Reproductive health risk behavior survey of Colombian high school students

Risk perception and sexual behavior in HPV-vaccinated and unvaccinated young Colombian women

OBJECTIVE

To compare sexual behaviors and risk perception between young women vaccinated for HPV and unvaccinated Colombian women.

METHODS

In a cross-sectional design study, 1436 women (231 adolescents, <18 years; 1205 young women, 18-26 years) completed a self-administered questionnaire between May 2011 and March 2012 in Bogotá, Colombia. Data from vaccinated and unvaccinated women were compared by descriptive statistics and multivariate models.

RESULTS

Sexual risk behaviors were not associated with vaccination after adjustment for risk perception, age, educational level, and HPV knowledge. By contrast, vaccination was associated with higher routine Pap smear screening (odds ratio [OR], 2.35; 95% confidence interval [CI], 1.69-3.28), use of modern contraceptives (OR, 2.02; 95% CI, 1.26-3.22), and consistent use of condoms (OR, 1.49; 95% CI, 1.11-2.01). Vaccinated young women were more likely to have had sex (OR, 2.08; 95% CI, 1.56-2.78), but sexual debut among adolescents was not associated with vaccination. In bivariate and multivariate analyses, vaccination status was negatively associated with perceived risk of HPV infection, warts, and cervical cancer. There was no association between vaccination and perceived risk of sexually transmitted infections in any model.

CONCLUSION

No association was found between changes in risk perception after HPV vaccination and sexual risk behaviors.

Sexual behavior and drug consumption among young adults in a shantytown in Lima, Peru

Background

Risky sexual behaviors of young adults have received increasing attention during the last decades. However, few studies have focused on the sexual behavior of young adults in shantytowns of Latin America. Specifically, studies on the association between sexual behaviors and other risk factors for sexually transmitted infections (STI) and HIV/AIDS transmission, such as the consumption of illicit drugs or alcohol are scarce in this specific context.

Methods

The study participants were 393 men and 400 women between 18 and 30 years of age, from a shantytown in Lima, Peru. Data were obtained via survey: one section applied by a trained research assistant, and a self-reporting section. Logistic regression was used to estimate associations between use of any illicit drug, high-risk sexual behaviors and reported STI symptoms, adjusting for alcohol consumption level and various socio-demographic characteristics.

Results

Among men, age of sexual debut was lower, number of lifetime sexual partners was higher, and there were higher risk types of sexual partners, compared to women. Though consistent condom use with casual partners was low in both groups, reported condom use at last intercourse was higher among men than women. Also, a lifetime history of illicit drug consumption decreased the probability of condom use at last sexual intercourse by half. Among men, the use of illicit drugs doubled the probability of intercourse with a casual partner during the last year and tripled the probability of reported STI symptoms.

Conclusion

Drug consumption is associated with high-risk sexual behaviors and reported STI symptoms in a Lima shantytown after controlling for alcohol consumption level. Development of prevention programs for risky sexual behaviors, considering gender differences, is discussed.

Developing scales for measuring gender behaviors in reproductive health in rural China

This article introduces two scales for measuring the gender-specific burden of family planning (FP) and reproductive health (RH) in rural China, following the implementation of a client-oriented approach to FP/RH. One scale (GHRHS-SC) measures FP/RH clients to examine whether gender influences FP/RH behaviors. The other scale (GHRHS-SP) measures service provider interactions with service clients to gauge whether FP/RH institutions are fulfilling the client-oriented mandate. The content of scales was developed through inductive analysis conducted on data generated from focus groups and in-depth interviews. The validation of the scales was confirmed with item analysis, exploratory factor analysis, and confirmatory factor analysis. To generate data for validation purposes, we employed a stratified cluster sampling method for a sample of service providers and a stratified multistage method for a sample of service clients. The analytical results indicate that the scales possess good internal consistency, reliability, and overall validity. The construct validity for the GHRHS-SP needs some improvement. Both the GHRHS-SC and GHRHS-SP are valid instruments for measuring gender differences in FP/RH behavior, though further refinements would be beneficial.

Brief report: Risky sexual behavior of adolescents in Belgrade: Association with socioeconomic status and family structure

OBJECTIVE

The aim of this study was to investigate the association between socioeconomic status and family structure with risky sexual behaviors in adolescents.

METHODS

A total of 1782 15-year-old Belgrade schoolchildren (47.5% boys and 52.5% girls) completed a questionnaire from the WHO study, "Health behavior of schoolchildren".

