Factors shaping sexual abstinence among adolescents and young adults: a systematic review

Sexual abstinence is considered as a reproductive health-promoting behavior in adolescents and young adults to prevent negative sexual outcomes, such as sexually transmitted infections, and unintended pregnancies.

To review the prevalence and factors related to sexual abstinence in adolescents and young adults aged between 10 and 24 years.

Studies were retrieved from Google Scholar, ResearchGate, PubMed, and Journal of Storage (JSTOR). The selection criteria were original population-based studies, published in the English or French language, on either sexual abstinence (primary and/or secondary abstinence) or intention to abstain, and in adolescents and/or young adults.

This study reviewed the literature on the prevalence of, motivations for and factors associated with abstinent behavior in adolescents and young adults.

1989 studies were retrieved, from which data were extracted for 55 studies. The overall prevalence ranged from 1.6% to 100%. The prevalence of primary sexual abstinence ranged from 22.1% to 100%; secondary sexual abstinence from 1.6% to 68.1%; and sexual abstinence intention from 50% to 73.8%. The significant factors reported were age, gender, educational level, socioeconomic status, religion, relationship status, sex education, HIV knowledge, not using alcohol, positive attitudes towards sexual abstinence, perceived risk of sexual intercourse, positive peer influence, social norms related to sexual abstinence, aspirations for the future, higher self-efficacy in sexual abstinence, and sexual communication. In addition, the review revealed various motives, such as religious beliefs, perceived physical and psychological consequences of sexual activities, perceived social benefits of sexual abstinence, and aspirations for a better life were related to young people's abstinent behavior. Although the variations in findings from different studies can be explained by differences in regions, cultures, and research design and methods.

The studies on sexual abstinence in the future should use a consistent and standard definition, cover the multidimensionality of sexual behavior, and examine all related factors and motivations.

The restricted timeframe (1998-2023), English/French language, availability of full text, and measurement of abstinent behavior may be the sources of bias.

The prevalence of sexually abstinent adolescents and young adults varies greatly across studies and was associated with a range of factors and motivations/barriers. Although factors and motivations/barriers were identified, further investigation is needed on the secondary sexual abstinence and the multidimensionality of sexual abstinence rather than simple abstinence from penile-vaginal intercourse.