Adolescent Sexual Risk Behavior Research Articles

Pathways to adolescent sexual risk behaviors: Effects of prenatal cocaine exposure

BackgroundTo assess the impact of prenatal cocaine exposure (PCE) on adolescent sexual risk behaviors. Externalizing behavior, teen substance use, and early sexual intercourse were examined as pathways mediating the effects of PCE on sexual risk behaviors. MethodsAdolescents (N=364; 185 PCE, 179 non-cocaine exposure (NCE); 205 girls, 159 boys), primarily African–American and of low socioeconomic status, were prospectively enrolled in a longitudinal study at birth. Risky sexual behaviors were assessed at ages 15 and 17. Externalizing behavior at 12 years was assessed with the Youth Self-Report. Substance use, via self-report and biologic assays, and early (before age 15) sexual intercourse were assessed at age 15. Path analyses with the weighted least squares estimator with mean and variance adjustments were performed. ResultsThe final structural equation model-based path model, χ2=31.97 (df=27), p=.23, CFI=.99, TLI=.99, RMSEA=.021, WRMR=.695, indicated a direct effect of PCE on sexual risk behavior (β=.16, p=.02). Although PCE was related to greater externalizing behavior (β=.14, p=.009), which in turn, predicted early sexual intercourse (β=.16, p=.03), leading to sexual risk behavior (β=.44, p<.001), bootstrapping indicated a non-significant indirect effect (β=.01, p>.10). Substance use was correlated with early sexual intercourse (r=.60, p<.001) and predicted sexual risk behavior by age 17 (β=.31, p=.01). ConclusionsPrenatal cocaine exposure was related to more engagement in sexual risk behaviors, suggesting the importance of reducing substance use among pregnant women as a means of prevention of offspring substance use and sexual risk behavior.

The Impact of Neighborhood Disadvantage on Adolescent Women’s Romantic Relationship Development

Purpose: Neighborhood-level disadvantage is an influential context for adolescent sexual risk behaviors, yet little is known about how this same context of disadvantage may impact the characteristics of romantic relationships that precede and organize sexual decision-making. Since many partners are met through neighborhood networks, differing levels of neighborhood disadvantage may impact the developmental trajectory of relationship attributes over time.

African American Parent–Son Sexual Communication Among a College Sample

To investigate whether reports of parent-child sexual communication (PCSC) varied by parental gender, education and living environments among African American adolescent and young male students attending a historically black university (n=146). Using secondary data a paired t-test was used to determine mean differences for PCSC by gender. Factorial ANOVA was calculated to examine the interaction between PCSC and living environment. Overall African American mothers were significantly more likely to engage in PCSC with their sons than African American fathers (t(68)=4.143, p<0.001). African American fathers from suburban areas were significantly more likely to engage in PCSC with their sons than urban fathers (t(137)=-2.295, p=0.023). No significant difference in PCSC by parental educational level was found. Findings from this research suggest that African American mothers continue to be the primary conversant in PCSC with their sons. Additional research is needed to understand the role that living environment (urban vs. suburban) plays in the father PCSC process. PCSC can play an important role in reducing adolescent sexual risk behaviors. Nurses should encourage and support PCSC among African American parents and their adolescent and young adult sons.

Sexual Risk Behaviors in the Adolescent Offspring of Parents with Bipolar Disorder: Prospective Associations with Parents' Personality and Externalizing Behavior in Childhood.

