Applying Ecological Perspectives to Adolescent Sexual Health: Rhetoric or Reality

This study sought to determine the perspective taken toward understanding adolescent sexual behaviors that put one at risk for HIV/STIs. We content analyzed 324 abstracts representing observational research published between January 1990 and December 2007 for inclusion of ecological factors, level of analysis, sample composition and type of behavioral and biological outcomes (i.e., sexually transmitted diseases, pregnancy). A majority (95%) of studies included individual characteristics; half were void of any environmental factors. Of those including environmental factors, 27% included familial, 23% community, 13% relational and 3% societal factors. Most (80%) were positioned at the individual level of analysis. Samples were diverse (43%) and of mixed gender (71%). Biomarkers of STD (7.5%) or pregnancy outcomes (2%) were rare. Ecological inclusion was not related to year of publication. Despite the rhetoric highlighting the importance of an ecological perspective in understanding adolescent sexual risk behavior, much published research excludes environmental influences.