Knowing versus doing: Sexual health knowledge and its influence on the sexual behaviors of minority youth

While unintended teen pregnancy and sexually transmitted diseases (STD) represent a serious public health threat for adolescents in general, these risks are particularly pressing for minority youth. Teen birth rates, as well as the risk for contracting STDs including HIV, are in general higher among African American and Hispanic youth (Basch, 2011; Sales et al., 2012). While the prevalence of these issues is well documented in the literature, less is known about adolescents' decision-making processes concerning sexual behaviors. Theoretically based in critical race feminism, this study seeks to identify the extent of sexual health knowledge among these adolescents as well as how this knowledge influences individual attitudes and pathways toward and away from sexual behaviors. We conducted semi-structured interviews with 60 African American and Hispanic adolescents ages 13-20, living in impoverished urban neighborhoods, concerning their attitudes and beliefs about sex, pregnancy, and STDs. Data analyses were guided by Ground Theory procedures outlined in Strauss & Corbin (1990) and LaRossa (2005). The findings revealed a wide spectrum of sexual health knowledge among the participants ranging from accurate information to rumors and myths. Furthermore the extent to which this knowledge influenced adolescents' decision to engage in or abstain from sexual behaviors, including contraception use, varied greatly. We conclude that while sexual health knowledge does play a role in the decision making processes of adolescents in terms of sexual behaviors, other factors such as peer influence and parental monitoring are also important. The implications of these findings will also be discussed.