Sexuality and Well-being: a Developmental Snapshot of Adolescents in Italy

Evidence on well-being correlates of adolescent sexuality balancing risks and opportunities remains limited and discordant. This study evaluates associations between adolescent sexuality and multidimensional well-being through a developmental lens. Data referred to a nationally representative sample of 17-year-olds (N = 22,568) from the 2022 Italian Health Behaviour in School-Aged Children study. Measures included sexual activity (inactivity, early initiation < 16, on-time initiation ≥ 16), emotional (high life satisfaction), psychophysical (psychosomatic health complaints, PHC), social well-being (loneliness), and condom use. Early initiation (vs. inactivity) was associated with PHC in boys (OR: 1.26; 95% CI: 1.06–1.51) and girls (OR: 1.56; 95% CI: 1.23–1.99). Among boys, it was linked to life satisfaction (OR: 1.49; 95% CI: 1.14–1.94) and lower loneliness (OR: 0.77; 95% CI: 0.59–1.00). Boys and girls with on-time initiation presented lower loneliness (OR: 0.69; 95% CI: 0.52–0.88; OR: 0.78; 95% CI 0.64–0.94, respectively). Exclusively girls with on-time initiation showed higher PHC (OR: 1.47; 95% CI: 1.20–1.81). Halved condom use appeared among adolescents with early (vs. on-time) initiation. A developmental shift, earlier among boys, emerged from predominantly risk to more protective well-being associations of sexuality. The mixed well-being findings associated with adolescent sexuality underscore the need for gender-sensitive, developmentally informed sexual health education.