Scottish Adolescents
Purpose:
Sexual risk behaviors continue to pose a serious health threat to adolescents worldwide; Scotland continues to experience higher rates of unplanned pregnancy, STI‘s and other sexual morbidities. Despite extensive basic descriptive data on sex behavior, particularly in teens under 16, there are little in-depth and detailed descriptions of the actual risk behaviors, prevention strategies and health promotion skills employed and experienced by Scottish teens. The purpose of our study was to gain a more in-depth description of both male and female current sexual behaviors and assess information, motivation or skill gaps needing to be addressed in any evidence-based sexual risk reduction modification for use within Scotland. We also compared similar focus group findings from US teens to identify similarities and differences needed in tailoring interventions.
Methods:
Following a multi-site IRB approval, we recruited sexually active and abstinent teens from a youth community Café and gathering center in Edinburgh, Scotland. The site serves predominately impoverished or lower SES, urban teens. We conducted focus groups with male and female adolescents ages 16 to 19 (N=18). Using a semi structured, theoretically-driven interview guide, we conducted mixed gender groups lasting approximately 90 minutes guided by a trained moderator. Sessions were taped and transcribed using with-in group and between-group analyses to identify major themes related to sexual risk information, motivation, and behavioral skills as well as recruitment and retention strategies for future interventions.
Results:
Of the 18 participants, 61% were male and 39% female. The average age of participants were 16.8 years. The majority were white (89%) and 17% black; 83% were born in Scotland. Two-thirds (67%) of the sample were sexually active. The majority of sexually active teens reported recent vaginal (92%), oral (85%), and anal (31%) sex. Although only 33% reported contraceptive use, those that did used condoms predominately. Data saturation in thematic responses emerged by group 3. Predominant themes included: (1) we really don’t talk about how to "talk about" sex; (2) private behaviors occur in public places; (3) concurrent use of substances is common especially with anonymous encounters; and (4) future time perspective was very limited among many of these teens. Participants cited involvement in the study as a way to pass empty time and participation incentives as a primary approach for recruitment and retention reporting the lack of employment and opportunities for youth as a major concern for Scottish teens.
Conclusion:
Similar to US teens, many of the Scottish youth were participating in multiple sexual and substance-use behaviors. Unlike in the US, these teens emphasized that, despite sex ed in schools, sex was rarely discussed outside required classroom discussions and the ability to practice communication and negotiation skills was minimal. Despite the ready availability of contraception and STI/HIV testing and related health care needs in this NHS country, teens admitted they lack the skills to plan, discuss or negotiate safer sex practices. Prevalence of anonymous and unplanned sex lead to “capturing the moment “resulting most often in unprotected sex. There was a glaring lack of teens' planning for or contemplating their future adult lives.