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Margaret J. Blythe, MD; J. Dennis Fortenberry, MD, MS; M’Hamed Temkit, MS; Wanzhu Tu, PhD; Donald P. Orr, MD

Arch Pediatr Adolesc Med. 2006;160:591-595.

Objectives  To determine the 3-month incidence of unwanted sex and to examine relationship factors and health-risk behaviors associated with incident unwanted sex.

Design  Data collected from face-to-face interviews every 3 months in a longitudinal study with a minimum of 2 interviews and maximum of 10 across 27 months.

Setting  Primary health care clinics for teens in an urban setting.

Participants  Adolescent women aged 14 through 17 years.

Main Outcome Measures  At each 3-month visit, cervical and vaginal specimens were obtained for the evaluation of Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis infection; for each partner, relationship characteristics and sexual behaviors were assessed, as well as the occurrence of unwanted sex. A logistic model was used to account for within-subject variability to model the probability of unwanted sex as a function of predictor variables.

Results  A total of 279 participants with a mean age of 15.9 years were enrolled, and most were African American (88.5% [247/279]). Unwanted sex was reported by 40.9% (n=114) of participants and in 15.5% (292/1880) of partner-visits. The most prevalent type of unwanted sex was due to fear that the partner would get angry if denied sex (37.6%, or 105 participants). Factors associated with unwanted sex included having a baby with the partner, lower relationship quality, lack of sexual control, less condom use, and partner marijuana use.

Conclusions  Unwanted sex occurs often within the sexual relationships of teens. 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.

Author Affiliations: Departments of Pediatrics (Drs Blythe, Fortenberry, and Orr) and Medicine (Mr Temkit and Dr Tu), and Regenstrief Institute (Dr Tu), Indiana University Medical Center, Indianapolis.

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