Unwanted sex appears common in some teen relationships

June 05, 2006

Many adolescent girls report being threatened or pressured by their partners into having sex, potentially increasing their risk for sexually transmitted infections and pregnancies, according to an article in the June issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.

Unwanted sex in the form of coercion and rape can harm mental and physical health and has been linked to depression, anxiety disorders, unplanned pregnancy and sexually transmitted infections (STIs), according to background information in the article. This type of sexual pressure or force can occur in a wide range of relationships, from those in which partners have just met to long-term partnerships.

Margaret J. Blythe, M.D., and colleagues at Indiana University Medical Center, Indianapolis, conducted two to 10 interviews with 279 female adolescents (average age 15.9 years, range 14 to 17 years; 88.5 percent African-American) over the course of 27 months. At each interview, the participants were tested for STIs and asked a series of questions about their sexual relationships. They identified each partner with whom they had had sexual contact since the last interview and provided details about the relationship, including duration, quality and feelings of control. They also responded to four questions that related to unwanted sex in the relationship, such as "Would he break up with you unless you wanted to have sex?" and "Would he get mad if you didn't want to have sex?"

Among all the participants, 40.9 percent reported unwanted sex at least once, with about 10 percent reporting that they had been forced to have sex. Most, 37.6 percent, had unwanted sex because they feared the partner would get angry if denied sex. Unwanted sex appeared more likely to occur in longer-term relationships, among partners who had a baby together, when a female perceived less sexual control with a partner, when condoms were not frequently used and when alcohol or marijuana were used by either partner. "The data cannot be used to assess causal associations of unwanted sex; rather, they point to the complex interpersonal and behavioral contexts that may link unwanted sex to other health risks," the authors write.

"Unwanted sex occurs often within the sexual relationships of teens," they conclude. "These unwanted sexual experiences result in risk for sexually transmitted infections and pregnancies. Sexual health counseling to reduce risk should focus on both the patient's and the partner's behaviors."
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(Arch Pediatr Adolesc Med. 2006;160:591-595. Available pre-embargo to the media at www.jamamedia.org.)

Editor's Note: This research was supported by a grant from the National Institute of Allergy and Infectious Diseases and a grant from the National Institute of Child Health and Human Development.

The JAMA Network Journals

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