The Association of Interpersonal Relationships to Adolescent Women’s Sexual Self-Efficacy

University of Minnesota Ph.D. dissertation. July 2019. Major: Family Social Science. Advisor: Jodi Dworkin. 1 computer file (PDF); vi, 91 pages.Due to proper contraception use, the rates of unplanned pregnancy among adolescents has decreased since the early 1990’s. However, the US still has the highest adolescent pregnancy rate among countries that track these data. In addition, there is concern about increasing rates of STIs among adolescents. Self-efficacy is a key construct to understanding adolescent women’s capacity to use condoms to prevent unplanned pregnancies and STIs. The Human Ecological Theory lays the foundation for seeing individuals within the context of their environments, particularly the most proximal contexts, that of their family and romantic partners. Two studies were proposed. The first study examined the relationship between family factors and adolescent women’s self-efficacy to refuse sex without condoms and self-efficacy to use condoms. The results of multinomial logistic regressions indicated that 1) family connection predicted 2.31 greater odds of being in the constant high self-efficacy category to refuse sex without condoms compared to the constant low self-efficacy category and 2) family contraception communication predicted 2.26 greater odds of being in the fluctuating high self-efficacy to use condoms category compared to the fluctuating low category. The second study examined the relationship between partner factors and adolescent women’s self-efficacy to refuse sex without condoms and self-efficacy to use condoms. The results indicated that 1) both women’s belief that condoms interfere with pleasure and perceived partner belief that condoms interfere with pleasure were individually associated with women’s sexual self-efficacy and 2) the interaction between the two variables was not significant. In alignment with the theoretical assumptions of self-efficacy and Human Ecological Theory, the findings of the current studies suggest that interpersonal factors influence adolescent women’s sexual self-efficacy. Family members, sexual educators, and primary care providers may influence condom use by addressing adolescent women’s potential beliefs that condoms interfere with pleasure and their partners’ belief that condoms interfere with pleasure. Adolescents may benefit from education around ways to reduce discomfort and increase pleasure when using condoms. Also, adolescent women who experience low levels of family connection may need additional support to develop their sexual self-efficacy compared to their peers who report high levels of family connection