- Email: [email protected]
Relationship Status, Instability, and Duration As Predictors of Daily Mood and Coitus Among Adolescent Women
Abstracts / 44 (2009) S14–S47
SESSION II (THURSDAY): RELATIONSHIPS AND SEX 74. A PROSPECTIVE STUDY OF ADOLESCENT WOMEN’S FIRST COITAL EXPERIENCE: THE INFLUENCE OF INDIVIDUAL FACTORS ON PROTECTIVE BEHAVIORS Amanda E. Tanner, PhD, MPH1, Devon J. Hensel, PhD2, and J. Dennis Fortenberry, MD, MS2. 1Dept of Health, Behavior, & Society, Johns Hopkins Univ, School of Public Health, Baltimore, MD; 2Section of Adolescent Medicine, Indiana Univ, School of Medicine, Indianapolis, IN Purpose: First coitus is a major transitional event into adulthood imbued with cultural and personal relevance, especially for women. Accordingly, the purpose of this study was to explore the phenomenology of young women’s first coital experiences by characterizing these events, specifically focusing on sexual interest, feelings of love, mood, and protective behaviors. Methods: Daily diary data were collected as part of an ongoing, longitudinal study of sexual relationships, sexual behaviors, and STI among adolescent and young women (n ¼ 387; 14 to 17 years at enrollment). First coital events were identified for 41 women; intrapersonal variables focused on sexual interest and feelings of love (1 item, 5-point Likert scales ranging from: none of the day to most of the day). Behavioral variables focused on contraceptive methods at first coitus and included: condom use (no/yes) and oral contraceptive use (no/yes). One way ANOVA was used to assess differences in mean levels of sexual interest and love on different days; c2 tests were used to examine the relationship of contraceptive method to first coital events. All analyses were performed with SPSS, 15.0; estimates were significant at p < 0.05). Results: Overall, feelings of being in love and sexual interest were reported at about ‘half of the day’ with the majority of these first events (27/36; c2 ¼ 38.920, df ¼ 1, p < 0.001) condom protected. Sexual interest was significantly higher (F [2,41] ¼ 20.696, p ¼ 0.013) on day of first sex (M ¼ 3.33, SD ¼ 1.39), as compared to day after first sex (M ¼ 1.64, SD ¼ 1.27), but not significantly different from day before first sex (M ¼ 2.53, SD ¼ 1.68). Feeling in love decreased from day before (M ¼ 3.08, SD ¼ 1.78) to day of first sex (M ¼ 2.97, SD ¼ 1.80), and to day after first sex (M ¼ 2.51, SD ¼ 1.68); however, none of these changes were significant (F [2,41] ¼ 0.953, p ¼ 0.393). Conclusions: While a variety of demographic, biological, psychological and social predictors of adolescent sexual initiation have been explored, the influence of sexual interest, feelings of love, and mood have largely been overlooked. Our findings suggest that these variables are independent and driving forces of sexual and contraceptive behavior. They are predictive of and responsive to first coital experiences. Therefore, the findings have implications for incorporating intrapersonal factors into sexual health programs targeted at young women to encourage protective behaviors at first (and subsequent) coital events. Sources of Support: NIH U19 AI 31494.
