1. Early Adolescent African American Girls’ Views about Sex and Pregnancy Gwendolyn D. Childs, PhD, RN Reashanda White Connie Hataway, RN, MSN

2. Purpose To identify developmental and socio-contextual factors that influence the sexual decision-making processes of African American girls aged 12 to 14. Specifically, to explore perceptions about: – what parents tell them about sex – what age is old enough to have sex – their lives if they were to become pregnant as a teenager

3. Background 2011 Youth Risk Behavior Surveillance – Conducted 9/2010 – 12/2011 in 43 states 158 high schools 15,503 surveys included in analysis – African American females 7% had sex before age 13* 53.6% have ever had sex* 17.5% had 4 or more sexual partners* 36.9% had sex 3 months prior to survey* – 53.8% used a condom during last sex** CDC (2012). Morbidity and Mortality Weekly Report, 61(4), 1-162. *Higher than national average of 6.2% sex before 13; 47.4% ever had sex; 15.3% more than 4 sex partners; and 33.7% sex 3 months prior to survey. **Slightly lower than national average of 60.2% condom use during last sex.

4. 2010 National STD Surveillance - Chlamydia: Adolescents 15 – 19 years CDC (2011). STD surveillance 2010. Retrieved from http://www.cdc.gov/std/stats.

5. 2010 National STD Surveillance - Gonorrhea: Adolescents 15 – 19 yrs CDC (2011). STD surveillance 2010. Retrieved from http://www.cdc.gov/std/stats.

6. 2010 National STD Surveillance - Syphilis: Adolescents 15 – 19 yrs CDC (2011). STD surveillance 2010. Retrieved from http://www.cdc.gov/std/stats.

7. Methodology Descriptive qualitative study 64 participants recruited from communities in and around Jefferson County, Alabama Participated in: – Individual interviews (n = 36) – Focus groups (n = 28)

8. Findings Mean age of study sample: 13 Sexually active: 7.8% (n = 5) Sexual Activity # ParticipantsMean Age at Debut Consistent Condom Use Oral1140 Anal1130 Vaginal51360% (n = 3) *Some participants engaged in more than 1 type of sexual activity. *All sexually active participants reported 1 to 2 sexual partners during past 12 months.

9. Theme: The ‘Big Talk’ “I’m 13 and some 13 year olds do stuff like that [have sex] but I’m not really into that. So we really don’t talk about that a lot. I mean of course she [mom] encourage me, you know I’m way too young to do that. I don’t need to talk to her about it because I’m not really worried about that.” “I talked to my mama. My cousin had called my grandmamma and saying she had started her period, whatever, and we talked about that. And we talked about my sister planning on having an abortion, and that’s all we have ever talked about.”

10. Theme: The ‘Big Talk’ “I shouldn’t do it [have sex] ‘til I’m married and stuff like that.” “They [parents] told me if I ever decided to have sex, be safe, use a condom and they tell me if I did start having sex come and talk to them about it.” “They [parents] told me like I should wait because like if I don’t, I might end up doing something wrong, have a STD, or end up getting pregnant.”

11. Theme: Waiting Until Older “’Cause you still in high school. What’s the point of you doing that [having sex] if you are in high school, and you still got to go to college and get a job, then find a house? And then you got to do all that stuff and then plus raise a child.” “[after graduation] because then it won’t distract you from your work.”

12. Theme: Waiting Until Older “Because like, I want to wait until it’s the right time, when I find the right person, and when I like get ready to be, yeah, I’m gonna, I think 26.” “When you are grow you are old enough to take care of yourself without your parents looking out for you when you get the disease from someone that you had sex with.” “Probably about 16, 17, 18. Because I feel like people that age know what to do…maybe 16.”

13. Theme: Impact of Pregnancy “They’d [parents/family] be angry, like after all we talked to you and told you about this you did it anyway and now you’re with a child that you can’t take care of and you’re like so young and now your life is just messed up.” “I’d be embarrassed to go back to school because I’d feel like everything that I worked hard for just got shattered.”

14. Theme: Impact of Pregnancy “I know like you wouldn’t be able to go to school ‘cause I know that babies cry a lot and you would have to get up in the middle of the night and try to calm them down and then you would not have enough rest for the next day at school.” “I wouldn’t be able to finish college and I wouldn’t be able to finish high school.” “I’d have more responsibilities. I’d have to think about the baby instead of just me and I can’t hang around as much as I’m used to and stuff like that.”

15. Conclusions Limited or superficial conversations with parents about sex and the associated consequences Rationale for waiting until older to have sex centered around concerns about taking care of a baby and dealing with having an STD Majority considered 16 old enough to have sex Becoming pregnant would have negative effects on family and future aspirations

16. Recommendations for Research Identify strategies to promote parent-child sexual communication Explore perceptions of “old enough” to have sex Explore the relationship between perceived negative impact of pregnancy and sexual practices

17. Acknowledgement This project is supported by Award Number K01NR011277 from the National Institute of Nursing Research (NINR). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NINR or the National Institutes of Health.

18. References Centers for Disease Control and Prevention. (2011). Sexually transmitted disease surveillance 2010. Atlanta: U. S.: Department of Health and Human Services. Retrieved from http://www.cdc.gov/std/stats. Centers for Disease Control and Prevention. (2012). Youth risk behavior surveillance - United States, 2011. Morbidity and Mortality Weekly Report, 61(4), 1-162.

19. Q & A

20. Contact Information Gwendolyn D. Childs, PhD, RN University of Alabama at Birmingham School of Nursing gchilds@uab.edu