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Predictors of Secondary Abstinence in U.S. College Undergraduates
Abstract
This study examined (1) the percentage of participants who practiced secondary sexual abstinence and (2) factors associated with its practice among a sample of U.S. college students. College undergraduate men and women (n = 1,133) in Texas completed a web-based survey assessing abstinence status and predictors of abstinent behavior. Results revealed that 12.5% of participants practiced secondary abstinence. Of eight variables, five significantly predicted secondary abstinence (following sexual initiation). Predictors were positive attitude toward abstinence, subjective norm supporting abstinence, greater religious ties, and previous negative sexual experiences. The fifth variable, participation in abstinence education, however, was associated with a significantly reduced likelihood of secondary abstinence. Fewer perceived barriers, less environmental manipulation (efforts to make physical and social environments supportive of abstinence), and greater religious ties significantly predicted self-efficacy for secondary abstinence. Findings provide an estimate of the percentage of participants who practiced secondary abstinence and suggest focal points for future research.
... Researchers also have been inconsistent in their definitions of sexual abstinence. In heterosexual samples, the term has most often been used to mean not having ever engaged in penile-vaginal intercourse (i.e., virginity;Blinn-Pike, Berger, Hewett, & Oleson, 2004;Donnelly et al., 1999;Keller, Duerst, & Zimmerman, 1996;Loewenson, Ireland, & Resnick, 2004;Oman, Vesely, Kegler, McLeroy, & Aspy, 2003;Ott et al., 2006;Paul, Fitzjohn, Ebert-Phillips, Herbison, & Dickson, 2000;Rasberry & Goodson, 2007). A few researchers have assessed ''secondary sexual abstinence,'' that is, individuals who have previously engaged in penile-vaginal intercourse but have chosen not to do so at the present time (Hulton, 2001;Loewenson et al., 2004). ...
... Research has shown that students who are sexually abstinent (mostly defined as never having engaged in vaginal intercourse) have more conservative values and sexual attitudes, few sexual experiences of any kind, and greater religious involvement (Blinn-Pike, 1999;Blinn-Pike et al., 2004;De Gaston, Weed, & Jensen, 1996;Haglund, 2003;Lefkowitz et al., 2004;Paul et al., 2000;Rasberry & Goodson, 2007). It is not known whether these characteristics affect how students define abstinence. ...
... These students also were more likely to be male. Research has shown that sexually abstinent (defined as never having engaged in penile-vaginal intercourse) adolescents tend to be female, have sexually conservative attitudes, greater religious involvement, and less overall sexual experience (Blinn-Pike, 1999;De Gaston et al., 1996;Donnelly et al., 1999;Lefkowitz et al., 2004;Paul et al., 2000;Rasberry & Goodson, 2007). However, our study showed that, similar to the concept of technical virginity, conservative male adolescents were likely to adopt a narrow definition of sexual abstinence as including bidirectional sexual activity only, perhaps as a way to adhere to a standard of sexual abstinence while engaging in sexual exploration. ...
We asked 298heterosexual Canadian university students about their definitions of the terms abstinence and having sex. For both terms, students were provided with a list of 17 sexual behaviors and indicated whether they would include each in
their definition. The majority of both male and female students included activities that did not involve genital stimulation
in their definition of sexual abstinence and did not include these activities in their definition of having sex. Conversely,
most students did not include bidirectional sexual stimulation (penile–vaginal intercourse or penile–anal intercourse) in
their definitions of sexual abstinence but did include them in their definitions of having sex. Students were quite mixed
in whether activities involving unidirectional genital stimulation (e.g., oral sex, genital fondling) constituted abstinence,
having sex, or neither abstinence nor having sex. However, they were more likely to see these behaviors as abstinent than
as having sex. Students were more likely to rate a behavior as abstinence if orgasm did not occur. A canonical correlation
analysis was used to examine the patterns of association between a number of predictors and inclusions of behaviors involving
no genital stimulation, unidirectional stimulation, and bidirectional genital stimulation in abstinence definitions. The results
indicated that male participants who were more involved with their religion and sexually conservative, less sexually experienced,
and who had not received sexual health education at home were more likely to define bidirectional genital stimulation and
less likely to define no genital stimulation and unidirectional sexual stimulation as sexual abstinence. The research and
health promotion implications of these results are discussed.
... Religion has been found to be an important protective factor for early sexual initiation and pregnancy prevention (Kirby, Lepore, & Ryan, 2005;Rasberry & Goodson, 2009), particularly among less acculturated Latina women (Edwards, Fehring, Jarrett, & Haglund, 2008). However, not all measures of religion are associated with reduced sexual behavior. ...
... The role of parents has been well documented in the literature. Living with a parent, communicating openly about sex, and parental education have been found to be protective factors (Gilliam, 2007a;Jaccard, Dodge, & Dittus, 2003;Raffaelli & Ontai, 2001;Rasberry & Goodson, 2009). While, these studies have focused on sexual behavior and pregnancy intentions, they have not addressed use of specific contraceptives, such as condom and BCP use, among young women. ...
... A recent survey found that 60% of adolescents with sexual experience wish they had waited [10]; and some intentionally abstain from sex following sexual debut, a practice known as secondary abstinence. Although estimates are scarce, the prevalence of secondary abstinence was approximated between 8% and 12.5% in large samples of high school [11] and college students [12], and 13% in an adolescent clinic-based sample comprised mostly of African American females [13]. A few recent studies have examined the practice of secondary abstinence [12,14,15]. ...
... Although estimates are scarce, the prevalence of secondary abstinence was approximated between 8% and 12.5% in large samples of high school [11] and college students [12], and 13% in an adolescent clinic-based sample comprised mostly of African American females [13]. A few recent studies have examined the practice of secondary abstinence [12,14,15]. However, little is understood about factors associated with interest in secondary abstinence, without regard to whether an individual has successfully adopted secondary abstinence. ...
Sexually active African American females are at increased risk for acquiring HIV or STIs. However, some reduce their risk by abstaining from sex for various periods of time following initiation, a practice known as secondary abstinence. Although this may be a valuable mechanism for reducing HIV or STI rates in this population, little is known about those interested in secondary abstinence. Baseline data were obtained from a sample of African American adolescent females, ages 14-20 years, prior to participation in an HIV-risk reduction intervention trial (N = 701). Differences in individual-level and interpersonal-level factors, as well as sociodemographic variables were examined between participants who reported strong interest in secondary abstinence and those who did not. 144 (20.5%) participants reported strong interest in secondary abstinence. Young women with strong interest in abstinence had higher odds of reporting a history of STIs and feeling negative emotions following sex because of their religious beliefs. They also had higher odds of believing their partner may be interested in abstaining and being less invested in their relationship with their main partner. Additionally, adolescents reported less interpersonal stress and more social support. African American females who are interested in practicing secondary abstinence and those who are not differ in their sexual health education needs. Findings from this study characterizing young women interested in secondary abstinence can help researchers provide more targeted health education by identifying those who may be more responsive to abstinence-promoting messages.
