Abstract
Although low socioeconomic status (SES) adolescents suffer from higher rates of adverse sexual and reproductive health outcomes, evidence on the association between SES and sexual behaviors has been less consistent. A cross-sectional analysis of the association between sociodemographic characteristics (household wealth, maternal education and race/ethnicity) and sexual behaviors (sexual initiation, multiple sexual partners, inconsistent condom use and inconsistent contraceptive use) of Brazilian adolescents was carried out using the 2015 Brazilian National Survey of School Health (PeNSE), a nationally representative school-based survey of 102,301 adolescents. Analyses included multivariable logistic models, which accounted for geographic and family characteristics. About 27.5% of adolescents were sexually initiated. Household wealth was associated with female sexual initiation, while race/ethnicity was associated with condom use and multiple sexual partners among males. For instance, black males had 35% higher odds of having multiple partners (aOR = 1.35, 95%CI: 1.13-1.62), but 22% lower odds of condom use (aOR = 0.78, 95%CI: 0.65-0.94), compared to white males. Frequent parental supervision was positively related to condom use (females, aOR = 1.28, 95%CI: 1.10-1.49; and males, aOR = 1.33, 95%CI: 1.18- 1.49). Results show the complex relationship between SES and sexual behaviors. Researchers should pay attention to gender, racial and social norms salient to adolescent sexual behaviors, as they can influence data collection and results. National policies should also support active parental supervision, since it can be a protective factor.
Highlights
Adolescence is a critical time for sexual development
Researchers have posed that adolescents in singleparent households are more likely to have had sex compared to those in dual-parent households because they might be subject to higher rates of parental absence 18 and permissive attitudes towards sex 34. These findings show that these factors may be at play in Brazil, since adolescents living alone, or with just one parent had higher odds of sexual initiation compared to those living with both parents
This study investigated the potential association between socioeconomic status (SES) and sexual behaviors among adolescents in Brazil and illustrated their complex relationship
Summary
Adolescence is a critical time for sexual development This period is marked by the onset of puberty, the start of fertility, and, often times, the beginning of sexual activity 1. This development is a natural part of adolescence 2, if condoms are not used, sexual activity can expose adolescents to sexually transmitted infections (STIs) and unintended pregnancies 3. A middle-income country home to 34 million adolescents 9, has been considered a global model in the prevention and treatment of STI’s such as HIV 10. Recent trends in new cases of HIV among adolescents indicate a quasi-doubling in the infection’s incidence among 15-19 years old youth Recent budgetary pressures and political turmoil have highlighted the need for more efficient STI preventive efforts in the country 10
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