Diverse Sexual Definitions and Their Predictors Among Adolescents: A Multilevel Analysis in Hungary.

Introduction: Inconsistency of sexual definitions may lead to misunderstandings when evaluating research data or delivering health education. Diverse sexual definitions are especially common with unidirectional genital contacts (only one participant is involved with their genitals). Our aim was to analyze sexual definitions of adolescents and the role of age, gender, previous sexual experience, anxiety, and body image as possible determinants of unidirectional intimate behavior definitions. Methods: Pooled cross-sectional survey data of 9th-grade Hungarian students (n = 612, mean age = 16.1 years, range from 15 to 18 years) were used from the baseline assessment (conducted in 2019 and 2020) of the Balassagyarmat Health Education Program. Our questionnaire was based on the Sexual Definitions Survey. The associations of definition of manual and oral stimulation with gender, age, sexual experience, trait anxiety, and body image were further examined in a multilevel logistic regression model. Results: The rating of different sexual behaviors as sex showed a hierarchy from kissing (10.3%) to vaginal intercourse (98.5%). Manual and oral stimulation was claimed to be sex by 73.4% and 84.3% of students. Girls (OR = 0.40; CI = 0.25–0.62) and older participants (OR = 0.75; CI = 0.59–0.96) were less likely to consider manual stimulation as sex. Conversely, previous sexual experience, anxiety, and body image were not significant predictors. Conclusions: Our study is the first to investigate sexual definitions among non-English-speaking adolescents. It contributes to the understanding of ambiguity regarding the definitions of oral and manual stimulation in this specific age group. Policy implications: As adolescents are the primary focus of sexual education, policies should take into consideration the semantic differences in sexual definitions, as these may influence the participants' interpretation of information and have an effect on their sexual behavior. [ABSTRACT FROM AUTHOR]