The Social Context of Sexual Health and Sexual Risk for Urban Adolescent Girls in the United States

Abstract

Sexually transmitted infections including HIV and teenage pregnancy have resulted in considerable morbidity and mortality among girls in the United States. There is a need to further strengthen prevention efforts against these persistent epidemics. In order to promote girls' sexual health and most effectively reduce sexual risk, it is important to understand the social factors that influence the development of a girl's sexuality. The purpose of this study was to begin to fill a void in the literature by exploring girls' perspectives about the social context in which they learn about sex, sexuality, and relationships. Coding and content analysis was used to identify patterns and themes in 33 individual interviews with African American and Euro-American girls. Participants identified family, friends/peers, partners, school, and the media as the most common sources for learning about sexual health. Girls sought out different types of information from each source. Many girls experienced conflicting messages about their sexual health and struggled to integrate the disparate cultural references to sex, sexuality, and relationships that emerged from these different spheres of social life. Girls often had to navigate the journey of their sexual development with little room for reflection about their own thoughts, feelings, desires, and decisions. Health care providers, especially those in mental health, are in an optimal position to promote girls' physical, developmental, and emotional sexual health.