Correlates of very early sexual intercourse among adolescents in a Southeastern European country

Background: Early sexual intercourse can lead to increased risks of unintended pregnancies, and negative impacts on adolescents’ health. Our aim was to assess the prevalence and correlates of very early sexual intercourse (≤14 years) among adolescents in a Southeastern European country undergoing rapid transformations. Methods: We carried out a cross-sectional study in Albania in 2022, which included a nationally representative sample of 1877 schoolchildren aged 15 years (about 55 % girls; overall response: ≈96 %). Data collection included age of commencement of sexual intercourse (if applicable) and important determinants of early sex comprising behavioural factors, health characteristics, child maltreatment indices and sociodemographic factors. Logistic regression assessed the association of very early sexual intercourse with covariates. Findings: Among 321 schoolchildren with lifetime sexual intercourse who also reported on age of commencement (≈17 % of the total), the prevalence of very early (≤14 years) sexual intercourse was ≈53 %. It was more prevalent in boys (P = 0.01), in children from more affluent families (P = 0.06), among lifetime smokers (P = 0.02), in children who never/rarely felt low (P = 0.06), and in children who reported lifetime physical abuse (P = 0.06), or lifetime sexual abuse (P = 0.10). In multivariable-adjusted logistic regression models, independent significant positive correlates of very early sexual intercourse included family affluence (OR = 1.8, 95 %CI = 1.0–3.1) and lifetime physical abuse (OR = 2.1, 95 %CI = 1.2–3.6). Conclusion: Our study evidenced a substantial prevalence of very early sexual intercourse, especially among male adolescents, which is a cause of concern. Interventions should address child maltreatment and promote healthy family environments, alongside comprehensive sexual education tailored to the developmental needs of adolescents.