Rural Adolescents’ Perspectives on Contextual Influences of Sexual Risk Behavior

Comfort Enah, Dr. David E. Vance, Linda Moneyham


Persistent health disparities in HIV on racial and ethnic minorities are evident in recent national reports of HIV rates. Furthermore, high rates of other sexually transmitted infections among minority adolescents point to the need for risk reduction interventions. Research in disproportionately affected rural communities in the Southern United States suggests that sexual risk reduction interventions targeting these communities should address contextual factors that perpetuate health disparities. In this article, we report findings on a formative study that was conducted to identify rural adolescent perspectives on sociocontextual influences on sexual risk behaviors. Thirty eight rural adolescents ages 12-16 participated in initial and follow-up focus group sessions that were segmented by age group (12-14, 14-16) and gender (male, female). A comprehensive theoretical model addressing the complex interplay of multi-level factors associated with risk behavior guided the study. Qualitative content analyses were used to analyze transcribed audiotapes of focus group sessions and observation notes. Emergent themes supported the theoretical model and revealed modifiable contextual and decision-making factors; and related consequences that can be used in risk reduction interventions. Collaborating with target population provided relevant input for a user-centric approach to intervention development aimed at reducing sexual risk behaviors.


adolescent sexual health, sexual risks, HIV prevention, rural south, health disparities

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