75. RELATIONSHIPS, REASONS FOR SEX AND COMMUNICATION AS PREDICTORS OF COITAL FREQUENCY AND CONDOM USE AMONG YOUNG MALES Lekeisha Terrell, MD, Devon J. Hensel, PhD, and J. Dennis Fortenberry, MD, MS. Indiana University, Indianapolis, IN Purpose: Despite their importance in heterosexual sexual relationships, little research has examined young male relationship charac-
S45
teristics and their association with reasons for sex, communication with sexual partner and sexual behaviors. Methods: As part of a larger STI study among young women, reported male sexual partners were recruited to complete quarterly reports of relationship characteristics and sexual behaviors. Partner specific variables included: Reasons for sex: physical (7-item, a ¼ 0.86), emotional (6-item, a ¼ 0.78), and impulsive (5-item, a ¼ 0.68); ease of sexual communication, ease of condom communication and ease of birth control communication (all single items). Behavior outcome included coital frequency; ratio of condom protected events and used a condom at last intercourse (no/yes). All models controlled for relationship quality ([RQ] 6-item a ¼ 0.96) and sexual satisfaction ([SS] 5-item a ¼ 0.98). Structural equation modeling with FIML estimation, in AMOS 7.0, assessed associations of relationship variables with communication, reasons for sex and behavior variables. Separate models were run for each behavioral outcome; effects were significant at p < 0.05. Results: Male partners (n ¼ 384) contributed 884 quarterly visits. Higher RQ was associated with easier communication about sex (B ¼ 0.222), condom use (B ¼ 0.141) and birth control (B ¼ 0.120); and emotional reasons for sex (B ¼ 0.278). Higher SS was associated with easier communication about sex (B ¼ 0.173) and all three reasons for sex: emotional (B ¼ 0.194), physical (B ¼ 0.314), and impulsive (B ¼ 0.210). Having sex more for emotional reasons was associated with lower sexual communication (B ¼ -0.090), and not associated with condom or birth control communication. Additionally emotional sex predicted a lower proportion of condom protected events (B ¼ -0.080) and was not associated with condom use at last sex. In contrast, sex for physical reasons was associated with higher sexual communication (B ¼ 0.179) but also predicted decreased condom use a last sex (B ¼ -0.127). Having sex for impulsive reasons predicted higher condom use at last sex (B ¼ 0.94) but was not associated with sexual, condom or birth control communication. Higher sexual communication predicted higher coital frequency (B ¼ 0.113) and lower proportion of condom protected events (B ¼ -0.117) and was not associated with condom use a last coitus. Birth control communication did not predict coital frequency or condom use. Conclusions: Communication about sex, condom use, and birth control was associated with different sexual behaviors and should be considered three separate levels of communication. Clinicians should address each separately to help male patients with partner communication. Support: NIH U19AI43924-06, R01HD044387-03, HRSA/T71 MC00008-17-00.
76. RELATIONSHIP STATUS, INSTABILITY, AND DURATION AS PREDICTORS OF DAILY MOOD AND COITUS AMONG ADOLESCENT WOMEN Rebekah L. Williams, MD, Devon J. Hensel, PhD, and J. Dennis Fortenberry, MD, MS. Indiana Univ., Indianapolis, IN Purpose: Prior work has suggested that relationship status is associated with the likelihood of coitus among adolescent women, and that coitus has temporally-specific effects on mood. Relationships provide the social context in which coitus occurs, and relationship history – past status, duration, and instability - may also influence mood. Thus, we examined historical relationship characteristics as predictors of daily mood on days with and without coitus. Methods: Women (n ¼ 387, 14-17 years at enrollment) provided partner-specific information during quarterly interviews, and measures of mood and coitus (no/yes) in daily diaries. Hierarchical linear modeling (HLM 6.0) assessed the effect of relationship characteristics (Level 2) on daily mood (Level 1.) Models were stratified by days with coitus and days without coitus. Partner-specific
S46
Abstracts / 44 (2009) S14–S47
relationship characteristics included: relationship status [RS] (6 categories ‘‘don’t know well’’ to ‘‘spouse’’), relationship duration (quarters with each partner), total number of Changes in RS, Starting RS, Average RS, Lowest ever RS, and Highest ever RS. Daily mood variables included positive mood (3-items, a ¼ 0.86) and negative mood (3-items, a ¼ 0.83). Effects were significant at p < 0.05. Models controlled for other daily factors known from prior analyses to effect daily mood (feelings of love, sexual interest, partner support and negativity, substance use, vaginal bleeding, age, and prior day mood.) Results: Participants contributed 3,934 partner-quarters and 281,456 partner-days. About 5% (14,538/281,456) of partner-days were associated with coitus. Positive mood on days with coitus was associated with higher Starting RS (b ¼ +0.37), higher Average RS (b ¼ +0.44), and fewer Changes in RS (b ¼ -0.34 to -0.25) in all models. Positive mood on days without coitus was associated with these same relationship characteristics - Starting RS (b ¼ +0.49), Average RS (b ¼ +0.40), Changes in RS (b ¼ -0.36 to -0.29) - and with higher Lowest ever RS (b ¼ +0.41.) Negative mood on days with coitus was associated with more Changes in RS (b ¼ +0.19); there were no associations with negative mood on days without coitus. Relationship duration had no association with daily mood. Conclusions: An adolescent woman’s entire relationship history – starting status, instability, and average status - effects daily mood. Consistent effects on daily positive mood are present regardless of the occurrence of coitus. As a measure of relationship instability, changes in relationship status are associated with lower positive mood on all days and with higher negative mood on days with coitus. Understanding relationship context and its effects on mood may allow clinicians to better address patients’ mental health and sexual decision-making. Support: NIH U19AI43924-06, R01HD044387-03.
