where an adolescent aged was present but not randomly selected, and 3 when females of any age or males aged 14 or younger were randomly selected for sampling.
We created nonresponse weights inversely proportional to the probability of enrollment indicated by this regression equation. After applying these weights, there were still small departures from the Current Population Survey, which we corrected with poststratification weights.
Extensive modeling with rich baseline response data found no evidence of selective attrition. Multivariate logistic regression modeling of attrition from baseline to T3 revealed some selective attrition. Overall, attrition was higher among all races for youth over 14 at baseline, males, and those whose parents had greater educational attainment.
Among blacks, attrition was also higher among those with the least sexual activity at baseline and was lower among those who, as of baseline, had not engaged in intercourse but had engaged in genital noncoital sexual activity. Results from this modeling were used to generate inverse-probability attrition weights, which were combined with the final baseline weights to produce longitudinal weights.
All analyses employed these weights, appropriately accounting for their effects on standard errors. Measures Sexual initiation regret We measured sexual initiation regret at T3 with an item taken from the survey of the National Campaign to Prevent Teen Pregnancy: To help us interpret responses to this item, we also asked three related questions of those who responded in the affirmative: At each interview, those with intercourse experience also reported the month and year of their first intercourse.
We used this information to determine the relevant analysis sample — youth who initiated sex between September the beginning of the reference period for television viewing; see below and the T3 survey.
Average hours of television viewing At T2, we measured the average amount of time spent watching television during a typical week with a series of items tapping viewing at various times of day and on various days of the week. We created a measure of exposure to television's sexual content by linking information from our survey to information about the sexual content of the programs.
Content information was obtained from ongoing research by Kunkel and colleagues. Kunkel sampled four to more than a dozen episodes for each program covered in our survey. Coders parsed the episodes into distinct scenes and coded the presence of any sexual behavior physical flirting, passionate kissing, intimate touching, implied intercourse, depicted intercourse and sexual talk e.
Raters coded the degree of focus on sexual behavior or talk in each scene. For each TV program studied, amount of sexual content was calculated as the average number of scenes per episode containing a major focus on sexual behavior plus the average number of scenes containing a major focus on talk about sex. We derived the exposure measure by multiplying the indicators of the amount of sexual content in each program covered in our survey by self-reported viewing of each program and then summing across programs.
Because we used average hours of TV exposure as a control, our sexual content variable reflects the proportion of sexual content relative to other material in one's television diet, regardless of the total amount of television exposure. Sexual outcome expectancies At each interview, participants responded to several questions about the likely consequences of having sex.
For the items about popularity and reputation, participants used a 2-point scale to say whether they agreed or disagreed that having sex would lead to increased popularity or worsen one's reputation among schoolmates.
Outcome expectancy items were coded so that higher scores indicate expectancies that are more positive. The alpha reliability for the outcome expectancy scale at T2 is. To create a measure of shift in outcome expectancies from T2 to T3, we standardized all T2 and T3 outcome expectancy items, subtracted participants' responses to corresponding pairs of items from the two surveys, and took the mean of the resulting difference scores. Difference scores were computed in such a way that higher scores on the shift in outcome expectancy scale indicate shifts toward less positive expectancies.
In the model that predicted shifts in outcome expectancies and the model that examined the potential mediating influence of shifts in outcome expectancies see below , we controlled for baseline sexual outcome expectancies.
Covariates We selected as covariates variables that might influence how adolescents react to their first sexual experience or how people in adolescents' social networks would react to their loss of virginity, reasoning that both types of variables are likely to influence initiation regret.
We also included several indicators known to predict adolescents' sexual attitudes and behavior, as little is known about predictors of sexual initiation regret. Unless otherwise noted, covariates were measured at baseline. Respondent age at baseline was measured continuously in years.
Controlling for age allowed us to examine the perception of having sex too soon independent of chronological age. Teenagers living with both biological parents were contrasted with all others. Because responses were bimodal, we recoded the item to dichotomously reflect parents' disapproval versus approval or neutrality. Sex self-efficacy was measured with the item: Missing Data Imputation A small number of respondents had missing data on one or more predictor variables.
To avoid bias that listwise deletion might introduce in our results, we imputed missing data on these predictors. Overview of Analyses We used two-group males vs.
Each of the first three questions was tested in a separate model. Model 1 predicted initiation regret among those who were virgins prior to the television exposure reference period.
Model 2 compared shifts in expectancies from pre- to post-intercourse initiation among high and low viewers of sex on television. To account for any changes that may occur over this time period as a result of maturation or other time-varying factors apart from intercourse 39 we compared such shifts to those evidenced among high and low viewers who did not have intercourse i.
In Model 3, we return to predicting initiation regret, incorporating shifts in expectancies in our model to test for mediation. We also conducted a Sobel test 40 of mediation based on Model 3. Although the Sobel test is regarded as conservative, 41 - 42 we employed this test, as it is the most common method for testing mediation.
If a constraint is reasonable, the chi-square difference test between the fully constrained model and one that allows for a gender difference will be non-significant. If the chi-square difference test is significant, then we infer that there is a moderating influence of gender on a relationship in the model, i.
In examining gender differences involving the two TV variables exposure to sexual content and average hours of viewing , we constrained and freed both parameters simultaneously due to their conceptual interdependence. All analyses were conducted in Mplus 3. Respondents also had to have valid sexual behavior and TV exposure data at all time points.
One hundred forty-eight respondents requested that we skip questions about sexual behavior an option given during the interview at one or more of the surveys.
These respondents were excluded from all analyses. The mean age of these youth at that time was 15 years. Thus, it appears that many of those who regretted the timing of first intercourse had more than one aspect of the experience that they subsequently looked back on with regret. The question about the timing of first intercourse seems to have captured both these feelings of regret with regard to the first experience with intercourse and a sense that things would have been better if only they had waited longer to have sex for the first time.