“Sex is not something you do with someone you don't care about”: Adolescent girls' definitions of sex

Background: Adolescent research and clinical practice often presumes a common definition of sexual intercourse, yet little is known about how adolescent girls themselves define sex.

Methods: In pilot research to develop measures for a longitudinal condom effectiveness study, twenty-four heterosexual, sexually active (intercourse within past 3 months) adolescent girls aged 15-21 were recruited from an urban adolescent health clinic in the northeastern United States. Semi-structured interviews were conducted to elicit participants' definitions of sexual intercourse and their beliefs about when sex begins and ends. Thematic analysis was used to analyze interviews transcripts. Preliminary results (n=5) are included in this abstract; data analyses from the entire sample are in progress.

Results: Participants defined sexual intercourse as taking place in the context of relationships with strong emotional foundations. Many participants specified that intercourse without emotional connection did not fit their definition of sex. Participants had differing views about the inclusion of oral sex in their definition of sex. The beginning of sex was marked by arousal and the end of sex with feelings of satisfaction and female as well as male orgasm.

Conclusions: In this study, sexually active adolescent girls defined sex using relational and emotional terms, varied in their inclusion of oral sex, and associated the beginning and end of sex with their physiological and emotional states. Adolescent girls' definitions of sex have implications for sexual health, STI/HIV prevention including assessments and instructions for condom use and other safe sex practices.