Adolescents are at high risk for a number of negative health consequences associated with early and unsafe sexual activity, such as infection with HIV and other sexually transmitted diseases, as well as unintended pregnancy. In the present study, a multisystem model was applied to one adolescent sexual behavior, penile-vaginal intercourse. Nine hundred seven Black and Hispanic adolescents (aged 14 to 17 years) and their mothers were interviewed. Factors from three systems (self, family, and extrafamilial) that are influential in the lives of adolescents were evaluated using four outcome measures. Factors from most or all systems emerged as predictors of each outcome measure. A cumulative risk index suggested a linear relationship between the number of systems identified as being at risk and indicators of adolescent sexual behavior. The implications for prevention are discussed.
According to Youth Risk Behavior Survey data, over one-half of high school students engage in sexual intercourse prior to graduation (Kann et al., 1995). Estimates appear to be higher for males, minority adolescents, and adolescents of lower socioeconomic status (Kann et al., 1995). Considering the high rate of sexual activity among adolescents, it is alarming that many engage in behaviors that are considered risky or unsafe, exposing them to possible infection with the human immunodeficiency virus (HIV) and other sexually transmitted diseases (e.g., syphilis, chlamydia), as well as unintended pregnancy (see Aggleton, 1995; Centers for Disease Control, 1997; Kegeles, Adler, & Irwin, 1989; Kirby et al., 1994). Of serious concern is the finding that only a small proportion (i.e., approximately 10-20%) of sexually active adolescents use condoms consistently (Kann et al., 1995). The consistent use of condoms appears to be lower for minority adolescents than for Caucasian adolescents (Brown, DiClemente, & Park, 1 992). Furthermore, adolescents tend to engage in sexual activities in the context of serial relationships that are of short duration, and having multiple partners increases the risk of experiencing the negative consequences associated with sexual behavior (Overby & Kegeles, 1994).
Research on the psychosocial context of sexual initiation and sexual risk-taking behavior has increased (e.g., Devine, Long, & Forehand, 1993); unfortunately, however, assessment of adolescent sexual activity has frequently been limited to one dichotomous variable, such as sexually active versus not sexually active. Furthermore, a multisystem approach has rarely been taken. Yet, accurate and comprehensive understanding of adolescent sexuality must include knowledge of both the personal and environmental factors that contribute to the decision to become sexually active and, subsequently, the decision to engage in risk-promoting or risk-reducing behaviors. Thus, a wide-sweeping multisystem perspective affords intervention specialists, health agencies, educators, and parents the best opportunity to help adolescents avoid the negative health consequences of sexual risk taking.
In a study employing a multisystem approach, Small and Luster (1994) examined variables from three systems--individual, familial, and extrafamilial--in a predominantly non-Hispanic Caucasian and Hispanic sample of seventh, ninth, and eleventh graders. One or more factors from each system contributed to the prediction of whether or not adolescents had experienced sexual intercourse, suggesting that engagement in intercourse is influenced by multiple risk factors from the multiple systems that impinge upon adolescents' lives. However, as only one aspect of adolescent sexual behavior was examined, namely the decision to engage in sexual intercourse, the implications of the findings for understanding the complex nature of adolescent sexual risk taking are limited.
A study by Resnick et al. (1997) examined the influence of individual, family, and school variables on age at first sexual intercourse. …