Context: While many surveys have documented trends in adolescent sexuality and fertility in Latin America, relatively few data are available that describe factors associated with the onset of sexual activity in a Latin American context. Methods: Variables hypothesized to be associated with early sexual debut, such as family structure, parental education, academic performance, peer-group influences, use of drugs and alcohol, and attitudes toward sexuality and early parenthood, were examined through multivariate logistic regression techniques among a sample of 4,248 urban Chilean students aged 11-19. Results: Overall, 21% of the young women and 36% of the young men had ever had sex, with the median ages of first intercourse being 15 years and 14 years, respectively. In the bivariate analyses, the father's absence from the home was significantly associated with early sexual initiation among female students but not among males; however, regardless of gender, students with more liberal attitudes toward sex, those who thought most of their peers were sexually experienced, those who rarely attended religious services, those who had ever used alcohol, tobacco or marijuana, and those with lower grade-point averages were all more likely to have ever had sex. In the final reduced model, there were few differences by gender in the attitudinal, behavioral and social relations factors that were significantly related to sexual debut, although father's presence in the home and academic achievement were still significant in the final model for young women only. Conclusions: Enough young people initiate sexual activity in the early teenage years to warrant offering sex education sooner than is now the case. Courses might thus include specific information on contraception, as well as take into account the ways in which adolescent attitudes, risk behaviors and familial and academic environments shape choices related to sexual behavior.
In 2016, the new edition of the Council for International Organizations of Medical Sciences (CIOMS) Ethical Guidelines was released, which are universally acknowledged as ethical standards in biomedical research. In this article, we critically analyze the improvements and shortcomings of the CIOMS Ethical Guidelines 2016. Among the improvements are the relevance assigned to the social value of research and its effects on decision-making and the creation of public policies; the research development in low-resources scenarios; the communities involvement in the research process; the determination of participants vulnerability and changes on informed consent related proceedings. Despite the improved harmonization with scientific, technologic and social changes, and that the guidelines provide a tool for researchers and members of research ethics committees alike, some topics remain unsolved, namely the management of participants minimal risk and conflicts of interest involved in research, and the development of research in low-incomes scenarios. Nonetheless, we recognize that these new guidelines constitute a progress regarding the context and needs of populations in which research will be conducted, with greater community involvement in the different phases of the investigation project, thus allowing them to access the potential benefits. The impact of the CIOMS Ethical Guidelines 2016, should be appraised over time, particularly in socio-sanitary inequities scenarios and in the context of commercial interests of industry on biomedical research.
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