Critiquing the Health Belief Model and sexual risk behaviours among adolescents : a narrative review of familial and peer influence

Research into the rising rates of sexually transmitted infections and unwanted pregnancies among adolescents has highlighted the challenge in developing sexual education campaigns that affect behavioural change. Frequent attempts to apply the otherwise robust Health Belief Model to the challenge of high-risk sexual behaviours have yielded confounding results from sexually active teens who discount the seriousness of consequences or their susceptibility to them. Social dynamics involving familial and peer relationships may strongly influence teen sexual risk-taking; the growing population of sexual risk-takers is strongly associated with disengaged family environments and a shift in alliance from family to peer community. This shift in identification to peer groups, in the absence of supportive parental relationships, is correlated with permissive and coercive sexual behaviour and a future of substance abuse, depression, sexually transmitted infections and unwanted pregnancy. This paper seeks to explore the correlation between peer interaction and parental relationships and availability, while assessing the predictive value of the Health Belief Model in relation to adolescent high risk sexual behaviour. Doing so can inform research to further clarify the nature of these associations and investigate new insights into adolescent sexual dynamics and new policy and programming approaches to sexual health promotion.