Perceptions of sexual assertiveness among adolescent girls: Initiation, refusal, and use of protective behaviors

Study Objective: We describe adolescent girls' perceptions of sexual assertiveness and examine the relationship of these perceptions with developmental and interpersonal variables. Design: Cross-sectional analysis. Setting: Participants were recruited from a school-based health clinic and local colleges, and through snowballing to participate in a 6-month study examining microbicide acceptability. Participants: 106 sexually experienced girls (ages 14 through 21 years). Methods: Girls described their demographics, sexual history, and romantic relationships and completed the Sexual Assertiveness Scale for Women (SAS-W), which assesses perceptions of sexual assertiveness: Initiation of Sex, Refusal of Unwanted Sex, and Pregnancy-STD Prevention. Results: Girls perceived themselves as asserting themselves between 50% and 75% of the time with their current or most recent partner. The Initiation subscale was not related to the other two subscales. In final models, girls with a prior pregnancy perceived themselves as initiating sex more than girls without a prior pregnancy. Having a greater number of lifetime partners was related to perceptions of less refusal, whereas greater number of partners, being sexually experienced longer, and engaging in more unprotected sex were related to perceptions of less implementation of preventive methods. None of the relationship variables were related to scores on any subscale. Conclusions: Most of these girls perceived themselves as sexually assertive. Given that sexual experience, not relationship factors, were related to perceptions of sexual assertiveness, the design of counseling messages should incorporate sexual experience. These messages should find effective ways to help girls both to communicate their sexual desires and to enhance their ability to protect themselves.