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Determinants and Disparities in High-Risk Sexual Behavior in US Adolescents

Preventing youths' high-risk sexual behaviors represent some of the most difficult and important challenges for social and behavioral scientists. Adolescent sexual risk-taking behaviors are major causes of premature death and disability in the US as well as lead to unplanned pregnancies. Despite evidence suggesting differing patterns of sexual behaviors between and within ethnic groups, the role of socio-cultural factors within comprehensive theory-guided models of the determinants of high-risk sexual behaviors have been relatively untested. This study will identify factors contributing to youths' high-risk sexual behaviors and their disparities. The objectives involve testing a causal model of sexual behaviors guided by the theory of triadic influence, a model well-tested in predicting other adolescent risk behaviors that specifies the operation of key proximal factors as well as more distal factors. Proximal factors will include self-efficacy, attitudes, and social norms. Distal factors include global positive expectancies, depressive symptoms, parental relatedness, and academic orientation. Finally, potentially vital socio-cultural influences will be tested as ultimate (most distal) factors in the model. Global expectancies and cultural orientation in Latinos are two important factors of emphasis in the model that are understudied within comprehensive models of adolescents' sexual behaviors. The objectives will be accomplished through secondary analyses of Add Health data (National Longitudinal Study of Adolescent Health) collected from 1994-2002. Behavioral outcomes of focus at follow-ups include reported early intercourse, unprotected sexual intercourse, and number of sexual partners. Additionally, reported unintended pregnancies, reported STDs, and positive tests on STD assays at Wave III will be included to validate the behavioral reports and to provide further testing of the model's predictive efficacy. By clarifying the causal paths leading to these behaviors and identifying which specific protective or risk factors are most critical for adolescent groups where disparities are apparent, the proposed project may aid in the development of more effective sexual-risk reduction programs designed for diverse adolescent populations. By clarifying such factors like cultural orientation within such a theoretical model, this study will assist preventive programs in their efforts to address the most critical sexual risk-taking deterrence factors for diverse adolescent groups.

The project was completed January 31, 2011. The project report was provided to the funder, National Institutes of Health, on April 1, 2011.

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Scott Carvajal

The University of Arizona