... Concerning the motivational determinants and similar to previous research (Cha et al., 2007;Elshiekh et al., 2021;Rasberry & Goodson, 2009;Salameh et al., 2016), our study identified attitude towards premarital sex as an important determinant of sexual abstinence. The study findings also suggested that the students' perceptions of the social and legal consequences of practising sex before marriage, rather than health-associated consequences, could influence their decision to abstain from premarital sex. ...
Sudan is one of the Islamic countries where extramarital sex is religiously forbidden and socially unacceptable. However, increasing numbers of university students become engaged in premarital sex practices, which increases their risk of contracting STIs, including HIV, and puts them into conflicts with their religious beliefs. As little is known about the motivations for abstinence from premarital sex, this study aimed to identify these psychosocial determinants. Using a cross-sectional design, a sample of 257 students between18 and 27 years old was recruited from randomly selected public and private universities in Khartoum. The participants filled out an online questionnaire based on the Integrated Change Model (ICM) to assess their beliefs and practices about abstinence from premarital sex. The analysis of variances (MANOVA) showed that the students who reported being sexually active differed significantly from abstainers in having more knowledge about HIV/AIDS, higher perception of susceptibility to HIV, more exposure to cues that made them think about sex and a more positive attitude towards premarital sex. The abstainers had a significantly more negative attitude towards premarital sex, higher self-efficacy to abstain from sex until marriage and perceived more peer support and norms favouring abstinence from sex until marriage. These findings suggest that promoting abstinence from sex until marriage among university students in Sudan, which aligns with the Sudanese religious values and social norms, requires health communication messages addressing these potential determinants. However, given that sexual encounters still may occur, health communication messages may profit from a more comprehensive approach by also addressing the need for condom use for those unwilling to refrain from sex.
... According to a large number of studies, the main factors that seem to foster sexual abstinence depend on personal values and religious beliefs (see Gardner 2011;Landor and Simons 2014) and sex education (see Santelli et al. 2006) received at school and at home. Regardless of the gender differences, sexually abstinent people have more conservative values and greater religious involvement (Paul et al. 2000;Lefkowitz et al. 2004;Rasberry and Goodson 2009). As Byers et al. (2009: 667) points out, "high quality sexual health education is more likely to include a discussion of the sexual health risks associated with a range of sexual behaviors as well as to define abstinence operationally". ...
Sexual abstinence is generally interpreted as a health-promotion practice, in particular to avoid HIV/AIDS risk and unwanted pregnancy and parenthood. This paper offers insight into narratives and interactional fantasizing that challenge common conceptions of sexual abstinence. The data come from several interviews and group discussions conducted in a netnographic context, altogether involving 21 European, middle-and upper-middle-class women who have never engaged in sexual intercourse or who are sexually experienced but have discontinued sexual practices for some reason. The women's narratives and interactional fantasizing about sexual abstinence can reveal positive societal effects such as opposing sexualisation of culture and pressure for sex, but also more individual perspectives such as promoting self-esteem, psycho-physical well-being, work productivity and career prospects. Narratives and interactional fantasizing seem to play an important role in examining how sexual abstinence can impact society, especially people's perception of sexuality and gender roles.
... Despite clear implications for well-being research, prior investigations of sexual activity levels and mental health, however, have mainly examined associations in the context of sexual dysfunctions (Laumann, Glasser, Neves, & Moreira, 2009;Laumann et al., 2005;Marsiglio & Donnelly, 1991;Nicolosietal.,2005;Shifren et al., 2008), in the chronically ill (Marsiglio & Donnelly, 1991;Pangman & Seguire, 2000), younger people (Eisenberg, Shindel, Smith, Breyer, & Lipshultz, 2010;Rasberry & Goodson, 2009), in substance abusing populations (Nettleman, Ingersoll, &Ceperich,2006), and in older adults (DeLamater & Moorman, 2007;Lindau & Gavrilova, 2010;Lindau et al., 2007;Matthias, Lubben, Atchison, & Schweitzer, 1997;Nicolosi et al., 2006;Palacios-Cena et al., 2012;Patel, Gillespie, & Foxman, 2003;Schick et al., 2010;Wong, Leung, & Woo, 2009). ...
Although sexual activity is commonly believed to be a key component of emotional well-being, little is known about the factors associated with the absence of sexual activity or its associations with self-reported happiness. Using the U.S. General Social Survey-National Death Index 2008 dataset, a series of nationally representative surveys (1988-2002), this study analyzed the sociodemographic and lifestyle factors associated with past-year sexlessness and self-reported happiness among American adults (n = 17,744). After adjustment for marital status, there were no significant time trends evident in the proportion of American adults reporting past-year sexlessness. Among participants (age = 18-89 years), 15.2% of males and 26.7% of females reported past-year sexlessness while 8.7% of males and 17.5% of females reported no sex for 5 years or more. For both genders, past-year sexlessness was most strongly associated with older age and being currently non-married in the multivariable models. Among males, the multivariable analysis also showed that sexlessness was associated with providing less than 20% of the household income (OR 2.27). In female participants, sexlessness was associated with very low income, poor health, lower financial satisfaction, absence of children, and having conservative sexual attitudes (OR 1.46-3.60). For both genders, Black race was associated with a much lower likelihood of sexlessness among currently non-married adults. The purported detrimental impact of sexlessness on self-reported happiness levels was not evident in this large, nationally representative study after adjusting for sociodemographic factors. Sexless Americans reported very similar happiness levels as their sexually active counterparts.
... Since most health problems are closely related to human behavior, theories and models of behavior can provide insights into finding ways to prevent health problems (20). Conceptual validity of the factors identified in this study was supported by numerous health behavior theories which used to understanding sexual behavior of adolescents and young people (21). Various models and theories have been used to explain the attitudes and sexual behaviors in adolescents worldwide (1,22). ...
Background:
Understanding sexual behavior before marriage is relatively rare in the East, especially in Islamic societies, because sexuality is a sensitive subject for many Muslims.
Objectives:
The purpose of this study was to identify premarital sexual intercourse-related individual factors among Iranian adolescents.