We recently reported that adolescent and young adult offspring of parents with bipolar disorder (OBD), relative to control offspring, were more likely to engage in sexual risk behaviors (SRBs). The present prospective study aimed to determine the contribution of parents' personality and offspring behaviour problems in middle childhood to offspring SRBs 10years later. We hypothesized that offspring externalizing problems in childhood would mediate the relationship between parents' personality traits of neuroticism and agreeableness and adolescent SRBs. Furthermore, we expected these associations to be more robust among the OBD than controls. At baseline, 102 offspring (52 OBD and 50 controls) aged between 4 and 14years were assessed along with their parents, who completed a self-report personality measure and child behavior rating. Behaviour ratings were also obtained from the children's teachers. Ten years later the offspring completed an interview assessing SRBs. Mediation analyses using bootstrapping revealed that, after controlling for age and presence of an affective disorder, externalizing behaviors served as a pathway through which high parental neuroticism, low parental agreeableness, and low parental extraversion were related to SRBs in offspring. Moderated mediation analyses revealed that the relationship between parental neuroticism and childhood externalizing problems was stronger for OBD than controls. These findings add to our previous results showing parents' personality contributes to intergenerational risk transfer through behavioral problems in middle childhood. These results carry implications for optimal timing of preventative interventions in the OBD.

A Community-Engaged Approach to Developing an mHealth HIV/STI and Drug Abuse Preventive Intervention for Primary Care: A Qualitative Study.

BackgroundDespite ongoing prevention efforts, HIV and other sexually transmitted infections (HIV/STIs) and drug use remain public health concerns. Urban adolescents, many of whom are underserved and racial minorities, are disproportionately affected. Recent changes in policy, including the Affordable Care Act, and advances in technology provide HIV/STI and drug abuse prevention scientists with unique opportunities to deliver mobile health (mHealth) preventive interventions in primary care.ObjectivesThe purpose of this community-engaged study was to develop an mHealth version of the Storytelling for Empowerment preventive intervention for primary care (hereinafter referred to as “S4E”).MethodsA total of 29 adolescents were recruited from a youth-centered primary care clinic in Southeast, Michigan, to participate in qualitative interviews. Participants were predominantly African American (n=19, 65.5%) and female (n=21, 72.4%) with a mean age of 16.23 (SD 2.09). The principles of community-based participatory research (CBPR), in conjunction with agile software development and the recommended core prevention principles of the National Institute on Drug Abuse (NIDA) were employed during S4E development. CBPR principles are aimed at improving the effectiveness of research by addressing locally relevant health problems, working with community strengths, and translating basic science into applied research. Complementing this approach, the NIDA prevention principles are derived from decades of drug abuse prevention research aimed at increasing the effectiveness and uptake of programs, through the development of culturally specific interventions and ensuring the structure, content, and delivery of the intervention fit the needs of the community. Data were analyzed using thematic analysis.ResultsA total of 5 themes emerged from the data: (1) acceptability of the mHealth app to adolescents in primary care, (2) inclusion of a risk assessment to improve clinician-adolescent HIV/STI and drug use communication, (3) incorporation of culturally specific HIV/STI and drug use content, (4) incorporation of interactive aspects in the app to engage youth, and (5) perspectives on the appearance of the app.ConclusionsThere is a dearth of mHealth HIV/STI and drug abuse preventive interventions for primary care. Incorporating the principles of CBPR in conjunction with agile software development and NIDA-recommended core prevention principles may be helpful in developing culturally specific mHealth interventions. An important next step in this program of research is to examine the feasibility, acceptability, and efficacy of S4E on adolescent sexual risk and drug use behaviors, and HIV/STI testing. Implications for prevention research and primary care practice are discussed in the context of the Affordable Care Act and technological advances.

Parental Monitoring and Its Associations With Adolescent Sexual Risk Behavior: A Meta-analysis.

