Sexual Scripting as a Tool for Understanding Unintended Pregnancy and STI

Recent interest in romantic love and sexual desire as the social and emotional context of sexual behavior has entered the public health discourse on prevention of STIs and unintended pregnancy. We use scripting theory to understand the meaning-centered and context dependent sexual behavior of African American and Puerto Rican inner city emerging adults (18-25). Multiple sexual scripts emerged from analysis of qualitative and quantitative data from 1,030 participants in a CDC-funded study in two northeastern cities. We present a primary script developed in the context of a disadvantaged environment where sexual debut is early, multiple partners are common, relationships are not permanent, and life affords little security. This script dictates that young people use condoms in casual relationships unless impaired by drugs or alcohol, but once they fall in love, they stop condom use and understand that pregnancy and childbearing are part of the package unless someone expresses strong verbal opposition. The script normalizes partner trust (no condoms), pregnancy that presents itself as a normal life event, and sexual behavior that is often negotiated behaviorally in real time rather than planned. It undermines prevention of STI infection (multiple partners) and unintended pregnancy (pregnancies are planned only be a few). A different sexual script guides most prevention strategies (i.e., protected sex with casual partners, mutually monogamous sex within a committed relationship, childbearing preferably within marriage). Scripting theory is a powerful tool for understanding seemingly irrational sexual behavior among different cultures or subgroups that can lead to more culturally competent intervention strategies.