The purpose of this research was to address the gap in the literature regarding the lack of first hand accounts of the factors that influence adolescent sexual decision making. Using a narrative approach, I asked a cohort of late adolescent participants to tell their stories about the events surrounding their decision to become sexually active, and how this initial decision affected subsequent decision making. The specific research questions that guided the study were: (1) What are late adolescents' perspectives of the factors that influenced their decision to become and remain sexually active? and (2) What is the effect of sexual decision making regarding coital debut on subsequent sexual activity?
To accomplish my research aims I used narrative inquiry to elicit rich information, in the adolescents' own words, about what they perceive to be the most salient factors that contributed to their decisions to engage in sexual activity. I recruited a purposive sample of 11 late adolescents between the ages of 18 and 22 years from a series of family planning and sexually transmitted infection (STI) clinics in the Northeastern United States. As their stories unfolded, four main components emerged. These components included the internal and external environmental context, expected social norms, implied sexual consent, and self-reflection and evaluation.
The results of this study provide evidence that adolescent sexual decision making is a complex process with multiple layers of influence. Through the stories of my participants, I have constructed a more comprehensive conceptualization of adolescent sexual decision making and related sexual behaviors. This will guide the development of possible interventions to improve health care for this population. These interventions include expanding nursing knowledge to inform the development of theories, practice innovations, research, sexual health education, and policies for addressing adolescents' needs across the continuum of the adolescents' development from childhood to adulthood.