Patients and methods:
This qualitative study was performed on 30 students of Payame Noor university of Shiraz city, Iran, in 2014. The study sample includes male and female university students selected using the convenience sampling method. Semistructured interviews were used to collect data. All interviews were conducted by the researcher in a comfortable atmosphere and carried out without the presence of others. Each interview lasted between 30 - 20 minutes. Interviews continued until data saturation occurred. Data were analyzed using the qualitative content analysis method. Participation in the study was voluntary by obtaining an informed consent.
Results:
The study included 30 participants, 56.6% (n = 17) males and 43.4% (n = 13) females. The age range of study, participants was from 19 to 25 years of age. Data analysis showed that three main categories extracted in shaping premarital sexual intercourse in adolescents: health beliefs, religious-spiritual beliefs, and character.
Conclusions:
This study can help find a culturally appropriate intervention to delay sexual initiation and prevent sexual behavior before marriage in adolescents and young adults. The results of the present study have both experimental and theoretical implications for future research. Finally, this study is a form of shared experience that can help similar studies.
... In comparison to condom use, much less research attention has been devoted to understanding what factors contribute to dissonance between interest in and the practice of secondary abstinence. One study of college students identified barriers such as alcohol use, physical attraction, and involvement in a serious relationship [19]. A qualitative study of African-American adolescent females revealed pressure from romantic partners made abstinence a challenge [20]. ...
Reducing disparities in STI/HIV rates for young heterosexual African-American women in the US is a public health priority. Although several strategies can reduce risk, some sexually experienced young women are choosing to abstain from sex for various reasons and periods of time following sexual debut, a practice known as secondary abstinence. However, others who desire to practice secondary abstinence find it difficult to do so. This qualitative study explored barriers that explained the dissonance between interest in secondary abstinence and continued sexual activity. In-depth interviews were conducted with 20 sexually-experienced African-American adolescent females, ages 18 - 23, who expressed interest in secondary abstinence. Partner-related barriers that created power imbalances presented the greatest challenges to becoming or remaining abstinent. Findings suggest that teaching young women how to recognize characteristics of healthy and unhealthy relationships, identify power imbalances, communicate assertively and develop positive coping skills can empower young women to build healthier relationships with their partners.
Indonesian teenagers are getting smarter and having higher achievements, yet experiencing disadvantage situation. Surveys revealed that their health knowledge/literacy and behavior are not getting better even though information access raising. Education (intra and extra curricula) is one of strongest strategy to intervene the fundamental problems. A rapid survey was conducted to assess abstinence and the need of sex education for adolescents in Jakarta and surrounding areas. Data were collected from 163 respondents interviewed at their schools or community. As much as 65% said they never had any kind of sexual activity (primary abstainers) and 81.6% said they need sex education with an offline (face to face) methode 47.8%. Adolescent’s sexual education in Indonesia is indeed an urgent need. An integrative and comprehensive sex education along with adolescent (and pre-adolescent) developmental stages, cultural, and religious values regarding the affect on future health should be undertake.
Indonesian government launched Gold Generation 2045 to anticipate demographic bonus that projected to be at the peak in 2030. Character education in preparing students for puberty were critical and potential intervention to build the principles of healty and responsible individual nowaday and in the future. This article aims to review the situastion and conduct SWOT analysis by disscuss as much as 13 articles and some research findings or surveys as well as books. Character education in Kurikulum 2013 have beed developed and still being enhanced to make it affordable and relevant to ideal education principles for Indonesian students. The role of school, family, and community are noteworhy to achieve holistic and integrated education goals. Abstrak: Visi Indonesia Emas 2045 yang ditetapkan pemerintah dipahami sebagai antisipasi bonus demografi yang puncaknya diperkirakan terjadi pada 2030. Pendidikan karakter dalam mempersiapkan pubertas merupakan intervensi pada titik kritis dan potensial meningkatkan dan meletakkan dasar dalam pembentukan pribadi yang sehat dan bertanggung jawab saat ini dan masa datang. Tulisan ini bertujuan mengkaji situasi dan melakukan analisis SWOT dengan membahas 13 artikel ditambah data/hasil penelitian dan buku. Pengembangan pendidikan karakter yang tertuang dalam Kurikulum 2013 terus mengalami perkembangan (direvisi) untuk disesuaikan dengan prinsip pendidikan ideal bagi anak didik Indonesia. Peran ketiga pihak, sekolah, keluarga, dan masyarakat dituntut demi tercapainya tujuan pendidikan yang holistik dan terintegrasi. Kata Kunci: pendidikan karakter, pubertas, analisis SWOT, situasi remaja
Indonesian teenagers are getting smarter and having higher achievements, yet experiencing disadvantage situation. Surveys revealed that their health knowledge/literacy and behavior are not getting better even though information access raising. Education (intra and extra curricula) is one of strongest strategy to intervene the fundamental problems. A rapid survey was conducted to assess abstinence and the need of sex education for adolescents in Jakarta and surrounding areas. Data were collected from 163 respondents interviewed at their schools or community. As much as 65% said they never had any kind of sexual activity (primary abstainers) and 81.6% said they need sex education with an offline (face to face) methode 47.8%. Adolescent's sexual education in Indonesia is indeed an urgent need. An integrative and comprehensive sex education along with adolescent (and pre-adolescent) developmental stages, cultural, and religious values regarding the affect on future health should be undertake. Abstrak Remaja Indonesia semakin cerdas dan memiliki pencapaian yang semakin tinggi, namun pada saat yang sama mengalami situasi yang tidak menguntungkan. Beberapa hasil survey menunjukkan bahwa pengetahuan/literasi kesehatan mereka tidak semakin baik padahal akses terhadap informasi sangat tinggi. Pendidikan (intra dan ekstra-kurikuler) merupakan salah satu strategi terkuat untuk mengintervensi masalah mendasar. Survei cepat dilakukan untuk menilai perilaku abstinensi (puasa seks) dan kebutuhan pendidikan seks remaja di Jakarta dan kota-kota sekitarnya. Data dikumpulkan dari 163 responden yang diwawancara di sekolah atau komunitasnya. Sebanyak 65% remaja mengaku melakukan abstinensi primer (tidak pernah melakukan aktivitas seksual) dan 81,6% menyatakan kebutuhannya akan pendidikan seks, dengan cara tatap muka 47,8%. pendidikan seks di Indonesia sejatinya merupakan kebutuhan mendesak. Pendidikan seks integratif dan komprehensif sesuai dengan tahapan perkembangan remaja (dan pra remaja), nilai budaya dan agama yang dianut serta tetap memperhatikan dampaknya terhadap kesehatan generasi mendatang harus segera dilakukan.
