According to a new study, researchers examined factors associated with sexual coercion among 10th graders in a rural Midwestern, low-to-middle income high school found that sexual coercion was reported by 18% (13% of males and 23% females). Predictors included age, race, ethnicity, prior alcohol, marijuana and/or prescription drug use, controlling relationship, adverse childhood experiences, sexual self-efficacy and comfort talking to a parent/guardian about sex.

Among males, sexual coercion was associated with higher adverse childhood experiences, controlling relationship behavior, alcohol use and lower sexual self-efficacy. Among females, sexual coercion was associated with lower sexual self-efficacy and lower comfort talking about sex with a parent. Consent is essential to healthy adolescent relationships, and sexual coercion is associated with poor sexual health outcomes.

Modifiable predictors are poorly understood, particularly among adolescents in rural areas who may have less access to sexual health resources. "On a national level, sex education policy has been reduced to a battle over abstinence," said Dr. Mary Ott, one of the authors of the study. "This community-based work, conducted in partnership with Health Care Education and Training, provides a more nuanced picture of adolescents' educational needs, particularly around sexual consent.

The study concluded that sexual coercion is common among adolescents in rural communities. In order to achieve positive sexual health outcomes, comprehensive adolescent pregnancy prevention programming in rural areas must integrate education on consent, identification of controlling behaviors, effects of substance use on decision-making, and parent/child communication.

The associations with adverse childhood experiences and parent communication highlight the importance of healthy environments in adolescent development. The associations with controlling behaviors and sexual self-efficacy point to the importance of teaching healthy relationship skills, including respect and gender equity.