Prevalence and Psychosocial Correlates of Forced Sexual Intercourse among U.S. High School Adolescents

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Sexual violence, in its myriad forms, is recognized as an important public health problem for adolescents, especially girls (Howard & Wang, 2005; Irwin & Rickert, 2005; Raghavan, Bogart, Elliott, Vestal, & Schuster, 2004; Champion, Foley, DuRant, Hensberry, Altman, & Wolfson, 2004). Yet, the nature and full extent of their victimization remains unclear. While it has been argued that sexual violence unfolds along a continuum from minor physical or psychological acts to homicidal rape (Prospero, 2006; Jezl, Molidor, & Wright, 1996; Hickman, Jaycox, & Aronoff, 2004; Reiss & Roth, 1993), the sundry questions which gauge "coercive" "unwanted," or "forced" sexual experiences continues to add to the ambiguity, particularly when these terms are not accompanied by explicit language as to their behavior referents (CDC, 2001; Koss, 1985; Erickson & Rapkin, 1991; Sawyer, Howard, Brewster, Gavin, & Sherman, 2006; Raghavan et al., 2004). Furthermore, there is strong indication that its prevalence are underestimations of the actual extent of sexual violence, due to a number of methodological issues associated with sampling and measurement, such the self-report nature of much of the data and confidentiality issues (Kreiter, Krowchuk, Woods, Sinal, Lawless, & DuRant, 1999; Brener, Kann, McManus, Kinchen, Sundberg, & Ross, 2002). On a national level, information on forced sexual intercourse has been gathered by the National Longitudinal Study of Adolescent Health (Add Health) beginning in 1995 (Upchurch & Kusunoki, 2004) and by the Center for Disease Controls, Youth Risk Behavior Survey (YRBS) since 1999 (YRBS, 2006). These surveys, while not the only studies of sexual violence, provide the most representative data on victimization experiences among U.S. high school students.

Across a host of studies on sexual dating violence, adolescent female victimization rates reportedly range from 7-18% (Howard & Wang, 2005; Foshee, Benefield, Ennett, Bauman, & Suchindran, 2004; Raghavan et al., 2004; Silverman, Raj, Mucci, & Hathaway, 2001). While it appears that girls are more likely to be victims of sexual victimization (Foster, Hagan, & Brooks-Gunn, 2004; Foshee et al., 2004; Hickman, Jaycox, & Aronoff, 2004; Bennett & Fineran, 1998), adolescent boys do report sexual violence as well (Howard & Wang, 2005; Foshee, 1996; Bergman, 1992), estimates range from 5-14% (Howard, Wang, 2005; Coker, McKeown, Sanderson, Davis, Valois, & Huebner, 2000; Shrier, Pierce, Emans, & Durant, 1998). Indeed, data from the 2001 national YRBS indicated that female adolescents were twice as likely as males to report a history of forced sexual intercourse (lifetime prevalence of 10.2% and 5.1%, respectively), with higher prevalence among ethnic groups, compared to Whites (Howard & Wang, 2005). It has been suggested that boys, in particular, may be less inclined to report interactions as constituting sexual violence, and thus these figures may represent an underestimation of their experiences (Hyman, 1999; Wekerle & Wolfe, 1999).

Based on the national 1999 YRBS, associations between forced sexual intercourse and emotional states (sad/hopeless feelings and considered suicide), fighting, physical dating violence, heavy cigarette use, sexual risk behavior (unprotected sex, multiple partners, alcohol or drug use before sex) were found for both males and females (Howard, Wang, 2005). Important gender differences in the risk correlates emerged as well. Among females, having considered suicide, fighting, heavy cigarette smoking, and use of alcohol or drugs before sex were associated with forced sexual experiences. In contrast, among males, attempted suicide and gun carrying were important correlates. Ethnic males were also more likely than their White peers to have experienced forced sex.

From the Add Health wave 1 data (April-December 1995), forced sexual intercourse among adolescent girls was associated with having been in a recent romantic relationship, past-year exposure to violence, alcohol or marijuana use, and increased levels of emotional distress (Raghavan et al. …


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