This mixed-methods study of emerging adults investigates the messages asserted to delay or abstain from sexual intercourse. Goals-plans-action theory and sexual script theory inform the investigation of 192 survey participants and 27 interview participants. Results confirm that when emerging adults aspire to abstain or delay from intercourse, they enact a sexual script that includes communicative actions taken to reach their goal during conversations. This study identifies phrases used to initiate a conversation, recommends the inclusion of a rationale, provides the primary and secondary goals that inform message construction, and shows three primary ways conversations unfold.
Presenting qualitative and quantitative findings on the lived experiences of around seven hundred young adults from Christian, Muslim, Jewish, Hindu, Buddhist, Sikh and mixed-faith backgrounds, Religious and Sexual Identities provides an illuminating and nuanced analysis of young adults' perceptions and negotiations of their religious, sexual, youth and gender identities. It demonstrates how these young adults creatively construct meanings and social connections as they navigate demanding but exciting spaces in which their multiple identities intersect. Accessible quantitative analyses are combined with rich interview and video diary narratives in this theoretically-informed exploration of religious and sexual identities in contemporary society. © Andrew Kam-Tuck Yip and Sarah-Jane Page 2013. All rights reserved.
Some sexually experienced African American females abstain from sexual activity for various reasons and periods of time following sexual debut (secondary abstinence), reducing their risk of HIV/sexually transmitted infection (STI) acquisition. However, few studies have sought to understand secondary abstinence motivations. Furthermore, the scope of existing knowledge may be limited by the quantitative approaches employed. Thus, the purpose of this qualitative study was to investigate secondary abstinence motivations among African American females using a grounded theory approach. Interviews were conducted with 20 young women, aged 18 to 23 years, who recently completed a sexual risk-reduction intervention. Motivations for secondary abstinence not identified in previous studies included feeling used for sex, partner infidelity, and abuse or sexual assault. Also, young women were motivated to abstain to focus on improving certain aspects of their lives. Other motivations similar to those previously identified included not being married or in a committed relationship, separation from one's partner, and STI and pregnancy experiences or fears. Insight from this investigation can be used to improve measurement of motivations and to develop and refine HIV/STI interventions for this population.
Secondary virginity—a sexually-initiated person’s deliberate decision to refrain from intimate encounters for a set period
of time and to refer to that decision as a kind of virginity (rather than “mere” abstinence)—has largely eluded sociological
scrutiny, despite its increasing popularity as a concept and practice among American youth. This study explores beliefs and
experiences regarding secondary virginity, drawing on qualitative interviews with 61 socially diverse women and men, of whom
four were avowed secondary virgins, five likened their experiences to a second virginity/virginity loss, and 16 had phenomenologically
similar experiences which they did not frame in terms of virginity. Respondents who endorsed the concept of secondary virginity
were disproportionately White conservative Christian women born after 1972. Secondary virginity reveals the social construction
of gendered sexuality and the heterosexual imaginary as it reinforces privilege along gender, racial, religious, and sexual
dimensions.
Acquired immunodeficiency syndrome (AIDS), caused by human immunodeficiency virus (HIV), is a leading cause of death.
We tested the hypothesis that religious variables would be inversely associated with prevalence of HIV/AIDS risk factors.
A 2002 national survey included 9,837 individuals aged 15-44 years with complete data on religious involvement, sexual, and drug use behaviors.
Women who never attended services had over two times greater odds of reporting HIV risk factors than those attending weekly or more after adjusting for age and race/ethnicity (p < 0.0001) and over 60% greater after adjusting for multiple confounders, but no significant association was seen in men. Mainline Protestants had lower odds of reporting risk factors than those with no affiliation. No significant independent associations were found with importance of religion.
Women with public religious involvement had lower prevalence of any HIV risk factors while only affiliation was so associated in men.
In the United States, religious practice is inversely associated with several chronic conditions, but no reports show whether it is inversely associated with prevalence of positive serology for infections.
Data on a multiethnic, national sample included 11,507 persons aged 17 years and over with complete data on frequency of attendance at religious services (FARS) and serologic testing for six pathogens.
Even after controlling for multiple confounders, persons attending religious services weekly (19.8%) or more (19.6%) were less likely to be seropositive for herpes simplex type 2 (HSV-2) than those attending less frequently (23.7%) or never (25.1%, P = 0.001). Analyses revealed the association to be partially accounted for by reduced risky sexual behavior and illegal drug use among frequent attenders. No associations were found with three enteric pathogens.
Infection with HSV-2 and hepatitis C virus (HCV) was inversely associated with FARS, independent of multiple confounders.
Teenagers undergo biological, cognitive, and social changes. Each of these changes interacts with the other developmental parameters and may affect outcomes in late adolescence and adulthood. Sequence, tempo, and timing of puberty all affect when changes in hormones, feelings, and behavior will emerge in children. The pediatrician should recognize stages of pubertal development and be able to provide counseling and information to patients and parents. Some suggested resources are listed in the Sidebar.
In this article, we attempt to distinguish between the properties of moderator and mediator variables at a number of levels. First, we seek to make theorists and researchers aware of the importance of not using the terms moderator and mediator interchangeably by carefully elaborating, both conceptually and strategically, the many ways in which moderators and mediators differ. We then go beyond this largely pedagogical function and delineate the conceptual and strategic implications of making use of such distinctions with regard to a wide range of phenomena, including control and stress, attitudes, and personality traits. We also provide a specific compendium of analytic procedures appropriate for making the most effective use of the moderator and mediator distinction, both separately and in terms of a broader causal system that includes both moderators and mediators. (46 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Research dealing with various aspects of* the theory of planned behavior (Ajzen, 1985,
1987) is reviewed, and some unresolved issues are discussed. In broad terms, the theory is
found to be well supported by empirical evidence. Intentions to perform behaviors of different
kinds can be predicted with high accuracy from attitudes toward the behavior, subjective
norms, and perceived behavioral control; and these intentions, together with perceptions of
behavioral control, account for considerable variance in actual behavior. Attitudes, subjective
norms, and perceived behavioral control are shown to be related to appropriate sets of salient
behavioral, normative, and control beliefs about the behavior, but the exact nature of these
relations is still uncertain. Expectancy value formulations are found to be only partly
successful in dealing with these relations. Optimal rescaling of expectancy and value
measures is offered as a means of dealing with measurement limitations. Finally, inclusion of
past behavior in the prediction equation is shown to provide a means of testing the theory*s
sufficiency, another issue that remains unresolved. The limited available evidence concerning
this question shows that the theory is predicting behavior quite well in comparison to the
ceiling imposed by behavioral reliability.
