Urban American Indian Adolescent Girls: Framing Sexual Risk Behavior

Abstract

Adolescent sexual risk behavior can have devastating effects for young women, including unintended pregnancy and sexually transmitted infections (STI). American Indian (AI) adolescent females have higher rates of sexual activity, births and STIs compared to the national average. However, research is limited on urban AI adolescent girls’ sexual behavior, pregnancy and STIs. The purpose of this grounded theory study was to explore how individual, family, tribal factors and processes, and national policy influence urban adolescent AI females’ in sexual risk behavior as a basis for developing a theoretical model. This grounded theory study revealed that urban AI adolescent females’ sexual behavior is influenced by social and structural systems consistent with Bronfenbrenner’s ecological model. The microsystem, mesosystem, and macrosystem framed sexual behavior for the AI girls in this study. The microsystem, including long-term goals, identification of being a normal teenager, and cultural identity helped participants form an identity that allowed them to make choices about sexual behavior consistent with the identity they developed. The mesosystem included family, friends, neighborhood, school, media, and health care. The messages that girls in this study received from these structural influences either discouraged or encouraged sexual behavior. Family and friends were reported as most influential on sexual behavior with neighborhood, school, media, and health care influences also reported as influential. The macrosystem, including culture and federal policy were influential on the daily lives of participants. The subsequent grounded theory model that emerged was an adaptation of Bronfenbrenner’s ecological model. Urban AI adolescent girls reported similar social and structural influences on sexual risk behavior as urban adolescents from other racial and ethnic groups. However, there were differenced noted in the family structure, cultural heritage, and unique history of AIs in American society. The similarities among racial groups can be used for guiding future research and when caring for this population in health care settings. Future research should focus on further exploration of microsystem, mesosystem, and macrosystem influences on sexual risk behavior among AI girls. Subsequently, providers should be cognizant of the AI girls’ social and structural surroundings and provide culturally sensitive care based upon these variables.