title: Variation in sexual behaviors in a cohort of adolescent females: the role of personal, perceived peer, and perceived family attitudes.
abstract: OBJECTIVE
  Little is known about how adolescent sexual behaviors develop and the influence of personal or perceived social attitudes. We sought to describe how personal, perceived peer, and perceived family attitudes toward adolescent sexual activity influence sexual behaviors of adolescent females' over time.
  
  
  METHODS
  Between the years of 1999 and 2006, 358 English-speaking female adolescents, aged 14-17 years, were recruited from three urban adolescent clinics. Participants completed quarterly and annual questionnaires over a span of 4 years. Primary outcomes included engagement in any of the following eight sexual behaviors: kissing, having breasts touched, having genitals touched, touching partners' genitals, oral giving, oral receiving, anal, or vaginal sex. Three attitudinal scales assessed personal importance of abstinence, perceived peer beliefs about when to have sex, and perceived family beliefs that adolescent sex is negative. We used generalized estimating equations to identify predictors of each sexual behavior and compared whether personal, perceived peer, or perceived family attitudes predicted sexual behaviors over time.
  
  
  RESULTS
  The odds of reporting each sexual behavior increased with age but were lower among those whose personal or perceived family attitudes were less positive. Participants' personal attitudes toward adolescent sex were the strongest predictor of engagement in all eight sexual behaviors even after controlling for perceived peer and perceived family attitudes.
  
  
  CONCLUSIONS
  Female adolescent's personal attitudes toward abstinence appear to be the strongest predictor of engagement in a variety of sexual behaviors. Efforts to influence adolescent attitudes toward abstinence may be an important approach to reducing sexual behaviors that increase the risk of pregnancy and sexually transmitted infections.
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh, 300 Halket Street, Pittsburgh, PA 15213, USA. aakers@mail.magee.edu
authors.forename: Aletha Y
authors.initials: AY
authors.lastname: Akers
authors.forename: Melanie A
authors.initials: MA
authors.lastname: Gold
authors.forename: James E
authors.initials: JE
authors.lastname: Bost
authors.forename: Ada A
authors.initials: AA
authors.lastname: Adimora
authors.forename: Donald P
authors.initials: DP
authors.lastname: Orr
authors.forename: J Dennis
authors.initials: JD
authors.lastname: Fortenberry
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D001294:Attitude to Health; D015331:Cohort Studies; D003075:Coitus / Q000523:psychology; D005195:Family Relations; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008137:Longitudinal Studies; D010379:Peer Group; D012736:Sex Education / Q000458:organization & administration; D012746:Sexual Abstinence / Q000523:psychology* / Q000706:statistics & numerical data; D012725:Sexual Behavior / Q000523:psychology* / Q000706:statistics & numerical data; D012747:Sexual Partners / Q000523:psychology; D012945:Social Values; D013334:Students / Q000523:psychology; D014481:United States / Q000453:epidemiology; D014505:Urban Population / Q000706:statistics & numerical data; D016387:Women's Health