Sexual Risk Behavior Knowledge and Attitudes Among Highly Acculturated, Religiously Engaged Nigerian American Adolescents: A Pilot Mixed-Methods Study

Background: Research on sexual risk behaviors (SRB) among Nigerian American adolescents (NAA) is limited, particularly regarding how acculturation, family, culture, and religiosity shape sexual health knowledge and attitudes. Methods: This pilot parallel mixed-methods design included a convenience sample of 25 Nigerian American adolescents aged 13–17 in South Florida. Quantitative data were collected via REDCap software version 10.5.2 using a sociodemographic questionnaire, the West Virginia Youth Health Risk Behavior Inventory, and a modified acculturation measure; analyses were exploratory because the study was not powered for confirmatory hypothesis testing. Qualitative data were collected from four sex-based focus group discussions virtually via WebEx version 40.11 and analyzed using content and thematic analysis in Atlas.ti. 7.5.18. Results: Most participants were classified as highly acculturated (88%), and 96% reported participation in religious activities at least weekly. Twenty-four participants (96%) reported never having had sexual intercourse, and all reported that they were not currently sexually active. Participants showed high knowledge or protective attitudes in several abstinence- and condom-related domains, although quantitative estimates were imprecise because of the small sample and highly unequal acculturation groups. The very strong association between abstinence and condom-use vulnerability (τb = 0.96) was treated as a potential signal of measurement overlap or sampling instability rather than definitive evidence of a large effect. Qualitative findings identified risk awareness, curiosity, and fear, and strong parental, cultural, and religious influences. Integrated results revealed that abstinence was primarily driven by fear-based motivations, with cultural norms reinforcing risk perceptions and gaps identified between knowledge, efficacy, and behavioral application. Conclusions: These findings characterize a small, highly acculturated and religiously engaged convenience sample and are not generalizable to all Nigerian American adolescents. Larger and more heterogeneous studies are needed to confirm quantitative patterns and evaluate the psychometric performance of the measures in this population.