Adolescent Girls' Experiences With Sexual Pressure, Coercion, and Victimization: #MeToo.

BACKGROUND: The #MeToo social media campaign in the United States has highlighted what is a pervasive problem in many cultures-the sexual intimidation and victimization of women by men, especially those in roles of authority. METHODS: In a study of 735 girls, ages 15-19 years, enrolled in a sexual risk reduction randomized controlled trial, we captured baseline data using audio-computer assisted self-interviews to increase validity and reliability of responses to questions regarding such behaviors. RESULTS: Despite their age, one-half of these girls reported being coerced into sex acts (excluding intercourse) with 1 in 5 reporting such victimization by a man who used his position of authority. Alarmingly, 12-28% of girls reported being forced into penetrative sex acts against their will. Far too many girls reported they had had multiple episodes of such violence. LINKING EVIDENCE TO ACTION: It is clear that this study captures a common, but minimally documented, threat faced by adolescent girls ranging from men pressuring them to engage in sex activities through the use of victimization, intimidation, or provision of substances to underage girls to gain compliance. Using such evidence to enhance and tailor sexual risk reduction, health, safety, and communication interventions for both males and females is essential. Identifying triggers to at-risk situations, providing skill building in communication, negotiation and refusal skills, as well as clearly discussing consent issues among both genders are important components in evidence-based interventions if we are to impact positively the next generation to curtail sexual pressure, coercion, and violence.

Understanding the "Why" for High-Risk Behavior: Adolescent Girls' Motivations for Sex.

Identifying why girls participate in safe and risky sexual behaviors is key to developing successful intervention strategies. This study identified motivations for sex in 738 girls enrolled in the Health Improvement Project for Teens (HIPTeens) randomized controlled trial and analyzed differences in sex motives among at-risk subgroups. Sexually active girls, ages 15-19 years, were recruited from urban community-based settings. Baseline data were collected via audio computer-assisted self-interview surveys including a modified Sex Motives Scale based on six domains (intimacy, enhancement, self-affirmation, coping, peer pressure, and partner approval), assessing drivers of both protective and risk-promoting motivations. Statistically significant motive differences across domains were identified among subgroups with different risk profiles, including mental health issues (depression, drug and alcohol use) as well as demographic group characteristics (race, age, and parental status). Understanding why girls have sex provides an opportunity to address motivation-focused strategies that may augment intervention efficacy.