Emerging evidence indicates that the mechanisms that create health (or ill health) at the population level exist at the intersection between the individual and more "upstream" forces that shape our social contexts. To investigate this proposition, we collected detailed descriptions of youth's perceptions about the socio-cultural and other structural aspects of their contexts that shape their sexual behaviour patterns, and ultimately their health outcomes. In this paper, we examine how social context shaped experiences and perceptions pertaining to sexual behaviour among 18-24 year olds living in two Canadian communities (one rural and one urban). We investigate explanations for the struggle that youth engage in as they attempt to situate their emergent sexual behaviour patterns within community, family, peer, and broader social contexts. Two central processes appeared to be important to the experiences of youth in the current study and their recollections about their adolescent sexual experiences. These processes are embedded in social norms and structures and are directed at pathologizing sex and silencing meaningful discussion about sex. Together, they interact to create a climate of sex-based shame. The findings of this qualitative study add to previous sociological and feminist research that has also demonstrated how traditional approaches to understanding youth sexual behaviour tend to ignore or discount the "embeddedness" of young people in their social structures and contexts.
Copyright 2003 Elsevier Ltd.