title: Psychosocial and behavioral correlates of refusing unwanted sex among African-American adolescent females.
abstract: OBJECTIVE
  To identify psychosocial and behavioral correlates of refusing unwanted sex among African-American female adolescents. We hypothesized that greater power in relationships, less concern about negative emotional consequences, supportive family and peers, positive self-perceptions, greater perceived risk, and fewer sexual risk behaviors would be associated with increased odds of refusing unwanted sex.
  
  
  METHODS
  Data regarding demographics, sexual behaviors, communication with parents, and psychosocial factors relevant to romantic and sexual partnerships were collected both via self-administered questionnaire and structured interview from a clinic- and school-based sample of 522 African-American adolescent females ages 14-18 years in Birmingham, Alabama. Adjusted odds ratios were calculated using logistic regression.
  
  
  RESULTS
  Of those who had experienced pressure for unwanted sex (n = 366), 69% consistently refused to engage in unwanted sex. Adolescents with high safer sex self-efficacy and low perceived partner-related barriers (i.e., concerns about partners' negative emotional reactions) to condom negotiation were over 2.5 times more likely to consistently refuse unwanted sex than were those reporting low safer sex self-efficacy and high partner-related barriers. Adolescents who spoke more frequently with their parents about sexual issues were nearly twice as likely to consistently refuse unwanted sex than were those who spoke less frequently with their parents.
  
  
  CONCLUSIONS
  Sexual-risk reduction efforts directed toward adolescent females should seek to build self-efficacy to negotiate safer sex and provide training in social competency skills that may help to reduce or eliminate partner barriers to condom use. Further, sexual risk-reduction programs may be more effective if they include parents as advocates of safer sexual behaviors.
authors.affiliation: Division of STD Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30333, USA. CSionean@cdc.gov
authors.forename: Catlainn
authors.initials: C
authors.lastname: Sionéan
authors.forename: Ralph J
authors.initials: RJ
authors.lastname: DiClemente
authors.forename: Gina M
authors.initials: GM
authors.lastname: Wingood
authors.forename: Richard
authors.initials: R
authors.lastname: Crosby
authors.forename: Brenda K
authors.initials: BK
authors.lastname: Cobb
authors.forename: Kathy
authors.initials: K
authors.lastname: Harrington
authors.forename: Susan L
authors.initials: SL
authors.lastname: Davies
authors.forename: Edward W
authors.initials: EW
authors.lastname: Hook
authors.forename: M Kim
authors.initials: MK
authors.lastname: Oh
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000208:ethnology*; D001741:Black or African American / Q000523:psychology*; D017280:Condoms / Q000706:statistics & numerical data; D005190:Family; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D007407:Interviews as Topic; D010379:Peer Group; D021841:Safe Sex / Q000208:ethnology / Q000706:statistics & numerical data; D020377:Self Efficacy; D012725:Sexual Behavior / Q000208:ethnology* / Q000523:psychology