Studies show that American teens have factual knowledge about the risks of acquiring a sexually transmitted infection (STI) including human immunodeficiency virus (HIV) infection from unprotected sexual intercourse. Yet, in 1999, nearly one-quarter of American high school students reported having unprotected sexual intercourse, and 3.8 million cases of STIs were concurrently reported among adolescents. Although previous studies have identified intrapersonal, interpersonal, and environmental factors associated with adolescent sexual behavior, little is understood about the process by which these factors interact to influence the ability and willingness of adolescents to act on what they know about protecting themselves from STIs, including HIV infection. As such, qualitative data from 32 middle and upper class, male and female, urban and suburban high school students provide the basis for a model that maps how they navigate a tortuous path that integrates conflicting messages about sexual risk and gender roles with personal experience and personal attributes. The integrated knowledge is central to their decisions whether or not to have sexual intercourse under specific conditions, and if so whether or not to use condoms. Their enactment of intended sexual behaviors varies depending on the social situation of the moment. In that moment the reciprocal and dynamic forces of sexual desire, self-efficacy, peers, parental monitoring, social opportunities, and alcohol act in concert to either encourage unprotected sexual intercourse or encourage safe sex or abstinence. This model contextualizes published quantitative findings, informs prevention and intervention strategies, and provides a basis for further qualitative and quantitative research.
Learning Objectives: Following this session, participants will be able to: 1) Describe the process by which contextual factors influence adolescent sexual decision-making and behavioral performance. 2) Identify contextual factors and other sources of information that compete with factual knowledge about preventing HIV and other sexually transmitted infections. 3) Recognize how the model might inform the design and evaluation of adolescent HIV prevention interventions.
Keywords: Sexual Risk Behavior, Adolescent Health
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.