Objective: To describe aspects of the social context that low-income, urban African American young women articulate as having influenced social messages they received during adolescence about pregnancy timing and childbearing. Methods: Individual interviews were conducted with 20 African American young women ages 18-22. Results: Findings clustered into 5 themes: first sex; getting ready and getting it over with; the path for African American girls; gender expectations: insecurity and independence; living into a future; and living in a context of instability and uncertainty. Conclusions: Findings portray a complex relationship between social context, social messages, and decisions about pregnancy timing and childbearing.

While it is recommended that adolescent health providers routinely screen for sexual risk behaviors, great variability exists in providers’ actual screening practices. The development of a brief, reliable set of sexual risk screening questions may provide a useful prompt to providers in consistently screening adolescent patients for sexual risk behaviors. Our study purpose was to examine the ability of a brief set of screening questions to predict sexual risk behaviors among participants in Prime Time, a pilot intervention study aimed at reducing sexual risk behaviors among sexually active adolescent girls at high risk for teen pregnancy. As a first step in determining eligibility for the Prime Time study, 13 to 17 year-old girls seeking services at three clinics completed an 8-item Prime Time Health Screening Survey (HSS). An elevated HSS score (≥ 3) was one of four inclusion criteria for the Prime Time study. Girls meeting any study inclusion criterion were invited to participate in Prime Time; those agreeing to participate returned 1-2 weeks later to complete a baseline study survey. Prime Time HSS and baseline survey data were collected between September 1999 and December 2002. The sample for the current study includes 103 Prime Time participants with HSS scores≥ 3. Analyses examined relationships between total HSS scores, individual HSS items and five sexual risk behaviors assessed as part of the Prime Time baseline survey. Higher HSS scores predicted lower levels of refusing unprotected sex and lower levels of condom use in the last 6 months (p<0.05 and p<0.01, respectively). Examining relationships between individual HSS items and baseline sexual risk behaviors, we found that a combination of two HSS items predicted all five sexual risk behaviors assessed by this study. A pattern of endorsing screening items indicating 3 or more sexual partners in the last six months and use of birth control or condoms≤ ½ the time in the last six months was significantly associated with lower levels of refusing unprotected sex, less consistent use of condoms and hormonal methods in the last six months, less consistent dual method contraceptive use with the most recent sexual partner, and increased numbers of sexual partners in the last six months. Findings indicate that several items within a brief screening survey predict multiple sexual risk behaviors. These screening questions provide a template that can be used to routinely screen sexually active adolescent girls for sexual risk.

While a body of empirical literature describes relationships between teens' contraceptive use behaviors and individual-level characteristics, relatively few studies have examined influences of sexual partners on adolescent contraceptive use. This is a critical gap, given that contraceptive use occurs in the context of a relationship between two people. The purpose of this study is to examine sexual partner, sexual relationship and individual-level influences on contraceptive use consistency among sexually active adolescent girls at high risk for pregnancy and sexually transmitted infections. Data for this study are from 13-17 year old participants in Prime Time, a clinic-based intervention study aiming to reduce sexual risk behaviors and improve condom and contraceptive use among teen girls at high risk for pregnancy. The Prime Time intervention included 18 months of case management and a 16-week peer leadership program. 111 non-pregnant Prime Time participants completing study surveys at baseline (T1) and 12 months (T2) comprise the sample for this study (T1 data collected 9/99-12/02, T2 data collected 9/00 –1/04). Contraceptive outcomes, measured at T2, included consistency of condom use, consistency of hormonal method use, and consistency of any birth control method use; outcomes were reported using 6-month contraceptive calendars. Predictor variables assessing individual characteristics at T1 were girls' attitudes about pregnancy and birth control, perceived benefits of birth control, and number of male sex partners in the past 6 months. Predictor variables assessing partner and relationship characteristics at T2 were having the same sex partner at T1 and T2, age difference between partners, communication with partner about sexual risk, and perceived partner attitude about birth control. Multivariate regression models predicting contraceptive consistency outcomes controlled for participant age, race, emergency contraceptive use history, and Prime Time study condition. In multivariate analyses, consistency of hormonal method use at T2 was significantly predicted by consistent hormonal use at T1, participants' positive attitudes about birth control, perceived partner attitude supporting birth control use, and having the same sex partner at T1 and T2. Consistency of using any birth control method at T2 was significantly predicted by participants' desire to avoid pregnancy, perceived partner attitude supporting birth control use, and minimal age differences between partners. In multivariate analyses, none of the individual, partner or relationship variable examined in this study predicted consistency of condom use at T2. This study underscores the importance of considering individual, partner and relationship characteristics in predicting contraceptive consistency. To promote consistent contraceptive use among sexually active adolescent girls, providers must find ways to address partner attitudes and relationship characteristics, as well as the beliefs and practices of individual girls.