Increasingly, health care providers are using approaches targeting parents in an effort to improve adolescent sexual and reproductive health. Research is needed to elucidate areas in which providers can target adolescents and parents effectively. Parental monitoring offers one such opportunity, given consistent protective associations with adolescent sexual risk behavior. However, less is known about which components of monitoring are most effective and most suitable for provider-initiated family-based interventions. We performed a meta-analysis to assess the magnitude of association between parental monitoring and adolescent sexual intercourse, condom use, and contraceptive use. We conducted searches of Medline, the Cumulative Index to Nursing and Allied Health Literature, PsycInfo, Cochrane, the Education Resources Information Center, Social Services Abstracts, Sociological Abstracts, Proquest, and Google Scholar. We selected studies published from 1984 to 2014 that were written in English, included adolescents, and examined relationships between parental monitoring and sexual behavior. We extracted effect size data to calculate pooled odds ratios (ORs) by using a mixed-effects model. Higher overall monitoring (pooled OR, 0.74; 95% confidence interval [CI], 0.69-0.80), monitoring knowledge (pooled OR, 0.81; 95% CI, 0.73-0.90), and rule enforcement (pooled OR, 0.67; 95% CI, 0.59-0.75) were associated with delayed sexual intercourse. Higher overall monitoring (pooled OR, 1.12; 95% CI, 1.01-1.24) and monitoring knowledge (pooled OR, 1.14; 95% CI, 1.01-1.31) were associated with greater condom use. Finally, higher overall monitoring was associated with increased contraceptive use (pooled OR, 1.42; 95% CI, 1.09-1.86), as was monitoring knowledge (pooled OR, 2.27; 95% CI, 1.42-3.63). Effect sizes were not uniform across studies, and most studies were cross-sectional. Provider-initiated family-based interventions focused on parental monitoring represent a novel mechanism for enhancing adolescent sexual and reproductive health.

Dynamic Relationships Between Parental Monitoring, Peer Risk Involvement and Sexual Risk Behavior Among Bahamian Mid-Adolescents.

Considerable research has examined reciprocal relationships between parenting, peers and adolescent problem behavior; however, such studies have largely considered the influence of peers and parents separately. It is important to examine simultaneously the relationships between parental monitoring, peer risk involvement and adolescent sexual risk behavior, and whether increases in peer risk involvement and changes in parental monitoring longitudinally predict adolescent sexual risk behavior. Four waves of sexual behavior data were collected between 2008/2009 and 2011 from high school students aged 13-17 in the Bahamas. Structural equation and latent growth curve modeling were used to examine reciprocal relationships between parental monitoring, perceived peer risk involvement and adolescent sexual risk behavior. For both male and female youth, greater perceived peer risk involvement predicted higher sexual risk behavior index scores, and greater parental monitoring predicted lower scores. Reciprocal relationships were found between parental monitoring and sexual risk behavior for males and between perceived peer risk involvement and sexual risk behavior for females. For males, greater sexual risk behavior predicted lower parental monitoring; for females, greater sexual risk behavior predicted higher perceived peer risk involvement. According to latent growth curve models, a higher initial level of parental monitoring predicted decreases in sexual risk behavior, whereas both a higher initial level and a higher growth rate of peer risk involvement predicted increases in sexual risk behavior. Results highlight the important influence of peer risk involvement on youths' sexual behavior and gender differences in reciprocal relationships between parental monitoring, peer influence and adolescent sexual risk behavior.

Assessment of Parenting Practices and Styles and Adolescent Sexual Behavior among High School Adolescents in Addis Ababa, Ethiopia

Background: Healthy sexuality is a developmental process which needs investments from parents. Nonetheless, little is known about the effect of parenting practices and styles on the sexual risk behavior of young people. Objectives: to assess the effect of different parenting styles and parenting practices on the sexual behavior of adolescents. Methods: A cross-sectional study was conducted among 3840 randomly selected high school adolescents using three stage sampling in Addis Ababa, Ethiopia. Data were collected by a self-administered anonymous pre tested questionnaire. Logistic regression analysis was done to identify parental factors associated with sexual behavior. Results: From the 3543 students participated in this study 723(20.4%) respondents reported ever having sexual intercourse and nearly three -quarter of those who initiated sex were involved in risky sexual practices. Respondents who live with both parents [AOR= 0.48 (95%CI: 0.21-0.83)] and perceived connected to their parents [AOR= 0.51(95%CI: 0.22-0.96)] were less likely to experience risky sexual behavior. Similarly, students from authoritarian and authoritative parents were more likely to have safe sexual practices [AOR = 0.38(95%CI: 0.23-0.86)] and [AOR = 0.41(95%CI: 0.24-0.93)] respectively compared to children from permissive parenting styles. In addition, parent child communication about sexual issues [AOR =0.56 (95%CI: 0.31-0.94)] and parental monitoring were protective from risky sexual behavior [AOR =0.52(95%CI: 0.32-0.92)]. Conclusion: Appropriate parenting practices have a shielding effect from adolescent sexual risk behavior. Interventions that enable parents to build proper parenting practices, skills and styles have paramount importance.

