Original Study| Volume 29, ISSUE 1, P42-47, February 2016

Download started.


Increased Body Mass Index Associated with Increased Risky Sexual Behaviors


      Study Objective

      The increasing prevalence of adolescent obesity has led to consideration of the potential effect of obesity on risky sexual behaviors. In the current study we examined whether body mass index (BMI) was related to age at sexual debut, type of sexual behavior, partner number, and condom use in a population of adolescent women at high risk for obesity and risky sexual behaviors.

      Design, Setting, and Participants

      Cross-sectional examination of 860 sexually active, predominantly minority, adolescent women who received medical care at an urban health center from 2007 through 2013.

      Intervention and Main Outcome Measures

      Self-reported age at sexual debut, types of sexual intercourse, number of partners and condom use was compared with clinically assessed BMI.


      BMI was positively associated with number of sexual partners (P = .001) and history of attempted anal intercourse (P = .002). An inverse association was observed with age at first anal intercourse (P = .040).


      In this sample of adolescent women, increased BMI was associated with riskier sexual practices at a younger age. Results of this study suggest that overweight and obese adolescents are a vulnerable population who might need targeted sexual health counseling.

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Pediatric and Adolescent Gynecology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Zimmer-Gembeck M.
        • Helfand M.
        Ten years of longitudinal research on U.S. adolescent sexual behavior: developmental correlates of sexual intercourse, and the importance of age, gender, and ethnic background.
        Dev Rev. 2008; 28: 153
        • Epstein M.
        • Bailey J.A.
        • Manhart L.E.
        • et al.
        Understanding the link between early sexual initiation and later sexually transmitted infection: test and replication in two longitudinal studies.
        J Adolesc Health. 2014; 54: 435
        • Greenberg J.
        • Magder L.
        • Aral S.
        Age at first coitus. A marker for risky sexual behavior in women.
        Sex Transm Dis. 1992; 19: 331
        • Pearson M.R.
        • Kholodkov T.
        • Henson J.M.
        • et al.
        Pathways to early coital debut for adolescent girls: a recursive partitioning analysis.
        J Sex Res. 2012; 49: 13
        • Johnson E.
        • Jackson L.
        • Hinkle Y.
        • et al.
        What is the significance of black-white differences in risky sexual behavior?.
        J Natl Med Assoc. 1994; 86: 745
        • Eisenberg M.E.
        • Neumark-Sztainer D.
        • Lust K.D.
        Weight-related issues and high-risk sexual behaviors among college students.
        J Am Coll Health. 2005; 54: 95
        • Cawley J.
        • Joyner K.
        • Sobal J.
        Size matters: the influence of adolescents' weight and height on dating and sex.
        Rationality and Society. 2006; 18: 67
        • Sabia J.J.
        The effect of body weight on adolescent sexual activity.
        Health Econ. 2011; 20: 1330
        • Pearce M.J.
        • Boergers J.
        • Prinstein M.J.
        Adolescent obesity, overt and relational peer victimization, and romantic relationships.
        Obes Res. 2002; 10: 386
        • Ogden C.L.
        Prevalence of obesity and trends in body mass index among US children and adolescents, 1999-2010.
        JAMA. 2012; 307: 483
        • Wingood G.M.
        • DiClemente R.J.
        • Harrington K.
        • et al.
        Body image and African American females' sexual health.
        J Womens Health Gend Based Med. 2002; 11: 433
        • Seth P.
        • Patel S.
        • Sales J.
        • et al.
        The impact of depressive symptomatology on risky sexual behavior and sexual communication among African American female adolescents.
        Psychol Health Med. 2011; 16: 346
        • Akers A.Y.
        • Lynch C.P.
        • Gold M.A.
        • et al.
        Exploring the relationship among weight, race, and sexual behaviors among girls.
        Pediatrics. 2009; 124: e913
        • Kershaw T.S.
        The skinny on sexual risk: the effects of BMI on STI incidence and risk.
        AIDS Behav. 2011; 15: 1527
        • Leech T.G.
        • Dias J.J.
        Risky sexual behavior: a race-specific social consequence of obesity.
        J Youth Adolesc. 2012; 41: 41
        • Ali M.M.
        Racial differences in the influence of female adolescents' body size on dating and sex.
