初次性行為發生在青少年時期，常伴隨著健康與社會議題，包括：青少年懷孕及性傳染病。國內關於青少年性行為之研究，多以是否經歷過婚前性行為為主軸，較少延伸至初次性行為的發生、初次性行為保險套的使用以及性伴侶數目；然而，青少年性行為的發生易受社會風險因子(如：個人及學校環境)影響。本研究應用社會流行病學觀點，整合Bronfenbrenner生態學模型(1979)及生命歷程觀點，進行探究。採用臺灣中央研究院『青少年成長歷程之長期追蹤調查資料』(TYP, 2000-2011)，連結2000年人口及住宅普查檔和各縣市鄉鎮村里之綜合所得總額，應用邏輯斯迴歸分析檢視青少年早期個人及學校因素與青少年性健康相關行為之關係。經分析結果顯示家庭月收入與青少年初次性行為(OR=0.69, P<0.05)以及性伴侶數目(OR=0.66, P<0.01)相關，青少年的學校處在家庭所得低(OR=0.10-0.16, P<0.01)地區其初次性行為未使用保險套的風險較低，但青少年的學校處在國中未畢業(OR=6.31-8.71, P<0.01)及離婚或分居為高比率(OR=3.61, P<0.01)地區則初次性行為未使用保險套的風險卻較高，且早期家庭因素仍具影響力，此結果有助於從台灣社會脈絡獨特性，提供青少年性行為相關政策在不同層級介入之實徵性參考。

Early sexual behaviors in adolescence implicate adverse public health and social consequences such as teen pregnancy and contraction of sexually transmitted infections (STI). Studies in Asian societies have focused on experiences of ever engaging in premarital sex. Relatively less emphasis was on the importance of social risk factors (such as individual and school environment). The present study thus proposes to develop a conceptual model that integrates Bronfenbrenner’s ecological model (1979) and life-course perspective to suit the specific Taiwan context. Using data from Taiwan Youth Project (TYP, 2000-2011) and link to 2000 Population and Housing Census and Income data, I employ logistic analysis to investigate the influences of individual and neighborhood-level factors on sexual behaviors among Taiwanese adolescents. The results found low family income significantly associated with adolescent first sex (OR=0.69, P<0.05) and sex partner (OR=0.66, P<0.01). Adolescent School is situated in low percentage of resident income (OR=6.31-8.71, P<0.01) area had lower risk of no contraceptive use at first intercourse but adolescent school is situated in high percentage of resident without a junior school diploma (OR=3.61, P<0.01) and marital dissolution (OR=3.61, P<0.01) area increase the risk of no contraceptive use at first intercourse. Family structure, peer behavior and school performance were remain influential at once. Implications of my findings will benefit future social and health policies as well as programmatic strategies aimed at promoting adolescent health in Taiwan.

目錄
致謝 I
摘要 II
ABSTRACT III
目錄
致謝 I
摘要 II
ABSTRACT III
目錄 IV
表目錄 VI
圖目錄 VII
第一章 緒論 1
第一節　研究背景 1
第二節　研究目的 4
第三節　研究重要性 5
第二章 文獻回顧 6
第一節　性健康相關行為 6
第二節　理論架構之探究 8
第三節　個人層級與性健康相關行為 10
第四節　學校層級與性健康相關行為 12
第五節　其他相關因素與性健康相關行為 16
第三章 研究方法 17
第一節　研究設計 17
第二節　研究架構與假說 18
第三節　資料來源與研究樣本 20
第四節　研究變項與測量 28
第五節　資料分析 32
第四章　研究結果 34
第一節　樣本特性 34
第二節　個人、學校因素與初次性行為的發生 38
第三節　個人、學校因素與初次性行為保險套的使用 41
第四節　個人、學校因素與性伴侶數目 45
第五節 縣市分層分析 48
第五章　討論與建議 56
第一節 研究結果之重要發現 56
第二節 政策意涵 60
第三節 研究限制及研究貢獻 61
參考文獻 63
表目錄
表3-3-1、2000年及2001年之青少年樣本數 22
表3-3-2、鄉鎮市區之青少年樣本數 22
表3-3-3、青少年分析樣本與原始樣本之流失分析 26
表3-5-1、縣市分層之ICC計算 32
表4-1-1、樣本基本特性 36
表4-1-2、個人與學校社經地位變項之相關性 35
表4-2-1、青少年初次性行為之邏輯斯迴歸分析 39
表4-3-1、青少年初次性行為保險套使用之邏輯斯迴歸分析 43
表4-4-1、青少年性伴侶數目之邏輯斯迴歸分析 46
表4-5-1、分層分析－台北市 49
表4-5-2、分層分析－台北縣 52
表4-5-3、分層分析－宜蘭縣 54
圖目錄
圖3-2-1、研究架構 19
圖3-3-1、TYP Sample Flow 24

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