This study examines two issues relevant to adolescents’ self‐reported sexual and contraceptive use behaviors: reliability of partner‐referent reports versus 3‐ and 6‐month reports, and test‐retest reliability of reports completed over a 2‐week period. Data are from 196 13‐ to 18‐year‐old girls recruited into this study while they sought reproductive care from health clinics in a metropolitan area. All participants reported having had sexual intercourse during the past 6 months. Twice over a 2‐week interval, participants completed the same paper‐and‐pencil surveys. The survey presented questions about sexual behavior and contraceptive use using 3 sequential frames of reference: within the past 6 months, within the past 3 months, and by specific sexual partners in the past 6 months. Findings demonstrate that adolescent girls can reliably report sexual behavior and contraceptive use over a 6‐month interval. Study findings have implications for future research utilizing adolescents’ self‐reported sexual and contraceptive use behaviors.

To inductively understand recurring themes in case mentoring (CM) relationships with high-risk sexually active girls. Mentoring is characterized by the belief that youth are more likely to successfully negotiate adolescence if caring, concerned adults are available to them. This qualitative descriptive study examines 18-month summary evaluation notes from the one-on-one CM component of a comprehensive pregnancy prevention intervention.

Purpose: To develop, implement and evaluate a youth development intervention, Prime Time (PT), to improve contraceptive use, reduce number of sexual partners and decrease unwanted sexual activity among adolescent girls seeking clinic services who are at high risk for pregnancy and other negative sexual health outcomes.

PURPOSE:To better understand maternal influence on the timing of first sex for adolescents.METHODS:Using data from the National Longitudinal Study of Adolescent Health, Cox proportional hazard models were used to assess the association between maternal characteristics and the timing of first sex. Matched dyads of mothers and their adolescent children were used.RESULTS:Of the 2,006 adolescents aged 14 and 15 years who reported to be virgins, 95 males (10.8%) and 162 females (15.8%) indicated they had initiated sex within the follow-up period, 1 year later. For males, few variables beyond the controls used in the models were predictive of timing of first sexual intercourse. For females, mother's satisfaction with her relationship with her daughter (hazard ratio =.62), mother's strong disapproval of her daughter having sex (hazard ratio =.56), and frequency of communication with the parents of her daughter's friends were associated with later sexual debut (hazard ratio =.88).CONCLUSION:Based on the variables in the model, mothers' values and beliefs and relationship satisfaction have more influence on daughters than on sons.

Objective: To identify important cognitive and behavioral predictors of sexually transmitted disease (STD) risk behavior among a sexually active adolescent cohort.Design: One-year longitudinal. study of health beliefs, sexual behaviors, and STD acquisition among 549 adolescents, 14 to 21 years of age.Setting: School- and community-based health clinics in a large metropolitan area.Participants: Data from 410 sexually active adolescents completing surveys at baseline and 1-year follow-up.Interventions: None.Main Outcome Measurer Sexually transmitted disease risk behavior-a composite measure of condom use consistency with most recent sexual partner(s), number of vaginal sex partners, and frequency of intercourse with most recent sexual partner(s).Results: For girls (n=335), a model including baseline STD risk behavior, condom use self-efficacy, oral contraceptive use, communication with sexual partners about STD prevention, and alcohol use in connection with sexual activity explained 21.1% of the variance in STD risk behavior at 1-year follow-up. For boys (n=75), the strongest predictors of STD risk behavior at follow-up included baseline STD risk behavior, perceived susceptibility to STD, condom use self-efficacy, negative outcome expectations associated with condom use, and perceived barriers to STD prevention.Conclusions: Efforts targeting reduction in STD risk behavior must begin before the onset of somewhat stable patterns of sexual risk behavior. Among adolescents who are sexually active, interventions should include components that increase condom use self-efficacy, build skills to communicate with sexual partners about STD prevention, and address behaviors associated with STD risk behavior including oral contraceptive use.