Understanding the “Why” for High Risk Behavior: Adolescent Girls Motivations for Sex

Aims: Adolescent girls continue to face negative health consequences of sexual risk behaviors. Tested in a randomized controlled trial, the Health Improvement Project for Teens (HIP Teens) is a CDC- and Dept. of HHSrecognized HIV/STI/pregnancy prevention evidence-based intervention. Identifying why girls participate in safe and risky sexual behaviors is key to developing successful intervention strategies. This study identified motivations for sex in the 738 girls enrolled in the RCT and analyzed differences in sex motives among at-risk subgroups. Methods: Sexually-active girls, ages 15-19 (n=738) were recruited from urban community-based settings and enrolled in the gender-specific intervention. Baseline data were collected via audio computer-assisted selfinterview 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. Descriptive and inferential analyses were used to describe the distribution of sex motives as well as differences in subgroups with different risk profiles. Results: Participants were predominantly African American and impoverished with reported risk behaviors. The predominant sex motives identified across the sample were enhancement and intimacy. Statistically significant motive differences across domains were identified among mental health variables (depression, drug and alcohol use) as well as demographic group characteristics (race, age, and parental status). Conclusion: Understanding sex motives in girls and their relationship to modifiable and unmodifiable factors can improve tailoring of evidence-based risk reduction interventions to target specific subgroups. Understanding why girls have sex provides an opportunity to address motivation-focused strategies that may augment intervention efficacy.