A Theory-Based Review of African-American Adolescents' Sexual Attitudes and Behaviors

Background: The U. S. has had the highest rates of STIs in the industrialized world for almost a decade. American adolescents are plagued by harmful effects of risky sexual behavior as the prevalence of most STIs peaks during adolescence. African-American adolescents report earlier ages of sexual initiation than others, which place them at an increased risk of negative health outcomes. Purpose: The purpose of this paper was to apply the Theory of Reasoned Action (TRA) to the sexual attitudes, beliefs, and intentions of early African-American adolescents. Methods: A comprehensive literature review was conducted using Medline, Pubmed and Google Scholar. Study inclusion criteria were utilization of the TRA or the theory's constructs and if sexual behavior or a related outcome was addressed among the adolescent population. Results: Studies describe the problems associated with early sexual initiation among African- American adolescents as costly. Most studies focused on the influence of sociodemographic and family factors which resulted in deficient knowledge concerning the more proximal factors that influence adolescents' sexual decision making. Discussion/Implications: The TRA can be used to predict and explain adolescents' sexual behaviors. Research supports use of the TRA in predicting distinct adolescent behaviors including sexual attitudes, beliefs, and intentions. Adolescent sexual behaviors are influenced by social norms and attitudes toward the behavior. Using this model to understand and predict adolescents who are at greatest risk for early sexual initiation is a strategy for targeting at-risk adolescents. This model provides promise for designing and implementing programs tailored to early, at-risk adolescent populations.