Community Involvement and Reduced Risk Behavior Engagement Among African American Adolescents

Studies have indicated disproportionate health risks among African American adolescents. Given these estimates, research has focused on the prevention of health risk behaviors among this population. Using a strengths-based approach, the current study explored associations between community involvement and African American youths’ health risk behaviors. Additionally, this investigation examined youths’ empowerment beliefs as a mediator of this association. Participants in this study were 1,452 African American youth ( M = 14.41; SD = 1.14; 59% female) residing in a large Midwestern city. Results indicated that community involvement was not directly associated with adolescent health risk behaviors. However, empowerment beliefs mediated the association between community youth involvement and adolescent sexual risk behaviors. Findings suggest the importance of identifying mechanisms that better illuminate the link between community involvement and African American adolescents’ health risk behaviors.

Intervening on conflict, parental bonds, and sexual risk acts among adolescent children of mothers living with HIV.

ObjectiveIn 1993–1994, a psychosocial intervention conducted in New York City significantly improved outcomes for parents living with HIV and their adolescent children over six years. We examine if the intervention benefits are similar for adolescents of mothers living with HIV (MLH) in 2004–2005 in Los Angeles when MLH’s survival had increased substantially.MethodsAdolescents of MLH in Los Angeles (N = 256) aged 12–20 years old were randomized with their MLH to either: 1) a standard care condition (n = 120 adolescent-MLH dyads); or 2) an intervention condition consisting of small group activities to build coping skills (n = 136 adolescent-MLH dyads, 78% attended the intervention). At 18 months, 94.7% of adolescents were reassessed. Longitudinal structural equation modeling examined if intervention participation impacted adolescents’ relationships with parents and their sexual risk behaviors.ResultsCompared to the standard care, adolescents in the intervention condition reported significantly more positive family bonds 18 months later. Greater participation by MLH predicted fewer family conflicts, and was indirectly associated with less adolescent sexual risk behavior at the 18 month follow-up assessment. Anticipated developmental patterns were observed - sexual risk acts increased with age. Reports were also consistent with anticipated gender roles; girls reported better bonds with their mothers at 18 months, compared to boys.ConclusionsAdolescents of MLH have better bonds with their mothers as a function of participating in a coping skills intervention and reduced sexual risk-taking as a function of MLH intervention involvement.

Sex Differences in Associations of School Connectedness With Adolescent Sexual Risk‐Taking in Nova Scotia, Canada

Associations of lower school connectedness have been seen with adolescent sexual risk behaviors, but little is known about gender differences with respect to these relationships. Understanding any such differences could contribute to better supporting the school environment to promote youth sexual health. We used provincially representative cross-sectional data from 1415 sexually active students in grades 10 to 12 in Nova Scotia, Canada, to determine whether lower school connectedness was associated with students' sexual risk behaviors using multivariate logistic regression, stratifying by sex. In boys, lower connectedness was associated with three risk behaviors, having ≥ 2 partners in the previous year (odds ratio [OR] 1.07; 95% confidence interval [CI] 1.01-1.13), no condom use at last intercourse (OR 1.06; 95% CI 1.01-1.12), and having unplanned intercourse due to substance use (OR 1.09; 95% CI 1.03-1.15). No such associations were seen in girls. These results demonstrate that gender differences may exist for associations of school connectedness and sexual risk behaviors; connectedness may be more important for boys than for girls in this area of adolescent health. Educators should consider gender differences when designing interventions to maximize youth sexual health through school-based interventions. Further research on school connectedness and risk-taking should examine genders separately.

