Date of Award

May 2020

Document Type


Degree Name

Doctor of Philosophy (PhD)


Institute on Family and Community Life

Committee Member

Martha Thompson

Committee Member

Arelis Moore de Peralta

Committee Member

Edmond Bowers

Committee Member

Bonnie Holaday


Despite a decline in adolescent fertility rates in the United States, unplanned pregnancy rates remain among the highest in the developed world and sexually transmitted infections (STIs) are on the rise. With U.S. sexuality education remaining inconsistent, exploring other platforms, such as religious institutions, to make an impression about sexuality on young people may provide an additional strategy to further reduce unplanned pregnancies and prevent the spread of STIs. While prior research has demonstrated links between religiosity and sexual health, a gap exists with respect to influences that may mediate the relation between religiosity and experiencing STIs and unplanned pregnancy. Additionally more remains to be understood about how lifetime religiosity levels influence long-term sexual health outcomes.

Using Waves I through IV of the National Longitudinal Study of Adolescent to Adult Health (Add Health), this study sought to assess the relation between religiosity and the sexual health outcomes of lifetime experiences of chlamydia, gonorrhea, HPV, any of these three STIs, and unplanned pregnancy. In the investigation of adolescent religiosity’s link to these outcomes, mediation analyses were conducted to assess whether attitudes toward sex, parent-child connectedness, peer religiosity, problem alcohol use, condom use knowledge, sexual debut, and number of sexual partners produced indirect effects. Additionally, logistic regression analyses were conducted to determine if there were differences in sexual health outcomes (chlamydia, gonorrhea, HPV, any STI, and unplanned pregnancy) between those who sustained religiosity from adolescence into adulthood and groups with lower levels of lifetime religiosity (late adopted religiosity, discontinued religiosity, and no religiosity).

Results showed religiosity to be significantly protective against poor sexual health outcomes (chlamydia, gonorrhea, HPV, any STI, and unplanned pregnancy) through the significant indirect effects of attitudes toward sex, parent-child connectedness, problem alcohol use, condom use knowledge, sexual debut, and number of sexual partners. However, the outcomes for which each mediator demonstrated significance varied. Peer religiosity did not demonstrate significant indirect effects for any of the STIs examined or unplanned pregnancy. Additionally, logistic regression results showed sustained religiosity to be most protective of having ever experienced chlamydia, gonorrhea, HPV, any STI, and unplanned pregnancy.

The findings of this study support prior research showing religiosity as a protective factor with respect to sexual health. Understanding more about the role religiosity plays in the long-term sexual health outcomes of adolescents and young adults is a helpful tool to inform parents, practitioners, and policymakers in the efforts to continue reducing unplanned pregnancies and preventing the spread of STIs.

Keywords: religiosity, sexual health, STIs, gonorrhea, chlamydia, HPV, unplanned pregnancy, sexual health outcomes, sexual debut, number of sexual partners



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