A tremendous growth in the use of multi-item scales in marketing research has occurred over the past two decades. Concurrently, there is increasing concern about the quality of these measures. Although the majority of marketing-related articles now discuss the reliability of the scales administered, few address the issue of scale validity. One aspect of scale validity, which should be of particular concern to marketing researchers, is the potential threat of contamination due to social-desirability response bias. However, a careful review of nearly 20 years of published research suggests that social-desirability bias has been consistently neglected in scale construction, evaluation, and implementation. The purpose of this article is to discuss the nature of such a bias, methods for identifying, testing for and/or preventing it, and how these methods can and should be implemented in consumer-related research. ©: 2000 John Wiley & Sons, Inc.
In this article, we attempt to distinguish between the properties of moderator and mediator variables at a number of levels. First, we seek to make theorists and researchers aware of the importance of not using the terms moderator and mediator interchangeably by carefully elaborating, both conceptually and strategically, the many ways in which moderators and mediators differ. We then go beyond this largely pedagogical function and delineate the conceptual and strategic implications of making use of such distinctions with regard to a wide range of phenomena, including control and stress, attitudes, and personality traits. We also provide a specific compendium of analytic procedures appropriate for making the most effective use of the moderator and mediator distinction, both separately and in terms of a broader causal system that includes both moderators and mediators.
Priority health-risk behaviors, which contribute to the leading causes of mortality and morbidity among youth and adults, often are established during youth, extend into adulthood, are interrelated, and are preventable.
February-May 1999.
The Youth Risk Behavior Surveillance System (YRBSS) monitors six categories of priority health-risk behaviors among youth and young adults --behaviors that contribute to unintentional and intentional injuries; tobacco use; alcohol and other drug use; sexual behaviors that contribute to unintended pregnancy and sexually transmitted diseases (STDs) (including human immunodeficiency virus [HIV] infection); unhealthy dietary behaviors; and physical inactivity. The YRBSS includes a national school-based survey conducted by CDC as well as state, territorial, and local school-based surveys conducted by education and health agencies. This report summarizes results from the national survey, 33 state surveys, and 16 local surveys conducted among high school students during February-May 1999.
In the United States, approximately three fourths of all deaths among persons aged 10-24 years result from only four causes: motor-vehicle crashes, other unintentional injuries, homicide, and suicide. Results from the 1999 national Youth Risk Behavior Survey demonstrate that numerous high school students engage in behaviors that increase their likelihood of death from these four causes--16.4% had rarely or never worn a seat belt; during the 30 days preceding the survey, 33.1% had ridden with a driver who had been drinking alcohol; 17.3% had carried a weapon during the 30 days preceding the survey; 50.0% had drunk alcohol during the 30 days preceding the survey; 26.7% had used marijuana during the 30 days preceding the survey; and 7.8% had attempted suicide during the 12 months preceding the survey. Substantial morbidity and social problems among young persons also result from unintended pregnancies and STDs, including HIV infection. In 1999, nationwide, 49.9% of high school students had ever had sexual intercourse; 42.0% of sexually active students had not used a condom at last sexual intercourse; and 1.8% had ever injected an illegal drug. Two thirds of all deaths among persons aged > or = 25 years result from only two causes--cardiovascular disease and cancer. The majority of risk behaviors associated with these two causes of death are initiated during adolescence. In 1999, 34.8% of high school students had smoked cigarettes during the 30 days preceding the survey; 76.1% had not eaten > or = 5 servings/day of fruits and vegetables during the 7 days preceding the survey; 16.0% were at risk for becoming overweight; and 70.9% did not attend physical education class daily.
These YRBSS data are already being used by health and education officials at national, state, and local levelsto analyze and improve policies and programs to reduce priority health-risk behaviors among youth. The YRBSS data also are being used to measure progress toward achieving 16 national health objectives for 2010 and 3 of the 10 leading health indicators.
To examine the tacit knowledge resulting from designing a complex Web site to facilitate administration of an Internet-based survey.
Formative methods guided studying the feasibility of conducting an online survey using versions of the Keirsey Temperament Sorter II and the National College Health Risk Behavior Survey.
Web-site design software and pilot testing were critical to success. Incorporating the target audience as consumers in both Web site development and formative evaluation simplified data collection and analysis.
Online instrumentation used in survey research is both practical and desirable. Future refinements are necessary, but improved designs can emanate from this particular effort.
To use youth and parent demographic factors, youth assets (strengths), and community constructs to develop age-group-specific profiles for youth who abstain from sexual activity.
Data were collected using in-person interviews of youth (N = 1253) residing in randomly selected, inner-city neighborhood households. Data were analyzed to create classification trees.
Results indicated that assets typically were the most important factors related to abstinence and that the profiles differed for each age group.
When sexual abstinence is considered, the influence of youth and parent demographics, youth assets, and community factors appears to vary across adolescent developmental age periods.
Theories and empirical studies of adolescent sexual behavior have identified the contributions of personal attributes and social experiences; however, it is rare that models have clarified developmental pathways to adolescent sexual behavior that include (1) factors assessed prior to and early in adolescence and (2) dyadic experiences in adolescence that provide the opportunity for sexual behavior (i.e., dating). Using data from a prospective study, structural equation modeling was used to test a model predicting adolescent sexual behavior at age 19, denoted by the number of lifetime sexual partners. Predictors examined were sociability and impulsivity assessed at 30 months of age, physical characteristics and experiences with peers measured at age 12-13, the age of first romantic relationship, and frequency of alcohol use at age 16. The pathway to greater sexual involvement was marked by some desired personal attributes (e.g., sociability) and peer experiences (e.g., higher quality friendships). These associations were mediated, however, by earlier initiation of romantic relationships and more frequent use of alcohol in middle adolescence. Earlier initiation of romantic relationships and more frequent alcohol use were predicted by greater sociability and less impulsivity in childhood, higher quality friendships and greater peer acceptance in early adolescence, and a more mature appearance and physical attractiveness (among females) at age 13. The findings imply a complex pathway that leads to a greater accumulation of sexual partners by age 19. This pathway begins in childhood and includes individual qualities, peer acceptance, romantic relationships, and alcohol use.