Sibling Conversations About Dating and Sexuality: Sisters as Confidants, Sources of Support, and Mentors

Using an observational methodology to examine sibling communication, sisters (N = 28 dyads) were videotaped discussing their ideas about dating and sexuality. Social provision theory was used as a framework for the examination of roles enacted by sisters during these conversations. Inductive thematic analytic procedures were conducted and three roles were identified: sisters as confidants, sources of support, and mentors. Older and younger sisters both served as confidants and sources of support for one another, whereas, older sisters were more likely to be mentors for their younger sisters than vice versa. Findings indicate the potential importance of sisters in the formation of adolescent girls' ideas about romantic relationships and sexuality, sibling communication as a socialization mechanism of sisters' similarities in romantic experiences and sexual behaviors/attitudes, and the inclusion of older sisters in prevention intervention programs focused on reducing adolescent sexual risk behaviors and promoting healthy romantic relationships and sexuality development.

Psychosocial Predictors of Adolescent Sexual Risk Behavior: A Quasi-Experimental Analysis in a Nationally Representative Sample of American Youths

Psychosocial Predictors of Adolescent Sexual Risk Behavior: A Quasi-Experimental Analysis in a Nationally Representative Sample of American Youths

A Brief Intervention to Reduce Adolescent Sexual Risk Behaviors: Feasibility and Impact

Many adolescents with high-risk sexual behaviors only receive health care episodically in the emergency department (ED). ED visits offer an opportunity to deliver brief interventions to improve health, but no proven ED-based brief intervention to reduce sexual risk behaviors exists. The study objectives were to 1) assess feasibility of a novel intervention using National Research Council criteria (effectiveness, efficiency, and satisfaction), and 2) examine impact on attitudes and behaviors. In this cross-sectional pilot study, sexually active patients aged 14-19 years presenting to a Midwestern ED were recruited to receive an intervention to reduce sexual risk behaviors. The intervention, based on motivational interviewing (MI), included agenda setting, exploration of behaviors, decisional balance exercise, tailored feedback, and referral to the hospital-affiliated Adolescent Clinic. Individually-tailored sessions offered provision of condoms, prescriptions for emergency contraception, and/or testing for sexually transmitted infections (STI). Participants completed a survey and intervention at baseline, an immediate post-intervention survey at Time 1, and a three-month phone follow-up survey at Time 2. Surveys assessed sexual behaviors, attitudes and self-efficacy regarding condoms and birth control. Additional questions included: demographics (baseline), satisfaction, and fidelity measures (Time 1). Feasibility criteria were: 1) Subject rated interventionist fidelity to MI principles (Likert scale 1 = strongly agree to 4 = strongly disagree), 2) Session duration (minutes), and 3) Subject satisfaction (Likert scale 1 = not at all to 5 = very). Sixty-six subjects (96% of approached) completed the screening with 24 (37%) qualifying for enrollment by reporting previous sexual activity. Of those, 20 (83%) participated (mean age 16.2 years; 60% female). Subjects somewhat or strongly agreed that the interventionist: 1) “was easy to talk to” (90%), 2) “was concerned about me” (78%), 3) “understood me” (89%), 4) “treated me like an equal” (89%), and 5) “did not push me into something I wasn't ready for” (80%). The mean duration was 15.7 minutes. All subjects were fairly (20%) or very (80%) satisfied. One subject tested positive for Chlamydia trachomatis and received treatment at Adolescent Clinic. When offered, most (59%) accepted condoms and 71% accepted a prescription for emergency contraception. Five subjects kept appointments at Adolescent Clinic where additional services were provided: STI testing (n = 2), birth control prescribed/administered (n = 2), provision of condoms (n=1), and influenza vaccination (n = 1). Fifteen subjects (75%) were reached for 3-month follow-up. Among those reporting sex since enrollment (n = 6), 67% reported continued condom use at most recent sex. There were positive trends in attitudes towards condoms and birth control self-efficacy. This ED-based intervention was delivered with high fidelity and relative rapidity, and resulted in high satisfaction among these sexually active adolescents. A considerable proportion received health services essential for optimal sexual health. Studies to assess efficacy appear warranted.

