Adolescent Perceptions of Importance, Discomfort and Interest with Sexual Behavior Research

Purpose: We know sensitive topics research may cause participant discomfort, but it is unclear which participants experience discomfort, how severe that discomfort is, nor when discomfort crosses into harm. Adolescents, as a group, are considered a vulnerable population and more likely to experience research harm. Sensitive topics research, such as a survey on sexual behaviors, with adolescents has long raised concerns about potential harm to the participant. Our objective was to examine adolescents’ experiences with sexual behavior research and identify factors that explain participants’ experiences in sensitive topics research.

Methods: As part of a study of middle and high school students in a medium sized city, data were collected on sexual experiences, beliefs about sex, and experiences participating in sexual behavior research. We assessed sexual experience (four items, alpha= .81) using questions about the adolescents’ history sending or receiving sexts, experience with deep kissing and oral sex. Beliefs about sex were assessed using two separate scales, the first evaluated beliefs about pregnancy (five items, alpha=.82) which assessed how embarrassing getting pregnant (or getting a partner pregnant) would be for the participant as well as for their family, and belief that getting pregnant or getting someone pregnant would be the worst thing that could happen. Additionally we utilized a beliefs about abstinence scale (six items, alpha=.80) which assessed importance of abstaining from all sex. Experiences of research were assessed using three separate questions that assessed importance of research, discomfort, and interest. Correlation and logistic regression were used to examine the influence of demographics, sexual experiences and beliefs on participants’ perceptions of sexual behavior research.

Results: 350 adolescents (195 males, 155 females) were recruited, with just over half being recruited from middle schools. 37% were African American, 26% were white, 5% Hispanic, and 32% reporting two or more races or a mixed racial identity. A small number of participants reported feeling very uncomfortable (10%) or embarrassed (4%) with the survey. 46% found the survey interesting and 57% thought they survey was important. Individuals in middle school, those with less sexual experience, and those with more conservative abstinence and pregnancy beliefs were more likely to report discomfort or embarrassment. Logistic regression analyses indicated strongly held beliefs against teen pregnancy was a significant predictor of participants finding STI research important. Having more sexual experience was a significant predictor of lower levels of discomfort. Similarly, higher levels of sexual experience and strongly held beliefs against teen pregnancy predicted higher levels of interest in sexual behavior research. No variables were significantly associated with finding the research upsetting, embarrassing, or weird.

Conclusion: The majority of students did not feel uncomfortable or embarrassed with sexual behavior research. Those reporting feeling uneasy with the research were more likely to female, in middle school, and have more conservative views on sex. These data aid social workers, researchers, and institutional review boards in crafting research procedures that are more sensitive to adolescent needs, including assessment and referral for the small percentage of participants who were very uncomfortable.