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JOURNAL OF ADOLESCENT HEALTH 2004;34:200–208 ORIGINAL ARTICLE Initiation of Sexual Intercourse Among Middle School Adolescents: The Influence of Psychosocial Factors JOHN S. SANTELLI, M.D., M.P.H., JAVAID KAISER, Ph.D., LESLEY HIRSCH, Ph.D., ALICE RADOSH, Ph.D., LINDA SIMKIN, M.Phil., AND SUSAN MIDDLESTADT, Ph.D. Purpose: To explore potential psychosocial predictors tion of sexual intercourse should reinforce norms about for initiation of sexual intercourse among middle-school, refraining from sex. © Society for Adolescent Medicine, inner-city youth, using longitudinal data from the 2004 Healthy and Alive! project. Methods: We conducted hierarchical, logistic regres- sion with adjustment for intraclass correlation over two KEY WORDS: sequential periods, including seventh and eighth grades Abstinence (N 3163), to assess the independent influence of Adolescence psychosocial and demographic factors. Internally reli- Drug and alcohol use Initiation of sexual intercourse able scales to assess psychosocial influences were cre- Peer norms ated, based on major theories of behavior. The sample Psychosocial factors was 52% female, 51% black, 30% Hispanic, 9% white, and Risk behaviors 3% Asian. At baseline, 13% of girls and 39% of boys reported already having initiated sexual intercourse. Results: Personal and perceived peer norms about One million adolescents become pregnant, and 3 refraining from sex were a strong and consistent protec- tive factor. Alcohol and other drug use, poor academic million new cases of sexu