The impact of future expectations on adolescent sexual risk behavior.

Rates of STIs, HIV, and pregnancy remain high among adolescents in the US, and recent approaches to reducing sexual risk have shown limited success. Future expectations, or the extent to which one expects an event to actually occur, may influence sexual risk behavior. This prospective study uses longitudinal data from the National Longitudinal Survey of Youth 1997 (n = 3,205 adolescents; 49.8% female) to examine the impact of previously derived latent classes of future expectations on sexual risk behavior. Cox regression and latent growth models were used to determine the effect of future expectations on age at first biological child, number of sexual partners, and inconsistent contraception use. The results indicate that classes of future expectations were uniquely associated with each outcome. The latent class reporting expectations of drinking and being arrested was consistently associated with the greatest risks of engaging in sexual risk behavior compared with the referent class, which reported expectations of attending school and little engagement in delinquent behaviors. The class reporting expectations of attending school and drinking was associated with having greater numbers of sexual partners and inconsistent contraception use but not with age at first biological child. The third class, defined by expectations of victimization, was not associated with any outcome in adjusted models, despite being associated with being younger at the birth of their first child in the unadjusted analysis. Gender moderated specific associations between latent classes and sexual risk outcomes. Future expectations, conceptualized as a multidimensional construct, may have a unique ability to explain sexual risk behaviors over time. Future strategies should target multiple expectations and use multiple levels of influence to improve individual future expectations prior to high school and throughout the adolescent period.

Neighborhoods and Racial/Ethnic Disparities in Adolescent Sexual Risk Behavior

Understanding the determinants of racial/ethnic disparities in adolescent sexual risk behavior is important given its links to the differential risk of teen pregnancy, childbearing, and sexually transmitted infections. This article tests a contextual model that emphasizes the concentration of neighborhood disadvantage in shaping racial/ethnic disparities in sexual risk behavior. We focus on two risk behaviors that are prevalent among Black and Hispanic youth: the initiation of sexual activity in adolescence and the number of sex partners. Using data from the 1997 National Longitudinal Study of Youth (N = 6,985; 48% female; 57% non-Hispanic White) evidence indicates that neighborhood disadvantage--measured by concentrated poverty, unemployment rates, and the proportion of female-headed households--partially explains Black and Hispanic disparities from Whites in the odds of adolescent sexual debut, although the prevalence of female-headed households in neighborhoods appears to be the main driver in this domain. Likewise, accounting for neighborhood disadvantage reduces the Black-White and Hispanic-White disparity in the number of sexual partners, although less so relative to sexual debut. We discuss theoretical and practical implications of these findings.

The Impact of Thai Family Matters on Parent–Adolescent Sexual Risk Communication Attitudes and Behaviors

This article reports on a combined family-based substance abuse and HIV-prevention intervention targeting families with 13–14-year-old children in Bangkok, Thailand. Families (n = 340) were randomly and proportionally selected from 7 districts in Bangkok with half randomly assigned to an experimental or control condition. Families in the intervention condition were exposed to 5 interactive booklets about adolescent substance use and risky sexual behavior. Trained health educators followed up by phone to encourage completion of each booklet. Primary outcomes reported in this article include whether the intervention increased the frequency of parent–child communication in general or about sexual risk taking in particular as well as whether the intervention reduced discomfort discussing sexual issues. The authors also tested to see whether booklet completion was associated with communication outcomes at the 6-month follow-up. Multivariate findings indicate that the intervention had a significant impact on the frequency of general parent–child communication on the basis of child reports. The intervention had a marginal impact on the frequency of parent–child communication about sexual issues on the basis of parent reports. Booklet completion was associated with reduced discomfort discussing sex and was marginally associated with frequency of parent–child discussion of sex on the basis of parent reports only. These findings indicate that a family-based program can influence communication patterns.

