Sexual Behavior and Prioritizing Sexual Health Among Inner-City Adolescents in a Small Urban Setting

Background: Adolescents may tune-out sexual health messages that are perceived as not relevant.  Little research has been conducted to identify which adolescents prioritize sexual health.

Objectives: To determine whether sexually active adolescents are those who prioritize sexual health, and to identify predictors of prioritizing sexual health among adolescents by sexual activity status.

Methods: Interviews were conducted with 432 participants aged 14-18 of a summer employment program in Albany, NY.  Participants were asked about demographics, behaviors, and social environment, and to choose the two most important health topics for themselves from a list of five.  Bivariate analysis and predictive modeling were performed to identify predictors of prioritizing sexual health (pregnancy/STDs/HIV), stratified by self-report of ever having sex.

Results: Almost half (43.4%) reported sexual activity.  Sexual health was the most prioritized health topic (66.0%); 71.6% among sexually active vs. 61.8% among non-sexually active participants (p=0.04).  Final predictors for sexually active teens included not being close to their mother (PR = 1.23, 95% CI = 1.03, 1.46); and number of partners (PR = 1.55, 95% CI = 1.15, 2.07 for 2-5 vs. 1, and PR = 2.39, 95% CI = 1.33, 4.30 for 6+ vs. 1).  The final predictor for non-sexually active participants was minority race (PR = 1.47, 95% CI = 1.06, 2.07).

Conclusions: Prioritizing sexual health was more common among sexually active vs. non-sexually active adolescents; however, it was highly prioritized by both.  Prioritization was related to behavioral risk and home environment among sexually active teens, and socio-demographics among non-sexually active teens.

Implications for Programs, Policy, and/or Research: In a small urban setting with high STDs and teen pregnancy rates, the majority of teens prioritized sexual health, regardless of sexual activity.  Incorporating both behavioral risks and perceived importance when developing sexual education programs is imperative to obtain buy-in from adolescents.