CONTEXT. Few rigorous evaluations have been conducted of locally designed, culturally consistent adolescent reproductive health programs. \ METHODS: A quasi-experimental research design was used to measure behavioral changes associated with a culturally consistent reproductive health program for young people in Kenya. Baseline and endline surveys were conducted in 1997 and 2001,respectively in the project and control areas. Multivariate analysis was used to assess whether the project was associated with changes in young people's sexual initiation, safer-sex behavior and discussion of reproductive health issues with adults. RESULTS: The 36-month project was associated with considerable changes in young people's sexual and reproductive health-related behavior, but behavior change differed by gender. Females in the project site were significantly more likely than those in the control site to adopt secondary abstinence (odds ratio, 3.3) and less likely to have had three or more sex partners (0.1). Males in the project site were more likely to use condoms than those in the control site (3.7). Both moles and females in the project site were more likely to discuss sexual and reproductive health issues with a nonparent adult than were young people in the control site (1.9 and 5.5, respectively). CONCLUSIONS: Interventions that adopt to indigenous traditions con be both acceptable to communities and associated with significant changes in young people's behavior.
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The sample in this study consisted of 697 students from 20 schools in Missouri who indicated on a survey of sexual attitudes and behaviors that they had not had sex. The subjects completed the 18-item Reasons for Abstinence Scale and identified those items that were reasons why they had not had sex. The most frequent reasons for not having sex were related to fears of pregnancy and disease (including HIV/AIDS). The least frequent reasons were related to problems concerning the cost and availability of birth control and protection. Principal components factor analysis revealed three factors that were labeled "fear-based postponement," "emotionality and confusion," and "conservative values." Factor scores differed by gender, grades, alcohol consumption, family structure, father's education, and urbanicity. The discussion centers on the need to design different prevention strategies to build protective factors that result in "sexual resilience" in target groups of adolescents.
The Big Idea: Both Jesus and the apostle Paul offer us straight talk about lust and what to do about it. Read the following to your students: Betsy, Reggie, and Juanita live on the same block and go to the same school. Back in the day, they used to ride bikes together in the neighborhood, but now they've drifted apart. They're into different things at school and have totally different friends now, so they barely say hi anymore when they bump into each other between classes or at lunch. But if you could look into their rooms after school, you'd see they still have a lot in common. Betsy sits in her bedroom watching soaps on the TV she talked her parents into buying for her birthday. The people on the screen are undressing each other (though Betsy doesn't actually see them naked), and in the next shot they're under the covers and there's no doubt what they're doing. Betsy's eyes, ears, and emotions are riveted to the screen. Reggie grabs chips and a Doctor Pepper, ducks a homework question from his mom, and heads up to his room. He pulls a sports magazine from the lining of his gym bag, but this issue has less to do with baseball and more to do with swimwear—if you catch my drift. He locks the door, flops down on the bed, and opens the magazine.
This study was a longitudinal follow-up of 697 early adolescents from 20 schools in Missouri, investigating students who, in 1997, indicated on a survey of sexual attitudes and behaviors that they had not had sexual intercourse. They completed the Reasons for Abstinence Scale (RAS) by identifying those items that were reasons why they had not had sex. In 1999, 18 months later, 568 of the same students were available to complete the RAS again. When the adolescents who remained abstinent in 1999 ( n = 422) were compared with their peers who had become sexually active ( n = 146), the abstinent adolescents (a) were significantly less likely to report consuming alcohol on a regular basis, (b) were significantly more likely to be male, and (c) gave more reasons for being abstinent. However, the adolescents who remained abstinent had a significant drop in the number of reasons for being abstinent over the 18 months.
Since 1993, in response to a movement sponsored by the Southern Baptist Church, over 2.5 million adolescents have taken public "virginity" pledges, in which they promise to abstain from sex until marriage. This paper explores the effect of those pledges on the transition to first intercourse. Adolescents who pledge are much less likely to have intercourse than adolescents who do not pledge. The delay effect is substantial. On the other hand, the pledge does not work for adolescents at ail ages. Second, pledging delays intercourse only in contexts where there are some, but not too many, pledgers. The pledge works because it is embedded in an identity movement. Consequently, the pledge identity is meaningful only in contexts where it is at least partially nonnormative. Consequences of pledging are explored for those who break their promise. Promise breakers are less likely than others to use contraception at first intercourse.
In contrast to studies of abstinence-only programs, studies of abstinence-plus curricula indicate that students do not increase sexual activity. Parents, teachers, and administrators should evaluate all sexuality education programs according to three important criteria: credibility of training materials, curriculum content, and curriculum sensitivity. (MLH)
This report summarizes three bodies of research on teenage pregnancy and programs to reduce the risk of teenage pregnancy. Studies included in this report were completed in 1980 or later, conducted in the United States or Canada, targeted adolescents, employed an experimental or quasi-experimental design, had a sample size of at least 100 in the combined treatment and control group, and measured the impact on sexual or contraceptive behavior, pregnancy, or childbearing. Six chapters focus on: (1) "Making the Case for Prevention Efforts: Adolescent Risk-Taking Behavior and Its Consequences"; (2) "Looking for Reasons Why: The Antecedents of Adolescent Sexual Behavior"; (3) "Assessing the Evidence: Factors Affecting the Strength of Research Results"; (4) "Emerging Answers: The Behavioral Impact of Programs To Reduce Adolescent Sexual Risk-Taking"; (5) "Looking Forward: Conclusions about the State of Research and the Effectiveness of Programs"; and (6) "Bringing It Home: Applying These Research Results in Communities." (Chapters contain references.) (SM)
There has long been controversy in this country about the implementation of school-based sexuality education. In recent years, however, the controversy has centered on abstinence education. Critics of abstinence education programs seem to have three major concerns relative to abstinence education programming: (1) promotion of religion; (2) provision of inaccurate information; and (3) ineffective programming. The focus of this article is on the charge that abstinence education programs are ineffective in reducing risky sexual behavior among teens. Since the federal government is spending hundreds of millions of dollars on programs that must meet the a-h definition of abstinence education this is an important public policy issue. This article includes a review of published evaluations of abstinence education programs (limited to evaluations that addressed behavioral outcomes), commentary on aspects of Doug Kirby's analysis of the effectiveness of abstinence programs, as well as commentary on Robert Rector's defense of the effectiveness of abstinence programs. Additionally, other evaluation issues are addressed, such as apparent opposition to evaluation efforts, concerns with the evaluations of state abstinence education programs, concerns with federally funded evaluation efforts, and evaluation requirements of federal funding agencies.