77. PARTNER MEETING VENUE AND ASSOCIATIONS WITH SEXUAL BEHAVIOR AMONG ADOLESCENT WOMEN Cynthia Robbins, MD, Devon J. Hensel, PhD, and J. Dennis Fortenberry, MD, MS. Indiana Univ., Indianapolis, IN Purpose: Today, adolescents are first meeting their future sexual partners in different places and it is unknown what impact meeting venue has on sexual behavior. This study will attempt to show where adolescents are meeting their sexual partners and if venue has a relationship with coital frequency and condom use. Methods: Young women (n ¼ 387; aged 14-17 years) provided partner specific relationship and behavior information over the past three months as part of a larger study of STI. The main predictor variable was partner meeting venue (school, church, neighborhood, internet, phone line, friends, family, clinic, party, club, and other). Outcome variables included: coital frequency, ratio of condom protected events and used a condom at last intercourse (no/yes). Analyses were GEE linear or logistic regression in SUDAAN, 10.0. Each outcome was run separately; each category of the partner meeting venue was used in turn as a reference category. All models additionally controlled for relationship status, relationship quality, sexual satisfaction, and prior quarter behavior. All effects were significant at p < 0.05. Results: Subjects provided 3,098 partner specific interviews. Partner meeting venues were school (23.3%; 723/3,098), neighborhood (21%; 650/3,098), friends (20%; 619/3,098), family (10%; 330/ 3,098), and church (0.25%). Compared with partners met in school, higher coital frequencies occurred with those met online, in clubs, or through family. Condom use also varied among venues. Meeting in clubs was more likely to lead to condom use during the last coitus than meeting online (OR ¼ 5.29), in the neighborhood (OR ¼
3.99), through family (OR ¼ 3.01), at school (OR ¼ 2.88), or in other venues (OR ¼ 5.42). Meeting on phone lines was associated with a lower condom use ratio than meeting in the neighborhood, in clubs, and online. Partners who met in the neighborhood had fewer condom protected events than those who met through family, through friends, and in clubs. Neighborhood partners were also less likely to have used a condom during their last coitus than those met through friends (OR ¼ 1.79) Conclusions: Adolescents are first meeting their sexual partners in traditional venues like the neighborhood, but also in new venues like phone lines; some of these new venues are associated with higher coital frequencies and less condom use. Because partner meeting venue can be used to predict sexual relationships and condom use, this information could be valuable for public health interventions aimed at decreasing STI and teen pregnancy rates. Support: NIH U19AI43924-06, R01HD044387-3, HRSA/T71 MC00008-14-00.
78. SOCIAL MESSAGES, SOCIAL CONTEXT, AND TEEN SEXUAL HEALTH: VOICES OF URBAN AFRICAN AMERICAN YOUTH M. Secor-Turner, PhD, RN, R. Sieving, PhD, RN, and A. Garwick, PhD, FAAN, RN. School of Nursing, Univ. of MN, Minneapolis, MN Purpose: Despite declining adolescent birth rates in the U.S., African American teens experience disproportionately high rates of pregnancy and childbearing. Coupled with higher rates of concentrated poverty, pregnancy and childbearing occur at much higher rates among low-income urban teens. The social contexts in which African American adolescents live have a significant impact on their decision making regarding sexual behavior and pregnancy. One important influence within the social contexts of African American youth is the social messages they receive, often containing race and gender stereotypes that encourage African American youth to engage in sexually risky behaviors. Through the use of qualitative methods, the current study aims to describe aspects of the social context that low-income, urban African American young women articulate as having influenced social messages they received during adolescence about sexual behaviors and beliefs about pregnancy timing. Methods: Participants were recruited from alternative high schools and a community health center. Purposive sampling was used to include participants who had and had not given birth as adolescents. The study included 20 young women ages 18 - 22 who identified as African American and whose families received public assistance during their adolescence. Structured individual interviews were conducted with all participants. Descriptive content analysis was used to categorize key concepts and patterns related to social contexts identified by participants. Results: Five themes were identified that described the context in which social messages received during adolescence influenced participants’ sexual behaviors and beliefs about pregnancy timing: First Sex: Getting Ready and Getting It Over With; The Path for African American Girls; Gender Expectations: Insecurity and Independence; Living Into a Future; and Living in a Context of Instability and Uncertainty. These themes frame the context in which participants made decisions about sexual behaviors and pregnancy timing during adolescence. In relation to their social context, participants clearly described perceived expectations for low-income African American young women that reflected their daily experiences with intersections of race, class, and gender stereotypes. In addition, underlying issues of race, class, and gender were woven into mixed social messages participants received about sexuality and childbearing.
