Differences by Gender and Sexual Experience in Adolescent Sexual Behavior: Implications for Education and HIV Prevention

Article excerpt

The prevalence of sexual activity, pregnancy, and STDs among US adolescents has caused some alarm. Researchers have described outcomes associated with adolescent sexual behavior in terms varying from "a public problem[1]" to a "near epidemic.[2]" Fear, anxiety, and concern over the life-altering nature of HIV and AIDS also prompted much research on adolescent sexual behavior and contraception use because, according to the Centers for Disease Control and Prevention (CDC), one in five AIDS cases in the United States is diagnosed in the 20-29 year-old age group[3] and most of these are likely to have resulted from HIV infections acquired up to 10 years earlier.

In response, many AIDS education programs were instituted in US schools. Although researchers have identified characteristics of effective programs (see Kirby et al[4] for a review), two important variables typically included in research and found to be related to adolescent sexuality[5-8] have not been considered when designing these programs: gender and sexual experience of adolescents. Because a relationship exists, these variables should be considered when studying the factors influencing adolescent sexuality and implementing adolescent sexuality education programs. This paper focuses on four factors -- intentions to engage in sexual behavior, intentions to use condoms, perceptions of peers' sexual activity, and peer pressure -- that have been shown empirically to influence adolescents' sexual behavior, and discusses differences in these factors by gender and level of sexual experience.

BACKGROUND

Intentions, Pressure, and Perceptions

Much of the research investigating ways to prevent unwanted consequences of sexual behavior among adolescents has focused on the identification of factors influencing adolescents' sexual behavior (ie, sexual intercourse and contraception use). Empirical evidence suggests that intentions to engage in sexual behaviors are related to actually engaging in these behaviors,[9-12] and that perceptions of peers' sexual behavior influence adolescents' decisions to engage in sexual behavior[13-15] more strongly than peers' actual behavior.[16] Though the argument that an individual's sexual behavior changes as a result of peer pressure has received relatively weak empirical support,[17] adolescents do report experiencing peer pressure to engage in sexual activity,[5, 18] and the extent and impact of this pressure seems to vary by age and gender.[13] This evidence underscores the need to consider these four variables when studying adolescent sexuality and when subsequently designing sexuality education programs.

Differences by Gender

Gender is consistently related to intentions to engage in sexual activity and use contraception, perceptions of peers' sexual activity, and peer pressure. One study found more frequent condom use among males than females ages 12, 13, and 17.[19] Others found that females were less likely than males to follow through on intentions to consistently use condoms,[12] and that males had more positive intentions to use condoms with steady partners, though not with casual partners.[20] National survey data suggested that, while the proportions of boys and girls engaging in sexual activity were similar, age of initiation was earlier for males than females.[7] In addition, males were more likely to intend to have sex before finishing high school[6] or getting married[5] than were females. Males also anticipated more partner pressure for sex than did females.[5] Females have been found to be more likely than males to perceive that a larger proportion of their peers were engaging in sex and using birth controls and to perceive less peer pressure for sex and more support for waiting than did males.[5] Though evidence suggests important gender differences in these variables, gender is seldom taken into account in sexuality education or AIDS prevention programs aimed at youth. …