Self-reported sexual debut and behavior in young adults aged 18-24 years in seven European countries: implications for HPV vaccination programs.

OBJECTIVE: To generate country-specific data on age of sexual debut in young adults in 7 European countries with regard to the optimal age for prophylactic human papillomavirus (HPV) vaccination. METHODS: Survey of self-reported sexual debut and behavior in a sample of young adults aged 18-24 years in 7 European countries (Czech Republic, Ireland, Italy, Netherlands, Poland, Russia, France). Subjects (minimum of 500 males and 500 females per country) were recruited at public places using an in-street collecting approach in all countries except France, where the survey was conducted at home. Data were collected using a short, anonymous, self-administered questionnaire designed to gather information about any kind of sexual activity the subject might have engaged in with a partner, with standardized content to enable comparison between countries. RESULTS: Up to 14% of young men and 22% of young women aged 18-24 years had yet to experience sexual activity at the time of the survey. Median age of sexual debut calculated by survival analysis ranged between 16 and 17 years in boys and between 17 and 18 years in girls. The proportion of boys sexually active before the age of 15 years ranged from 5.0% (Poland) to 15.8% (Italy). The proportion of girls sexually active before the age of 15 years was lower compared with boys in all countries, ranging from 2.6% (Poland) to 11.9% (the Netherlands). The first sexual partner for girls was typically at least 1 year older, irrespective of the age of sexual debut. Almost one-third of young women did not use a condom at sexual debut. CONCLUSIONS: This survey provides an update on sexual debut and behavior in young adults in some European countries. Estimated age at sexual debut ranged between 16 and 18 years and appeared to be later in girls than in boys. The proportion of girls sexually active before the age of 15 years was low (