Childhood Behavior Problems and Adolescent Sexual Risk Behavior: Familial Confounding in the Child and Adolescent Twin Study in Sweden (CATSS)

Previous studies have found associations between childhood behavior problems and adolescent sexual risk behavior. Using a quasi-experimental approach, we examined the extent to which this association may be due to between-family differences (i.e., unmeasured familial confounds) not adequately explored in prior research. We used data from a longitudinal, population-based cohort of young twins in Sweden (first assessment: age 9 or 12 years; second assessment: age 15; n = 2,388). We explored the nature of the association between symptom scores for attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD) at age 9 or 12 and the likelihood of having had sexual intercourse and number of sexual partners by age 15. Two-level mixed-effects models were used to estimate the effect of symptom score on each outcome after controlling for potential unmeasured familial confounds. Higher ADHD, ODD, and CD scores were associated with significantly increased likelihood of sexual intercourse by age 15. Higher ADHD and ODD scores were also associated with increased number of sexual partners. After controlling for unmeasured familial confounds, however, behavior problems were no longer significantly associated with either outcome. The association between childhood behavior problems and sexual risk behaviors may be due to characteristics shared within families. Hence, prevention strategies aimed at reducing these behaviors might need to address broader risk factors that contribute to both behavior problems and a greater likelihood of sexual risk behavior.

Relationships between Adolescent Sexual Risk Behaviors and Emotional Self-Efficacy

Relationships between sexual risk behaviors and emotional self-efficacy among high school adolescents (N = 2,566), with the exclusion of some respondents, were explored via cross-sectional study in South Carolina. The CDC Youth Risk Behavior Survey sexual risk-taking items and an adolescent emotional self-efficacy scale were utilized. Adjusted logistic regression analyses revealed significant race/gender differences. Findings suggest that ever having sexual intercourse, early age of first sex, number of recent and lifetime sexual partners, non-condom use/non-contraceptive use, alcohol use before intercourse and being forced to have sex were associated (α ≤ .05) with reduced emotional self-efficacy for specific race/gender groups. Results have implications for sexual risk reduction interventions for adolescents.

Paternal Influences on Adolescent Sexual Risk Behaviors: A Structured Literature Review

To date, most parent-based research has neglected the role of fathers in shaping adolescent sexual behavior and has focused on mothers. The objective of this study was to conduct a structured review to assess the role of paternal influence on adolescent sexual behavior and to assess the methodological quality of the paternal influence literature related to adolescent sexual behavior. We searched electronic databases: PubMed, PsychINFO, Social Services Abstracts, Family Studies Abstracts, Sociological Abstracts, and the Cumulative Index to Nursing and Allied Health Literature. Studies published between 1980 and 2011 that targeted adolescents 11 to 18 years and focused on paternal parenting processes were included. Methodological quality was assessed by using an 11-item scoring system. Thirteen articles were identified and reviewed. Findings suggest paternal factors are independently associated with adolescent sexual behavior relative to maternal factors. The most commonly studied paternal influence was emotional qualities of the father-adolescent relationship. Paternal communication about sex was most consistently associated with adolescent sexual behavior, whereas paternal attitudes about sex was least associated. Methodological limitations include a tendency to rely on cross-sectional design, nonprobability sampling methods, and focus on sexual debut versus broader sexual behavior. Existing research preliminarily suggests fathers influence the sexual behavior of their adolescent children; however, more rigorous research examining diverse facets of paternal influence on adolescent sexual behavior is needed. We provide recommendations for primary care providers and public health practitioners to better incorporate fathers into interventions designed to reduce adolescent sexual risk behavior.