NATIONAL

HEALTH BEHAVIOUR IN SCHOOL-AGED CHILDREN:
WHO COLLABORATIVE CROSS-NATIONAL STUDY (HBSC)
2014 SURVEY IN SCOTLAND NATIONAL REPORT
SEXUAL HEALTH
INTRODUCTION
Sexual health is not simply the absence of sexual disease or dysfunction, but rather a state of emotional, social, physical
and mental well-being in relation to sexuality 1 . Adolescence is a key period for the development of sexual attitudes and
experiences of sexual behaviour 2 . Between 2006-2008, approximately 18% of UK 15-year-olds reported having engaged in
sexual activity during the previous year 3 . Of these, a third were not considered ready for this experience because they were
either coerced, felt regret, lacked autonomy or did not use contraception 3 . The HBSC study found that overall prevalence
of early sexual intercourse was stable in Europe between 2002 and 2010 4 . Precursors of sexual activity can occur at earlier
ages; with 19% of UK 11-12 year olds and 34% of 12-13 year olds reporting having being kissed on the mouth by a peer 5 . The
nature of sexual activity can be driven by an individual’s own curiosity, peers, the mass-media (especially the internet and
social media) and by information and discussion in the family setting, in school, and through public health and well-being
initiatives 6 .
Information sources and access to information are important elements in adolescents’ understanding of and engagement
in sexual activity. Family and peers are both strong influencers of intention to have sex, early sexual initiation and the
frequency and nature of sexual behaviour 7,8 . Age of first sexual experience is further influenced by macro-level cultural
norms 9 , and infrequency of eating together as a family has also been identified as good predictor of early onset of sexual
activity 10 . There are also differences between adolescent heterosexual and same-sex sexual activity, with, for example,
greater risk-taking behaviours reported amongst teenagers with same-sex partners 11 .
Early sexual activity has been strongly linked to adverse health outcomes such as sexually-transmitted infections (STIs) 12 ,
unplanned pregnancies, 13 poor mental health 14 and reduced academic performance 14 . In addition, high numbers of sexual
partners 15 and inconsistent contraception 16 can be health risk factors for young people. Low socio-economic status has
been identified as a risk factor for higher rates of sexual activity amongst young people 3 .
Scotland has one of the highest rates of sexual activity among adolescents in the developed world 17 , in conjunction with
relatively low condom and contraceptive pill use 18 . Moreover, STI prevalence has risen in Scotland this century 19 .
The Scottish Government’s first strategy for improving sexual health – Respect and Responsibility 20,21 – in conjunction with the
more recent Sexual Health and Blood Borne Virus Framework (2011-2015) 22 , identifies the priorities and methods for improving
sexual health amongst young people in Scotland. These include improving the range and quality of sexual health services
available to young people regardless of gender, sexuality or socio-economic background, and to positively influence the
social and cultural factors that shape sexual health behaviours. Since the launch of the strategy, the Scottish Government
has noted improved availability of sexual health education in schools and other contexts 23 . This has been achieved in part
through the launch of the Sexual Health Scotland 23 website, which aims to provide non-judgemental information regarding
sexual health and relationships, and highlight available services.
HBSC FINDINGS
HBSC Scotland has collected data from 15-year olds about sexual intercourse in some schools since 1990, and across the
whole sample since 1998. Information on 15-year olds’ condom and contraceptive use has been collected since 2002, and in
2014, questions are included to examine the age at sexual initiation amongst those that report having had sexual intercourse.
SEXUAL INTERCOURSE
The proportion of 15-year olds who have had sexual intercourse remained stable between 1998 and 2010, however between
2010 and 2014 there was a decline in the proportion of girls that report having had sex (from 35% to 27%). Little change
was seen among boys over this period, therefore, the gender difference that emerged in 2010 (that girls were more likely
to report having had sexual intercourse) is no longer evident (Figure 13.1).
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