        Econ Hum Biol. 2014; 12: 140
        • Hensel D.J.
        Factors associated with event level anal sex and condom use during anal sex among adolescent women.
        J Adolesc Health. 2010; 46: 232
        • Roye C.F.
        Prevalence and correlates of heterosexual anal intercourse among Black and Latina female adolescents.
        J Assoc Nurses AIDS Care. 2010; 21: 291
        • Halperin D.T.
        Heterosexual anal intercourse: prevalence, cultural factors, and HIV infection and other health risks, Part I.
        AIDS Patient Care STDS. 1999; 13: 717
        • Roye C.F.
        Heterosexual anal intercourse among black and latino adolescents and young adults: a poorly understood high-risk behavior.
        J Sex Res. 2013; 50: 715
        • Gorbach P.M.
        Anal intercourse among young heterosexuals in three sexually transmitted disease clinics in the United States.
        Sex Transm Dis. 2009; 36: 193
        • Ali M.M.
        • Rizzo J.A.
        • Heiland F.W.
        Big and beautiful? Evidence of racial differences in the perceived attractiveness of obese females.
        J Adolesc. 2013; 36: 539
        • Braun-Courville D.
        • Schlecht N.
        • Burk R.
        • et al.
        Strategies for conducting adolescent health research in the clinical setting: the Mount Sinai Adolescent Health Center HPV experience.
        J Pediatr Adolesc Gynecol. 2014; 27: e103
        • Dietz W.H.
        Use of the body mass index (BMI) as a measure of overweight in children and adolescents.
        J Pediatr. 1998; 132: 191
        • Burk R.D.
        • Ho G.Y.
        • Beardsley L.
        • et al.
        Sexual behavior and partner characteristics are the predominant risk factors for genital human Papillomavirus infection in young women.
        J Infect Dis. 1996; 174: 679
        • Morrison E.A.
        Development of a multi-item scale to quantitatively assess sexual behaviors and the transmission of high- and low-risk human papillomaviruses.
        Sex Transm Dis. 1998; 25: 509
        • Lescano C.M.
        • Houck C.D.
        • Brown L.K.
        • et al.
        Correlates of heterosexual anal intercourse among at-risk adolescents and young adults.
        Am J Public Health. 2009; 99: 1131
        • Koblin B.A.
        Correlates of anal intercourse vary by partner type among substance-using women: baseline data from the UNITY study.
        AIDS Behav. 2010; 14: 132
        • Misegades L.
        • Page-Shafer K.
        • Halperin D.
        • et al.
        Anal intercourse among young low-income women in California: an overlooked risk factor for HIV?.
        AIDS. 2001; 15: 534
        • Jenness S.
        • Begier E.
        • Neaigus A.
        • et al.
        Unprotected anal intercourse and sexually transmitted diseases in high-risk heterosexual women.
        Am J Public Health. 2011; 101: 745
        • Brody S.
        Heterosexual anal intercourse: increasing prevalence, and association with sexual dysfunction, bisexual behavior, and venereal disease history.
        J Sex Marital Ther. 2011; 37: 298
        • Moskowitz D.A.
        Revisiting obesity and condom use in men who have sex with men.
        Arch Sex Behav. 2010; 39: 761
        • Averett S.
        • Corman H.
        • Reichman N.
        Effects of overweight on risky sexual behavior of adolescent girls.
        Econ Inq. 2013; 51: 605
        • Chetwynd J.
        • Chambers A.
        • Hughes A.
        Condom use in anal intercourse amongst people who identify as homosexual, heterosexual or bisexual.
        N Z Med J. 1992; 105: 262
        • Topping A.A.
        A comparison of condom use errors and problems for heterosexual anal and vaginal intercourse.
        Int J STD AIDS. 2011; 22: 204
        • Halpern C.T.
        Effects of body fat on weight concerns, dating, and sexual activity: a longitudinal analysis of black and white adolescent girls.
        Dev Psychol. 1999; 35: 721
        • Flynn K.J.
        Body images and obesity risk among black females: a review of the literature.
        Ann Behav Med. 1998; 20: 13
        • Lanza H.I.
        Deviating from the norm: body mass index (BMI) differences and psychosocial adjustment among early adolescent girls.
        J Pediatr Psychol. 2013; 38: 376
        • Averett S.L.
        For better or worse: relationship status and body mass index.
        Econ Hum Biol. 2008; 6: 330
        • Kaestle C.E.
        Sexual insistence and disliked sexual activities in young adulthood: differences by gender and relationship characteristics.
        Perspect Sex Reprod Health. 2009; 41: 33