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Multiple-group structural equation models tested the hypotheses across three timepoints including variables of pubertal timing, perception of peer substance use, sexual behavior, and self-reported substance use. Focus groups were stratified by sexual experience to capture variations among different subgroups. On average, communication was more frequent among adolescents who were female, African American, older, and sexually active , despite some variation in subgroups across partner, parent, and friend communication. We aim to examine changes in sexual activity and function among younger breast cancer survivors who were sexually active before diagnosis and to investigate risk factors for negative impacts on them. The results also supported the temporal sequence of sexual activity preceding increases in delinquency.