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Multi-system influences on adolescent risky sexual behavior


  • Angela Chia-Chen Chen,

    Corresponding author
    1. College of Nursing & Health Innovation, Arizona State University, 500 N. 3rd Street, Phoenix, AZ 85004
    • College of Nursing & Health Innovation, Arizona State University, 500 N. 3rd Street, Phoenix, AZ 85004.
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    • Assistant Professor.

  • Elaine Adams Thompson,

    1. Department of Psychosocial and Community Health Nursing, School of Nursing, University of Washington, Seattle, WA
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    • The Sandra and Peter Dyer Term Professor.

  • Dianne Morrison-Beedy

    1. University of South Florida, Tampa, FL
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    • Dean, College of Nursing, Senior Associate Vice President USF Health, Professor of Nursing and Public Health.

  • This research uses data from Add Health, a program project directed by Kathleen Mullan Harris and designed by J. Richard Udry, Peter S. Bearman, and Kathleen Mullan Harris at the University of North Carolina at Chapel Hill, and funded by grant P01-HD31921 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, with cooperative funding from 23 other federal agencies and foundations. Special acknowledgment is due Ronald R. Rindfuss and Barbara Entwisle for assistance in the original design. Information on how to obtain the Add Health data files is available on the Add Health website ( No direct support was received from grant P01-HD31921 for this analysis. The research on which this article is based was supported by the Hester McLaws Nursing Scholarship at University of Washington. We would like to thank Dr. Cathy Lindenberg, Dr. Karen G. Schepp, and Dr. Ross L. Matsueda at University of Washington, and Dr. Mark Roosa and Dr. Joan Dodgson at Arizona State University for their valuable input on the earlier versions of this article.


We examined multi-system influences on risky sexual behavior measured by cumulative sexual risk index and number of nonromantic sexual partners among 4,465 single, sexually experienced adolescents. Hierarchical Poisson regression analyses were conducted with Wave I–II data from the National Longitudinal Study of Adolescent Health. Individual and family factors predicted both outcome measures. Neighborhood set predicted cumulative sexual risk index only, and peer factors predicted the number of nonromantic sexual partners only. School set did not predict either outcome. There were significant associations among risky sexual behavior, drug use, and delinquent behaviors. The results highlight the need for multifaceted prevention programs that address relevant factors related to family, peer and neighborhood influence as well as individual factors among sexually active adolescents. © 2010 Wiley Periodicals, Inc. Res Nurs Health 33:512–527, 2010