Adolescent sexual risk behavior: a multi-system perspective

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Abstract

Adolescents are at high risk for a number of negative health consequences associated with early and unsafe sexual activity, including infection with human immunodeficiency virus, other sexually transmitted diseases, and unintended pregnancy. As a result, researchers have attempted to identify those factors that influence adolescent sexual risk behavior so that meaningful prevention and intervention programs may be developed. We propose that research efforts so far have been hampered by the adoption of models and perspectives that are narrow and do not adequately capture the complexity associated with the adolescent sexual experience. In this article, we review the recent literature (i.e., 1990–1999) pertaining to the correlates of adolescent sexual risk-taking, and organize the findings into a multisystemic perspective. Factors from the self, family, and extrafamilial systems of influence are discussed. We also consider several methodological problems that limit the literature's current scope, and consider implications of the adoption of a multisystemic framework for future research endeavors. We conclude with a discussion of the implications of the available research for practitioners working to reduce sexual risk behavior among adolescents.

Section snippets

Adolescent sexual risk-taking: sobering statistics

Consistent data across a number of national surveys indicate that sexual activity among American adolescents has increased dramatically over the past two decades. According to the 1997 Youth Risk Behavior Survey data, nearly one half of high school students have engaged in sexual intercourse prior to graduation (Kann et al., 1998). Estimates appear to be higher for males, minority adolescents, and adolescents of lower socioeconomic status Kann et al., 1998, Kann et al., 1995, Leigh et al., 1994

Reviewing the literature: a multisystemic perspective

Sexual risk behavior, like many other problematic behaviors of youth, has been studied for quite some time (see Brooks-Gunn & Furstenberg, 1989, Goodson et al., 1997, Miller & Moore, 1990, for earlier reviews). However, the research that has accumulated thus far still leaves several important issues unaddressed. First, most existing literature on adolescent sexuality has framed all sexual behavior among youth as being problematic; little empirical attention has been given to the developmental

Literature search methods

In order to gather as many relevant articles for this review as possible, several search methods were employed. First, three on-line databases in the social and health sciences (PsycINFO, MEDLINE, and ERIC) were searched for publications dated between January 1990 and June 1999 using the following terms: adolescent sexual behavior, adolescent sexual activity, adolescent sexuality, and adolescent risky sexual behavior. These initial searches produced more than 500 articles; this number was

The self-system

The self-system refers to a constellation of factors, including qualities, skills, knowledge, attitudes, and behaviors, that belong to an individual person and which have either a direct or indirect influence on behavior. For the purpose of this review, the self-system variables will be divided into biological, psychological, and behavioral correlates of sexual risk practices.

Conclusions and recommendations

Certainly, research in the area of adolescent sexual risk behavior has come a long way from the exploratory and mostly descriptive studies of several decades ago (e.g., Kinsey et al., 1948, Kinsey et al., 1953). Much has been learned about the variables that are related to adolescent sexual risk behavior, and effective programs have been developed based on this research literature that provide youth with the knowledge, skills, and resources to manage their transition to sexual adulthood safely

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