The January issue of the Journal of Adolescent Health features a study that examines the psychosocial and behavioral aspects of refusing unwanted sexual intercourse among African-American adolescent females.

Data were collected from self-administered questionnaires and structured interviews with a clinic– and school-based sample of 522 African-American adolescent females ages 14 to 18 years of age in Birmingham, AL.

To be eligible for the study adolescents needed to be African-American females, between the ages 14 and 18, sexually active in the previous 6 months, and provide written consent.

Researchers collected data regarding demographics, sexual behaviors, communication with parents, and psychosocial factors relevant to romantic and sexual partnerships.

Measures

The study had various measures to help determine if and how African-American adolescent females were able to refuse unwanted sexual intercourse.

To determine power dynamics, measures included economic dependence on one’s partner, partner’s age (2 years older vs. similar age or younger), partner communication self-efficacy, safer sex self-efficacy, and beliefs about male control in relationships.

Emotional dynamics were measured through relationship length and fear of partner reaction to condom negotiation.

To measure family and peer influences, researchers assessed parental communication about sexual issues in the previous 6 months, along with family support.

Self perceptions were determined by measuring body image, ethnic identity, and self esteem.

To determine perceived risks, researchers measured how often in the 6 months prior to assessment adolescents were worried they were or would become infected with HIV, an STD, or become pregnant.

Refusal of unwanted “sex” was measured with a single item in the self-administered questionnaire. Participants were asked to complete the following sentence: “During the past 6 months, when a guy wanted to have sex and I didn’t I...” Responses participants were able to choose ranged from [1] “Never said no” to [4] “Always said no.” An additional category allowed participants to indicate that this had never happened to them.

Results

Age

• 36% of respondents were ages 13 - 15
• 64% of respondents were ages 16 - 18

Currently Pregnant*

• 89% of respondents were not currently pregnant
• 11% of respondents were currently pregnant

* Data not available for those respondents who may have previously been pregnant.

Relationship Status

• 16% of respondents were single
• 84% of respondents were in a relationship

Typical Birth Control Use

• 14% of respondents did not use birth control
• 63% of respondents used condoms*
• 23% of respondents used a female-controlled method

* Data not available to determine frequency of condom use and whether or not condoms were used with another method of birth control.

Self-Reported STD

• 75% of respondents did not report a history of an STD
• 25% of respondents did report a history of an STD

Frequency of Sexual Intercourse in Past 6 Months

• 46% of respondents reported having had sexual intercourse less than 4 times in the past 6 months
• 54% of respondents reported having had sexual intercourse more than 4 times in the past 6 months

Always Refused Unwanted “Sex”

• 31% of respondents did not always refuse unwanted “sex”
• 69% of respondents did always refuse unwanted “sex”

The study also found that self-efficacy to negotiate safer sex is associated with consistent refusal of unwanted “sex.” None of the other indicators of power dynamics in the present study were associated with refusing unwanted “sex.”

The authors found that adolescents who were less concerned about partners’ emotional reactions to condom negotiation were more likely to refuse unwanted “sex.”

The authors suggest that consistent refusal of unwanted “sex” may be an indicator of the ability to resist male control in sexual relationships. This ability may be a tool that adolescents can bring to their sexual relationships to help them avoid a variety of unwanted, and/or risky, sexual behaviors. Adolescent sexual health promotion efforts may benefit from programs tailored to increase the use of sexual refusal as an STD/HIV-protective strategy.

For more information: C. Sionean, et al., “Psychosocial and Behavioral Correlates of Refusing Unwanted Sex Among African-American Adolescent Females,” Journal of Adolescent Health, vol. 30, no. 1, pp. 55-63.