RESULTS

Adolescents with a higher weekly disposable income, those who perceived their family as wealthy, and those with difficulties in communication with their mothers were more likely to have had been sexually active (odds ratios (OR)=2.497, 1.876, and 1.253, respectively). Adolescents with a higher weekly disposable income were more likely to use contraception (OR=0.233), but those who perceived their families as better-off and those living with only one parent were more likely not to use contraception (OR=4.794, 22.295 [living with father], and 6.169 [living with mother], respectively).

CONCLUSIONS

The perceived family wealth was significantly associated with having sexual intercourse and having sexual intercourse without using contraception. Family structure had a limited independent association with sexual behavior.

A descriptive study of youth risk behavior in urban and rural secondary school students in El Salvador

Background

Adolescence is an important stage of life for establishing healthy behaviors, attitudes, and lifestyles that contribute to current and future health. Health risk behavior is one indicator of health of young people that may serve both as a measure of health over time as well as a target for health policies and programs. This study examined the prevalence and distribution of youth health risk behaviors from five risk behavior domains–aggression, victimization, depression and suicidal ideation, substance use, and sexual behaviors–among public secondary school students in central El Salvador.

Methods

We employed a multi-stage sampling design in which school districts, schools, and classrooms were randomly selected. Data were collected using a self-administered questionnaire based on the United States Center for Disease Control and Prevention's Youth Risk Behavior Survey. Sixteen schools and 982 students aged 12–20 years participated in the study.

Results

Health risk behaviors with highest prevalence rates included: engagement in physical fight (32.1%); threatened/injured with a weapon (19.9%); feelings of sadness/hopelessness (32.2%); current cigarette use (13.6%); and no condom use at last sexual intercourse (69.1%). Urban and male students reported statistically significant higher prevalence of most youth risk behaviors; female students reported statistically significant higher prevalence of feelings of sadness/hopelessness (35.6%), suicidal ideation (17.9%) and, among the sexually experienced, forced sexual intercourse (20.6%).

Conclusion

A high percentage of Salvadoran adolescents in this sample engaged in health risk behaviors, warranting enhanced adolescent health promotion strategies. Future health promotion efforts should target: the young age of sexual intercourse as well as low condom use among students, the higher prevalence of risk behaviors among urban students, and the important gender differences in risk behaviors, including the higher prevalence of reported feelings of sadness, suicidal ideation and forced sexual intercourse among females and higher sexual intercourse and substance use among males. Relevance of findings within the Salvadoran and the cross-national context and implications for health promotion efforts are discussed.

The role of peer, parent, and culture in risky sexual behavior for Cambodian and Lao/Mien adolescents

PURPOSE

The purpose of this study was to investigate the role of age, gender, peer, family, and culture in adolescent risky sexual behavior for Cambodian and Laotian (Lao)/Mien youth.

METHODS

We obtained cross-sectional, in-home interview data including measures of individualism, collectivism, acculturation, risky sexual behavior, peer delinquency, parent engagement, and parent discipline from a sample of mostly second-generation Cambodian (n = 112) and Lao/Mien (n = 67) adolescents. Data were analyzed using step-wise, hierarchical multiple regressions.

RESULTS

Peer delinquency and age (older) were significant predictors of risky sexual behavior in both groups. Parent discipline also significantly predicted risky sexual behavior, but only for Lao/Mien adolescents. Vertical and horizontal individualism were associated positively with risky sexual behavior for Cambodian youth whereas collectivism (horizontal) was associated negatively with risky sexual behavior for Lao/Mien youth. Acculturation was nonsignificant in both groups.

CONCLUSIONS

In addition to age, parents, and peer groups, the findings suggest that culture also matters in risky sexual behavior, particularly for Cambodian and Laotian youth.

Adolescent health in the Caribbean: a regional portrait

OBJECTIVES

This study assessed youth health in the Caribbean Community and Common Market countries and describes the prevalence of health-related factors.

METHODS

We used a self-administered classroom questionnaire; questions addressed general health, health care, nutrition, sexual history, drug use, mental health, violence, family characteristics, and relationships with others.

RESULTS

Most youths reported good health; however, 1 in 10 reported a limiting disability or significant health problems. Violence was a pervasive concern. Of those who reported history of sexual intercourse, many reported that their first intercourse was forced, and nearly half reported that they were aged 10 years or younger when they first had intercourse.

CONCLUSIONS

Although most young people are healthy, problems indicate the importance of monitoring trends and designing effective youth health programs.