Exploring dissonance between interest in secondary abstinence and continued sexual activity among African-American female adolescents

Background: STI and unintended pregnancy rates remain high among African-American adolescent females. However, some opt to refrain from sex for various periods of time following sexual debut, a practice known as secondary abstinence. Periods of abstinence are significant because they reduce one's risk for HIV/STIs and unintended pregnancies. Others interested in abstaining may experience challenges that make it difficult for them to do so. Thus, the purpose of this study was to examine the dissonance between interest in secondary abstinence and continued sexual activity. Methods: A sequential logistic regression was conducted to examine individual-level and interpersonal-level barriers to abstaining from sex. Analyses utilized baseline data collected from 701 African-American female adolescents, ages 14 – 20, prior to participation in a randomized trial of an HIV prevention intervention. Results: After controlling for interest in secondary abstinence, adolescents who reported thinking about sex often, were older, and had lower abstinence self-efficacy were significantly less likely to report abstaining for two or more consecutive months. In the model including interpersonal-level factors, adolescent females who had less relationship power were also less likely to report periods of abstinence. Conclusions: African-American adolescent females interested in secondary abstinence must be equipped to overcome personal and partner-related obstacles, many of which are amenable to change. Researchers and health professionals must make addressing power imbalances that hinder adolescent females from adopting desired sexual health practices a priority. Findings also highlight the importance of considering context of adolescent females' sexual behavior when providing education and services for this population.