SESSION II (THURSDAY): RELATIONSHIPS AND SEX 74. A PROSPECTIVE STUDY OF ADOLESCENT WOMEN’S FIRST COITAL EXPERIENCE: THE INFLUENCE OF INDIVIDUAL FACTORS ON PROTECTIVE BEHAVIORS Amanda E. Tanner, PhD, MPH1, Devon J. Hensel, PhD2, and J. Dennis Fortenberry, MD, MS2. 1Dept of Health, Behavior, & Society, Johns Hopkins Univ, School of Public Health, Baltimore, MD; 2Section of Adolescent Medicine, Indiana Univ, School of Medicine, Indianapolis, IN Purpose: First coitus is a major transitional event into adulthood imbued with cultural and personal relevance, especially for women. Accordingly, the purpose of this study was to explore the phenomenology of young women’s first coital experiences by characterizing these events, specifically focusing on sexual interest, feelings of love, mood, and protective behaviors. Methods: Daily diary data were collected as part of an ongoing, longitudinal study of sexual relationships, sexual behaviors, and STI among adolescent and young women (n ¼ 387; 14 to 17 years at enrollment). First coital events were identified for 41 women; intrapersonal variables focused on sexual interest and feelings of love (1 item, 5-point Likert scales ranging from: none of the day to most of the day). Behavioral variables focused on contraceptive methods at first coitus and included: condom use (no/yes) and oral contraceptive use (no/yes). One way ANOVA was used to assess differences in mean levels of sexual interest and love on different days; c2 tests were used to examine the relationship of contraceptive method to first coital events. All analyses were performed with SPSS, 15.0; estimates were significant at p < 0.05). Results: Overall, feelings of being in love and sexual interest were reported at about ‘half of the day’ with the majority of these first events (27/36; c2 ¼ 38.920, df ¼ 1, p < 0.001) condom protected. Sexual interest was significantly higher (F [2,41] ¼ 20.696, p ¼ 0.013) on day of first sex (M ¼ 3.33, SD ¼ 1.39), as compared to day after first sex (M ¼ 1.64, SD ¼ 1.27), but not significantly different from day before first sex (M ¼ 2.53, SD ¼ 1.68). Feeling in love decreased from day before (M ¼ 3.08, SD ¼ 1.78) to day of first sex (M ¼ 2.97, SD ¼ 1.80), and to day after first sex (M ¼ 2.51, SD ¼ 1.68); however, none of these changes were significant (F [2,41] ¼ 0.953, p ¼ 0.393). Conclusions: While a variety of demographic, biological, psychological and social predictors of adolescent sexual initiation have been explored, the influence of sexual interest, feelings of love, and mood have largely been overlooked. Our findings suggest that these variables are independent and driving forces of sexual and contraceptive behavior. They are predictive of and responsive to first coital experiences. Therefore, the findings have implications for incorporating intrapersonal factors into sexual health programs targeted at young women to encourage protective behaviors at first (and subsequent) coital events. Sources of Support: NIH U19 AI 31494.
75. RELATIONSHIPS, REASONS FOR SEX AND COMMUNICATION AS PREDICTORS OF COITAL FREQUENCY AND CONDOM USE AMONG YOUNG MALES Lekeisha Terrell, MD, Devon J. Hensel, PhD, and J. Dennis Fortenberry, MD, MS. Indiana University, Indianapolis, IN Purpose: Despite their importance in heterosexual sexual relationships, little research has examined young male relationship charac-
S45
teristics and their association with reasons for sex, communication with sexual partner and sexual behaviors. Methods: As part of a larger STI study among young women, reported male sexual partners were recruited to complete quarterly reports of relationship characteristics and sexual behaviors. Partner specific variables included: Reasons for sex: physical (7-item, a ¼ 0.86), emotional (6-item, a ¼ 0.78), and impulsive (5-item, a ¼ 0.68); ease of sexual communication, ease of condom communication and ease of birth control communication (all single items). Behavior outcome included coital frequency; ratio of condom protected events and used a condom at last intercourse (no/yes). All models controlled for relationship quality ([RQ] 6-item a ¼ 0.96) and sexual satisfaction ([SS] 5-item a ¼ 0.98). Structural equation modeling with FIML estimation, in AMOS 7.0, assessed associations of relationship variables with communication, reasons for sex and behavior variables. Separate models were run for each behavioral outcome; effects were significant at p < 0.05. Results: Male partners (n ¼ 384) contributed 884 quarterly visits. Higher RQ was associated with easier communication about sex (B ¼ 0.222), condom