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Influences of Social Norms and Context on Sexual Decision Making Among Adolescent Women


  • Heidi Collins Fantasia PhD, RN, WHNP-BC

Address correspondence to Heidi Collins Fantasia, PhD, RN, WHNP-BC, Boston College, William F. Connell School of Nursing, 140 Commonwealth Avenue, Chestnut Hill, MA 02467. E-mail:


Introduction: The aim of this study was to explore women's decisions to initiate and continue sexual activity in late adolescence.

Methods: Narrative inquiry was the qualitative methodology used to research the perceptions of factors that influence the sexual decision making of women in late adolescence. Single interviews were conducted with 10 late-adolescence women between the ages of 18 and 22. Both purposive and snowball sampling were used, and recruitment ended when data saturation was achieved.

Results: The main findings that emerged as the story contained 3 distinct and influential components: the influence of social context provided the introduction to the story, perceptions of the expected social norm for sex and relationships formed the plot, and the narratives concluded with a discussion of how these adolescents’ decision-making processes evolved in the years since coital debut.

Discussion: The results of this study provide evidence that adolescent sexual decision making is a multifaceted process with many layers of influence that reflect the complex world adolescents must navigate as they make decisions about their sexual behaviors. Detailed assessment of adolescent sexual activity and anticipatory guidance by health care providers will lay the foundation for risk reduction behavior and safer sexual encounters.