Evidence from behavioural surveys for a transient delay of sexual debut among German gay male adolescents: does it reflect a spontaneous reaction to increasing AIDS awareness in the 1980s and 1990s?
Background: Observations from sub-Saharan Africa on delayed sexual debut among adolescents have been interpreted as evidence for successful promotion of delayed initiation of sexual intercourse. In Germany, later initiation of sexual activity among adolescents has never been actively promoted as an HIV prevention strategy.
Methods: Based on a large (n=6,833) mainly internet-recruited cross-sectional sample of German men who have sex with men (MSM) (2006) and repeated representative surveys on youth (14 – 17 years) sexuality (1980 – 2005) we analysed data on time of first same sex sexual experiences (MSM) and on frequency of reported “close physical contact” with same sex friends (youth).
Results: Successive MSM age cohorts report a progressive decline of median age at first heterosexual intercourse over time from 20 years for MSM born before 1956 to 16 years for MSM born after 1982. In contrast, median age at first homosexual intercourse increased for age cohorts who became sexually active in the period between 1984 and 1996, and seems to decrease again in recent years. In youth surveys, reported close physical contact with same sex friends declined from 10% in boys in 1980 to 5% in 1996 and 2001, while it remained largely stable between 6 and 8% in girls.
Discussion: Increasing AIDS awareness in Germany during the 1980s and 1990s seems to have had an effect on same sex sexual experiences and “coming out” among gay male adolescents, resulting in delayed same sex sexual debut. In recent years, this not intentionally promoted effect seems to wane, probably as a result of HIV “normalization” and/or decreasing visibility of HIV/AIDS in the public discourse. Delayed sexual activity in African adolescents may have been at least partly a spontaneous reaction to increasing AIDS awareness and not a result of respective prevention messages.
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