Investigated the response rate, response speed, and response quality of e-mail surveys in comparison with mail surveys and examined the relative advantages and disadvantages of the 2 methods. 500 Ss, consisting of administrative and teaching staff of the Chinese University of Hong Kong responded to questionnaires either emailed or sent via inhouse mail. Results show that e-mail yields faster returns than mail. The level of reply quality is about the same for the 2 methods. The response rate for e-mail is lower than mail. However, it is concluded that if one takes into account the low popularity of e-mail usage in Hong Kong, e-mail actually produces an acceptable response rate at a lower cost per returned questionnaire than mail. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Opinion change increased as the amount of effort expended to deliver a persuasive counternorm speech was increased. In two experiments physical effort was manipulated by varying the interval of delay in auditory feedback. No differences were found between Ss who improvised a speech advocating a discrepant attitude position and those who merely read the speech sincerely. The theory of cognitive dissonance appears to offer adequate and parsimonious explanation of the results.
An understanding of both sexual activity and sexual abstinence among young people is crucial in preventing the negative consequences of early sex initiation. The study of motivation is essential for health educators to be effective in persuading individuals to adopt healthy behaviors and avoid health-compromising ones. A discussion of the multi-dimensional construct of motivation for sexual abstinence is absent from the adolescent sexual behavior literature. Within this study, in-depth brainstorming sessions among college students and the construction of concept maps were used to identify and visually represent potentially relevant dimensions of motivation for sexual abstinence. Based upon these results, the Sexual Abstinence Motivation Scale (SAMS) was developed and psychometrically tested with a pilot group, as well as a statistically representative final group from two major universities in central Texas. Based on the results from this exploratory analysis, the final version of the SAMS included eight scales and 41 items. The eight factors were: Commitment to Self-Schema, Risk of Disappointing Authority Figures, Fear/Apprehension of the Sexual Experience, Fear of Physical Consequences, Value of Virginity, Reputation Regret, No Opportunity/Not Important, and Manipulation. The analyses of the psychometric properties of the SAMS lend support to the validity and reliability of scores it generated. The examination of convergent validity of the SAMS showed significant negative correlations with the Sexual Ideology Instrument -- an indication that the instrument appeared to be measuring motivation for sexual abstinence. Adequate reliability computed through Cronbach alpha demonstrated the items in the SAMS were measuring the same construct ? motivation for sexual abstinence. Prior to this study, assumptions about factors of motivation for sexual abstinence and their possible structure were unknown. Based on results of this examination, preliminary elements now exist that can be tested for the development of these assumptions. The dimensions uncovered in this analysis contribute to the development and refinement of a theory of motivation for sexual abstinence. Further examination, specifically confirmatory factor analysis using the SAMS, is needed.
This report presents a three-stage model (ARRM) that characterize people's efforts to change sexual behaviors related to HIV transmission. ARRM focuses on social and psychological factors hypothesized to influence (1) labeling of high risk behaviors as problematic, (2) making a commitment to changing high risk behaviors, and (3) seeking and enacting solutions directed at reducing high risk activities. The proposed model integrates important concepts from prior behavioral medicine and human sexuality studies, specifies their differential import to achieving the goals associated with each stage of the model, and denotes factors hypothesized to influence people's motivation to continue the change process over time. Current findings are discussed within this three-stage model and directions for further research are suggested. Recent findings from our ongoing studies of gays and heterosexuals in San Francisco are presented.
This investigation predicted adolescents' delay of intercourse onset from attitudes, social norms, and self-efficacy about refraining from sexual intercourse. Age, gender, ethnicity, and parental education were also examined as predictors and moderators of the relationships among the 3 psychosocial determinants and onset. The participants (N = 827), part of a cohort initially surveyed in the 9th grade, reported at baseline that they had never engaged in intercourse. The multivariable proportional hazards regression model suggested that adolescents with more positive attitudinal and normative beliefs, as well as those with a parent who graduated from college, were less likely to engage in intercourse in the follow-up period (up to approximately 2 years). Interventions that include an objective to delay onset may benefit from addressing psychosocial determinants, especially attitudes and norms about sexual intercourse.
Previous research has focused on risk factors associated with early onset of sexual intercourse among adolescents. This study hypothesizes that protective factors identified for other health compromising behaviors are also protective against early onset of sexual intercourse. The study sample included 26,023 students in grades 7-12 (87.5% white, 52.5% male) who did not report a history of sexual abuse in a statewide survey of adolescent health in 1988.
Bivariate analyses were stratified into early (13-14 years), middle (15-16 years) and late (17-18 years) adolescence and by gender. Cox proportional hazards survival analysis, stratified by gender, was used to determine risk and protective factors associated with delayed onset of sexual intercourse.
Variables showing a significant bivariate association with lower levels of sexual activity across all age groups and genders were: dual-parent families, higher socioeconomic status (SES), better school performance, greater religiosity, absence of suicidal thoughts, feeling adults or parents cared, and high parental expectations. High levels of body pride were associated with higher levels of sexual activity for all age and gender groups. In the multivariate survival analyses, variables significantly associated with delayed onset of sexual activity for both males and females included: dual-parent families, higher SES, residing in rural areas, higher school performance, concerns about the community, and higher religiosity. High parental expectations were a significant protective factor for males but not for females.
While many protective factors are not subject to intervention, the present analyses indicate that teen pregnancy prevention may be enhanced by addressing family and educational factors.
PIP
This article assesses the abstinence-based programs developed by family life educators and the factors associated with positive results through a review of abstinence promotion programs of the federal government. In 1996, Section 510 was added to Title V of the Social Security Act allocating US$50 million annually from 1998-2000 to fund abstinence education programs, while in 1997, a National Strategy to Prevent Teen Pregnancy was launched by the Office of Adolescent Pregnancy Prevention to provide teen pregnancy programs to at least 25% of the communities. Presented in this paper is a discussion of the Abstinence Only programs, which focus on the prevention of pregnancy and sexually transmitted disease among adolescents, and the Abstinence Plus programs, which emphasize other prevention methods as well as abstinence. Evaluation of Abstinence Only programs include Success Express, Project Taking Charge, Sex Respect, Teen Aid, Values and Choices and Facts and Feelings. Moreover, programs such as Reducing the Risk, Postponing Sexual Involvement, Project Education Now, and Babies Later were evaluated under the Abstinence Plus programs. Several programs evaluated have shown to have a positive effect on attitudes among adolescents, but are not proven to have a significant effect on sexual behavior. In conclusion, this article encourages exploration of new approaches to address teen pregnancy and the increasing incidence of sexually transmitted diseases among adolescents, while the federal government must utilize the implementation of existing programs with positive effects.
To guide the development of an intervention to reduce the incidence of sexually transmitted diseases (STDs) in urban, adolescent girls, we investigated such girls' reasons for deciding to have or not to have sexual intercourse.
