Is lack of sexual assertiveness among adolescent and young adult women a cause for concern?

CONTEXT: Understanding young women's sexual assertiveness is critical to developing effective interventions to promote sexual health and reduce sexual risk-taking and violence. Young women's perception of their sexual rights may vary according to demographic characteristics, sexual health behaviors and victimization history. METHODS: Data were collected from 904 sexually active 14-26-year-old clients of two family planning clinics in Texas, reflecting their perceptions of their right to communicate expectations about or control aspects of their sexual encounters. Logistic regression analysis was used to assess which characteristics were independently associated with believing that one never has each specified sexual right. RESULTS: Almost 20% of women believed that they never have the right to make their own decisions about contraception, regardless of their partner's wishes; to tell their partner that they do not want to have intercourse without birth control, that they want to make love differently or that their partner is being too rough; and to stop foreplay at any time, including at the point of intercourse. Poor grades in school, sexual inexperience, inconsistent contraceptive use and minority ethnicity were independently associated with lacking sexual assertiveness. CONCLUSIONS: Many sexually active young women perceive that they do not have the right to communicate about or control aspects of their sexual behavior. Interventions to prevent sexually transmitted diseases, unwanted pregnancy and coercive sexual behaviors should include strategies to evaluate and address these perceptions.