use (B ¼ 0.141) and birth control (B ¼ 0.120); and emotional reasons for sex (B ¼ 0.278). Higher SS was associated with easier communication about sex (B ¼ 0.173) and all three reasons for sex: emotional (B ¼ 0.194), physical (B ¼ 0.314), and impulsive (B ¼ 0.210). Having sex more for emotional reasons was associated with lower sexual communication (B ¼ -0.090), and not associated with condom or birth control communication. Additionally emotional sex predicted a lower proportion of condom protected events (B ¼ -0.080) and was not associated with condom use at last sex. In contrast, sex for physical reasons was associated with higher sexual communication (B ¼ 0.179) but also predicted decreased condom use a last sex (B ¼ -0.127). Having sex for impulsive reasons predicted higher condom use at last sex (B ¼ 0.94) but was not associated with sexual, condom or birth control communication. Higher sexual communication predicted higher coital frequency (B ¼ 0.113) and lower proportion of condom protected events (B ¼ -0.117) and was not associated with condom use a last coitus. Birth control communication did not predict coital frequency or condom use. Conclusions: Communication about sex, condom use, and birth control was associated with different sexual behaviors and should be considered three separate levels of communication. Clinicians should address each separately to help male patients with partner communication. Support: NIH U19AI43924-06, R01HD044387-03, HRSA/T71 MC00008-17-00.
76. RELATIONSHIP STATUS, INSTABILITY, AND DURATION AS PREDICTORS OF DAILY MOOD AND COITUS AMONG ADOLESCENT WOMEN Rebekah L. Williams, MD, Devon J. Hensel, PhD, and J. Dennis Fortenberry, MD, MS. Indiana Univ., Indianapolis, IN Purpose: Prior work has suggested that relationship status is associated with the likelihood of coitus among adolescent women, and that coitus has temporally-specific effects on mood. Relationships provide the social context in which coitus occurs, and relationship history – past status, duration, and instability - may also influence mood. Thus, we examined historical relationship characteristics as predictors of daily mood on days with and without coitus. Methods: Women (n ¼ 387, 14-17 years at enrollment) provided partner-specific information during quarterly interviews, and measures of mood and coitus (no/yes) in daily diaries. Hierarchical linear modeling (HLM 6.0) assessed the effect of relationship characteristics (Level 2) on daily mood (Level 1.) Models were stratified by days with coitus and days without coitus. Partner-specific
S46
Abstracts / 44 (2009) S14–S47
relationship characteristics included: relationship status [RS] (6 categories ‘‘don’t know well’’ to ‘‘spouse’’), relationship duration (quarters with each partner), total number of Changes in RS, Starting RS, Average RS, Lowest ever RS, and Highest ever RS. Daily mood variables included positive mood (3-items, a ¼ 0.86) and negative mood (3-items, a ¼ 0.83). Effects were significant at p < 0.05. Models controlled for other daily factors known from prior analyses to effect daily mood (feelings of love, sexual interest, partner support and negativity, substance use, vaginal bleeding, age, and prior day mood.) Results: Participants contributed 3,934 partner-quarters and 281,456 partner-days. About 5% (14,538/281,456) of partner-days were associated with coitus. Positive mood on days with coitus was associated with higher Starting RS (b ¼ +0.37), higher Average RS (b ¼ +0.44), and fewer Changes in RS (b ¼ -0.34 to -0.25) in all models. Positive mood on days without coitus was associated with these same relationship characteristics - Starting RS (b ¼ +0.49), Average RS (b ¼ +0.40), Changes in RS (b ¼ -0.36 to -0.29) - and with higher Lowest ever RS (b ¼ +0.41.) Negative mood on days with coitus was associated with more Changes in RS (b ¼ +0.19); there were no associations with negative mood on days without coitus. Relationship duration had no association with daily mood. Conclusions: An adolescent woman’s entire relationship history – starting status, instability, and average status - effects daily mood. Consistent effects on daily positive mood are present regardless of the occurrence of coitus. As a measure of relationship instability, changes in relationship status are associated with lower positive mood on all days and with higher negative mood on days with coitus. Understanding relationship context and its effects on mood may allow clinicians to better address patients’ mental health and sexual decision-making. Support: NIH U19AI43924-06, R01HD044387-03.