Consecutive girls >or=14 years of age attending an urban adolescent clinic were invited to complete an anonymous survey about sexual decision-making. In this pilot study, girls were asked: (a) whether they agreed with a statement that they had or had not had sexual intercourse "because of my values and beliefs"; and (b) to select from a list one or more specific reasons why they had or had not had intercourse. The girls were categorized by self-report as either "virgins," "currently inactive" (no intercourse in the preceding 3 months), or "currently active" (had intercourse during the preceding 3 months).
Usable surveys were obtained from 197 adolescents whose age (18.2 +/- 2.6 years) and race (69% black) were comparable to those of clinic attendees in general. Forty girls (20%; age 16.1 +/- 2.1 years) were virgins, 25 girls (13%; age 17.8 +/- 2.3 years) were inactive, and 132 girls (67%; age 18.9 +/- 2.5 years) were currently active. "Values and beliefs" were cited as the reason for decisions about sexual behavior by 53% of the virgins, but only by 24% of the sexually inactive and 24% of the sexually active girls (p = .002). Virgins were more likely than inactive girls to cite three specific reasons for not having sex: "not the right thing for me now" (82% vs. 50%, p = .007), "waiting until I am older" (69% vs. 8%, p = .001), and "waiting until I am married" (67% vs. 38%, p = .02). The reason "against my religious beliefs" was cited by 23% of virgins and 13% of inactive girls (p = not significant). Personal values were implicit in the two specific reasons for having sex that active girls chose most frequently, namely, "I like/love the person" (86%) and "I like having sex" (37%), although only 24% of these girls had explicitly cited "values and beliefs" as their reason for having sex.
Our data indicate that urban girls, both those who have had sexual intercourse and those who have not, view their sexual behavior as being based on personal (although infrequently religious) values. Many of the virginal urban, adolescent girls we surveyed hold abstinence as a personal value. The sexually active adolescents perceive the decision to have sexual intercourse as being based affirmatively on their personal values rather than on the chance occurrence of opportunities to have intercourse. These data may be useful in the development of new strategies for reducing urban adolescent girls' risk of acquiring sexually transmitted diseases.
To identify the most important antecedents associated with adolescent initiation of sex, contraceptive use, and pregnancy.
Statistically significant antecedents in more than 250 studies were identified and summarized.
More than 100 antecedents create a complex and detailed picture of the correlates of adolescent sexual behaviors. They describe characteristics of the adolescents themselves, their partners, peers, families, schools, and communities, as well as relationships to these entities. They included antecedents that were inherently sexual and nonsexual.
To reduce teen pregnancy substantially, multiple sexual and nonsexual antecedents in different clusters may need to be addressed.
Nurses may choose to promote sexual abstinence, particularly when they are working with young adolescents. However, it is difficult to know how to intervene because sexual abstinence has not been well defined in the literature. The purpose of this study was to evaluate the psychometrics of a four-item measure of sexual abstinence behavior (the SABS) that both registered nurses and advanced practice nurses may find useful in their practice.
African American, middle school students (n = 113) completed a self-administered questionnaire during their health education class. The questionnaire contained the SABS along with items assessing demographics, sexual behavior, and psychosocial variables related to sexual behavior.
Psychometric analysis supported SABS reliability (alpha =.73) and validity. For example, SABS scores correlated with perceived negative consequences of teen sex (r = 0.38) and sexual abstinence self-efficacy (r = 0.48).
Although the SABS is still in a preliminary stage of development, it is useful for assessment purposes and for directing registered nurses and advanced practice nurses toward specific behaviors they may want to promote when teaching sexual abstinence to their young adolescent patients.
To describe sexual abstinence from the perspective of abstinent African American female adolescents.
Descriptive qualitative.
Data were collected from 14 sexually abstinent, African American adolescent girls during two semi-structured interviews. Data were collected using the life history method and were analyzed in the style of narrative analysis.
This analysis indicated four themes in descriptions of abstinence: limited information, categorization of sexual behaviors, activities that lead to intercourse, and abstinence as a self-determined choice. For most participants, "having sex" referred to heterosexual vaginal intercourse and being abstinent meant that one chose to refrain from intercourse.
The participants' limited definition of abstinence might lead them to unknowingly put themselves at risk by engaging in other forms of genital sexual activities. They may think that they are protected because they believe that they are practicing abstinence.
To assess reasons for choosing not to have sexual intercourse among two groups: virgins (primary abstainers) and already sexually experienced youth (secondary abstainers).
73,464 Minnesota ninth- and twelfth-grade adolescents completed the 1998 Minnesota Student Survey. Respondents identified reasons for abstinence from a checklist from which they could nominate all relevant items. Reasons for each group were analyzed using Chi-square with a conservative criterion value (p <.001) owing to large sample size. Logistic regression was used to examine the associations of gender, grade, and their interactions, with reasons for abstinence.
Sixty-six percent reported never having had intercourse (primary abstainers). Among sexually experienced youth, 7.8% reported choosing not to have intercourse (secondary abstainers). Fear of pregnancy was the reason endorsed most often, more by girls than by boys (OR = 26 for primary abstainers, 6.9 for secondary abstainers). Fear of other adverse consequences, such as sexually transmitted infections, parental disapproval, or fear of getting caught, were generally selected by more girls than boys, and by more primary than secondary abstainers. Similarly, more girls and primary abstainers than boys or secondary abstainers generally selected statements reflecting normative beliefs on youth or their friends having intercourse.
Fear of adverse consequences and normative beliefs about the appropriateness of having sexual intercourse were most frequently endorsed as important reasons by both groups of abstainers.
Few rigorous evaluations have been conducted of locally designed, culturally consistent adolescent reproductive health programs.
A quasi-experimental research design was used to measure behavioral changes associated with a culturally consistent reproductive health program for young people in Kenya. Baseline and endline surveys were conducted in 1997 and 2001, respectively, in the project and control areas. Multivariate analysis was used to assess whether the project was associated with changes in young people's sexual initiation, safer-sex behavior and discussion of reproductive health issues with adults.
The 36-month project was associated with considerable changes in young people's sexual and reproductive health-related behavior, but behavior change differed by gender. Females in the project site were significantly more likely than those in the control site to adopt secondary abstinence (odds ratio, 3.3) and less likely to have had three or more sex partners (0.1). Males in the project site were more likely to use condoms than those in the control site (3.7). Both males and females in the project site were more likely to discuss sexual and reproductive health issues with a nonparent adult than were young people in the control site (1.9 and 5.5, respectively).
Interventions that adapt to indigenous traditions can be both acceptable to communities and associated with significant changes in young people's behavior.