Research Brief
Social and Emotional Consequences of Sexual Decision-Making Across the Ninth and Tenth Grade
By Sonya S. Brady, Ph.D.
Assistant Professor
Division of Epidemiology and Community Health
University of Minnesota School of Public Health
Background
Numerous prevention efforts are aimed at convincing adolescents to abstain from or delay the onset of sexual behavior. These efforts are motivated, in part, by a desire to protect adolescents from negative physical health consequences of sexual behavior (e.g., unintended pregnancy, sexually transmitted infections). Traditional models developed to explain health behavior, such as the Theory of Planned Behavior and the Health Belief Model, emphasize the importance of considering both positive and negative consequences of behavior. These theories suggest that it is equally important to consider the consequences of engaging and not engaging in a given behavior. When applied to adolescent sexual behavior, however, empirical tests of these models and prevention efforts tend to emphasize the negative health consequences of engaging in sexual behavior.
This research brief presents the results of a two-part study examining the social and emotional consequences that adolescents report subsequent to engaging in or refraining from sexual behavior. This work was done in collaboration with Bonnie L. Halpern-Felsher, Ph.D., Associate Professor in the Department of Pediatrics at the University of California, San Francisco.
Study Design and Methods
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Surveys were completed by 612 adolescents of diverse ethnic and socioeconomic background. Adolescents were recruited from two public high schools in the fall of 9th grade, 2002, and completed surveys at four time points separated by 6-month intervals. At the beginning of the study, adolescents were aged 14 (SD=0.5) and 58% female. Ninety-four percent of this sample completed surveys during the spring of 9th grade, while the percentages completing surveys during the fall and spring of 10th grade were both 84%. Institutional Review Board approval, written parental consent, and adolescent assent were obtained prior to the initiation of the study protocol. At each time point, adolescents reported whether they had ever engaged in sexual behavior (defined as oral or vaginal sex) and the consequences they experienced as a result.
Results
Consequences of engaging in sex. At each time point, sexually experienced participants indicated whether they had ever experienced a number of consequences as a result of engaging in sexual behavior (yes or no). Adolescents¿ report of consequences was examined at the first time point that they indicated being sexually experienced. Two hundred seventy-five adolescents reported sexual experience during the 9th or 10th grade (44% of 612). The percentage reporting positive consequences was as follows: experienced pleasure (76%), felt good about oneself (73%), relationship became better (51%), became popular (16%). Negative consequences were generally reported by fewer adolescents: felt bad about oneself (43%), felt regret (43%), felt used (38%), felt guilty (34%), relationship became worse (20%), got in trouble with parents (14%), had a bad reputation (10%), experienced a pregnancy (8%), contracted a sexually transmitted infection (7%). Figure 1 depicts adolescents¿ overall report of consequences of having sex. Notably, only 3% of adolescents reported only experiencing negative consequences of having sex. In contrast, 34% of adolescents reported only experiencing positive consequences. Boys were more likely than girls to report only experiencing positive consequences of having sex (not shown in figure).
Consequences of refraining from sex. At each time point, all participants indicated whether they had ever experienced a number of consequences as a result of refraining from sexual behavior (yes or no). Assessed positive consequences included feeling responsible, having one¿s friends be proud, and having a good reputation. Assessed negative consequences included feeling regret, feeling left out, having a bad reputation, feeling like one¿s partner was let down, and one¿s partner becoming angry. Figure 2 shows that the percentage of adolescents reporting only positive consequences of refraining from sex dramatically declined across the two years of study. At each time point, girls were more likely than boys to report only positive consequences of refraining from sex.
Three hundred forty-four adolescents (56%) reported that they were sexually inexperienced throughout the 9th and 10th grade, 135 (22%) reported sexual experience at the beginning of the study, and 133 reported becoming sexually experienced by the end of the study. Figure 3 shows that adolescents¿ report of any negative consequence of refraining from sex increased over time, regardless of sexual experience. Girls were more likely than boys to report any negative consequence of refraining from sex (not shown in figure).
Discussion
Study findings highlight the importance of examining the social and emotional consequences adolescents experience subsequent to engaging in or refraining from sexual behavior.
- For many adolescents, engaging in sexual behavior may be more rewarding than refraining from sexual behavior. Positive consequences of engaging in sex were experienced more frequently than only negative consequences, and this experience may serve to reinforce sexual behavior. Among both sexually experienced and inexperienced adolescents, the percentage reporting negative consequences of refraining from sex steadily increased over time. It is critical for sexual education and health promotion programs to provide medically accurate and complete information about sexuality and sexual protection to adolescents.
- Girls appear to experience more negative consequences of sexual decision-making than boys, regardless of whether they engage in or refrain from sexual behavior. Sexuality education programs should explicitly address gender-based norms in society that discriminate against women, and promote respect for one¿s peers and sexual partners regardless of their gender.
References and Acknolwedgements
Findings were published in the January, 2008 issue of the American Journal of Public Health and the February, 2007 issue of Pediatrics. This research was supported by grants awarded to Dr. Halpern-Felsher from the National Institute of Child Health and Human Development (R01 HD41349) and the William T. Grant Foundation (202030129). Dr. Brady was partly funded through the Ruth L. Kirschstein National Research Service Award (T32 MH019391).
Research Brief is published by the University of Minnesota School of Public Health, 420 Delaware Street, S.E., Minneapolis, MN 55455. www.sph.umn.edu.
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