A healthy sexual self-concept that captures an understanding of the risky and the positive aspects of sexuality is imperative to life-long well-being. Parents have a unique opportunity to instill knowledge of sexual risk as well as confidence and comfort around sexuality in their adolescents. Although parent–child communication about sexual risk is fairly common, less is known regarding the frequency of parent–child communication about sex-positive topics, such as sexual desire and satisfaction. This study examined the frequency of parents’ communication with their children about sexual risk and sex-positive topics among a sample of 901 parents of 13–17-year-old adolescents (parent M_age= 40.61; 71% mothers) from across the U.S. Parents reported on sexual communication with their adolescent children (child M_age = 14.68; 50% daughters). We examined gender differences in communication patterns. Few parents communicated with their adolescents about sex-positive topics. Only 38% discussed sexual satisfaction, 38% discussed different types of sexual practices (e.g., oral sex), and 55% discussed sexual desire. Parents communicate more about sexual risk than sex-positive topics with their adolescents and this discrepancy was largest for mothers of daughters. Fathers of daughters communicate the least about sex-positive topics. Implications for intervention development and future research on sexual communication are discussed.

Objectives. To evaluate the efficacy of an interactive, Web-based sexual health program (Health Education and Relationship Training [HEART]) for developing sexual assertiveness skills and enhancing sexual decision-making in adolescent girls. Methods. Participants were 222 tenth-grade girls (mean age = 15.2; 38% White, 29% Hispanic, 25% Black) in the Southeastern United States who were randomized in fall 2015 to the HEART intervention or an attention-matched control. We assessed participants at pretest, immediate posttest, and 4-month follow-up. Results. Both groups had similar demographic and sexual behavior characteristics at pretest. At immediate posttest, girls who completed the HEART program demonstrated better sexual assertiveness skills measured with a behavioral task, higher self-reported assertiveness, intentions to communicate about sexual health, knowledge regarding HIV and other sexually transmitted diseases (STDs), safer sex norms and attitudes, and condom self-efficacy compared with the control condition. At 4-month follow-up, group differences remained in knowledge regarding HIV and other STDs, condom attitudes, and condom self-efficacy. Conclusions. This brief online sexual health program can improve short-term outcomes among adolescent girls and offers an exciting new option in the growing array of digital health interventions available to youths. Trial Registration Number. NCT02579135.

This study evaluated the feasibility, acceptability, and preliminary efficacy of a 45-minute interactive, online sexual health program for adolescents, called Health Education and Relationship Training (HEART). The program was originally developed and evaluated among adolescent girls (HEART for Girls); the current project describes and evaluates a new version of the program that was adapted for boys and girls. Participants were 226 high school students (mean age = 16.3; 58% girls; 46% White; 79% heterosexual). Students were randomized to HEART or an attention-matched control and assessed at pre-test and immediate post-test. Overall, the program was feasible to administer in a school setting and youth found the program highly acceptable (83% liked the program, 87% learned new things, and 93% would use program content in the future). At post-test, students who completed HEART demonstrated improvements on every outcome we examined: sexual communication intentions, condom use intentions, HIV/STD knowledge, condom attitudes, condom norms, self-efficacy to practice safer sex, and sexual assertiveness compared to control participants (effect size ds = .23 to 1.27). Interactions by gender and sexual orientation revealed the program was equally acceptable and worked equally well for boys and girls and for heterosexual and sexual minority youth. We propose several avenues to further adapt and tailor HEART given its promise in promoting adolescent sexual health.

A clear understanding of sexual consent is important for sexual violence prevention. To date, most research has focused on how college students understand and negotiate consent. Although adolescence is a critical period for the development of sexual attitudes, identity, and intimate relationships, the perspectives of high school-aged youth have been largely absent from the consent literature. The current study investigated adolescents’ attitudes toward affirmative consent in a sample of 226 high school students (58% female; 46% White, 24% Black, 25% Hispanic) from the southeastern U.S., as well as associations between affirmative consent attitudes and gender, gender role beliefs, and sexual activity status. Additionally, we tested whether gender role beliefs were a mediator between gender and affirmative consent attitudes. Overall, adolescents reported supportive attitudes toward affirmative consent. On average, girls and adolescents with more egalitarian gender role beliefs had more positive attitudes toward affirmative consent than boys and those with less egalitarian gender role beliefs, though no differences by sexual activity status were found. Gender role beliefs mediated the relationship between gender and attitudes toward affirmative consent. The results suggest that adolescents are generally supportive of affirmative consent practices, although some important group differences emerged.

Adolescent girls are at substantial risk of sexually transmitted diseases including HIV. To reduce these risks, we developed Health Education And Relationship Training (HEART), a web-based intervention focused on developing sexual assertiveness skills and enhancing sexual decision-making. This study assessed the feasibility and acceptability of this new program and examined if perceived acceptability varied according to participant ethnicity, sexual orientation or sexual activity status. Participants were part of a randomized controlled trial of 222 10th-grade girls (M_age = 15.26). The current analyses included those in the intervention condition (n = 107; 36% white, 27% black and 29% Hispanic). HEART took approximately 45 min to complete and was feasible to administer in a school-based setting. Participants found the program highly acceptable: 95% liked the program and learned from the program, 88% would recommend the program to a friend and 94% plan to use what they learned in the future. The primary acceptability results did not vary by the ethnicity, sexual orientation or sexual activity status of participants, suggesting broad appeal. Results indicate that this new online program is a promising method to reach and engage adolescents in sexual health education.