77. PARTNER MEETING VENUE AND ASSOCIATIONS WITH SEXUAL BEHAVIOR AMONG ADOLESCENT WOMEN Cynthia Robbins, MD, Devon J. Hensel, PhD, and J. Dennis Fortenberry, MD, MS. Indiana Univ., Indianapolis, IN Purpose: Today, adolescents are first meeting their future sexual partners in different places and it is unknown what impact meeting venue has on sexual behavior. This study will attempt to show where adolescents are meeting their sexual partners and if venue has a relationship with coital frequency and condom use. Methods: Young women (n ¼ 387; aged 14-17 years) provided partner specific relationship and behavior information over the past three months as part of a larger study of STI. The main predictor variable was partner meeting venue (school, church, neighborhood, internet, phone line, friends, family, clinic, party, club, and other). Outcome variables included: coital frequency, ratio of condom protected events and used a condom at last intercourse (no/yes). Analyses were GEE linear or logistic regression in SUDAAN, 10.0. Each outcome was run separately; each category of the partner meeting venue was used in turn as a reference category. All models additionally controlled for relationship status, relationship quality, sexual satisfaction, and prior quarter behavior. All effects were significant at p < 0.05. Results: Subjects provided 3,098 partner specific interviews. Partner meeting venues were school (23.3%; 723/3,098), neighborhood (21%; 650/3,098), friends (20%; 619/3,098), family (10%; 330/ 3,098), and church (0.25%). Compared with partners met in school, higher coital frequencies occurred with those met online, in clubs, or through family. Condom use also varied among venues. Meeting in clubs was more likely to lead to condom use during the last coitus than meeting online (OR ¼ 5.29), in the neighborhood (OR ¼
3.99), through family (OR ¼ 3.01), at school (OR ¼ 2.88), or in other venues (OR ¼ 5.42). Meeting on phone lines was associated with a lower condom use ratio than meeting in the neighborhood, in clubs, and online. Partners who met in the neighborhood had fewer condom protected events than those who met through family, through friends, and in clubs. Neighborhood partners were also less likely to have used a condom during their last coitus than those met through friends (OR ¼ 1.79) Conclusions: Adolescents are first meeting their sexual partners in traditional venues like the neighborhood, but also in new venues like phone lines; some of these new venues are associated with higher coital frequencies and less condom use. Because partner meeting venue can be used to predict sexual relationships and condom use, this information could be valuable for public health interventions aimed at decreasing STI and teen pregnancy rates. Support: NIH U19AI43924-06, R01HD044387-3, HRSA/T71 MC00008-14-00.
78. SOCIAL MESSAGES, SOCIAL CONTEXT, AND TEEN SEXUAL HEALTH: VOICES OF URBAN AFRICAN AMERICAN YOUTH M. Secor-Turner, PhD, RN, R. Sieving, PhD, RN, and A. Garwick, PhD, FAAN, RN. School of Nursing, Univ. of MN, Minneapolis, MN Purpose: Despite declining adolescent birth rates in the U.S., African American teens experience disproportionately high rates of pregnancy and childbearing. Coupled with higher rates of concentrated poverty, pregnancy and childbearing occur at much higher rates among low-income urban teens. The social contexts in which African American adolescents live have a significant impact on their decision making regarding sexual behavior and pregnancy. One important influence within the social contexts of African American youth is the social messages they receive, often containing race and gender stereotypes that encourage African American youth to engage in sexually risky behaviors. Through the use of qualitative methods, the current study aims to describe aspects of the social context that low-income, urban African American young women articulate as having influenced social messages they received during adolescence about sexual behaviors and beliefs about pregnancy timing. Methods: Participants were recruited from alternative high schools and a community health center. Purposive sampling was used to include participants who had and had not given birth as adolescents. The study included 20 young women ages 18 - 22 who identified as African American and whose families received public assistance during their adolescence. Structured individual interviews were conducted with all participants. Descriptive content analysis was used to categorize key concepts and patterns related to social contexts identified by participants. Results: Five themes were identified that described the context in which social messages received during adolescence influenced participants’ sexual behaviors and beliefs about pregnancy timing: First Sex: Getting Ready and Getting It Over With; The Path for African American Girls; Gender Expectations: Insecurity and Independence; Living Into a Future; and Living in a Context of Instability and Uncertainty. These themes frame the context in which participants made decisions about sexual behaviors and pregnancy timing during adolescence. In relation to their social context, participants clearly described perceived expectations for low-income African American young women that reflected their daily experiences with intersections of race, class, and gender stereotypes. In addition, underlying issues of race, class, and gender were woven into mixed social messages participants received about sexuality and childbearing.