Associated factors and sex differences in condom non-use among adolescents: Brazilian National School Health Survey (PeNSE)

Abstract

Background Condom non-use among sexually active adolescents is a major cause of unintended pregnancy and sexually transmitted infections. In order to promote condom use, it is essential to understand factors associated with condom non-use. Aim Our aim was to evaluate sex differences and associated factors of condom non-use based on the nationally representative Brazilian National School Health Survey. Methods The study participants were 100,962 adolescents 13–18 years old, 9th graders from both public and private schools throughout Brazil. The following factors were considered as explanatory group variables for the outcome of condom non-use among adolescents: school and health service, sexual behavior, substance use, and self-reported body and health perception. Poisson regression model was performed. Results Of the total students, 28% (n = 28,157) had had sexual intercourse at least once. (boys, 37.1%; girls, 19.5%). Of these, 69.2% had used condoms the last time they had intercourse (girls: 68%; boys: 69.9%). The variables associated with condom non-use for both sexes were not having accessed a health service or approached a health professional for health-related care; not having received pregnancy prevention counseling or guidance on AIDS or STI prevention at school; early sexual initiation; no additional contraception method; substance use; feeling alone; not being satisfied with their own body; feeling fat or thin; and poor self-reported health. The number of sexual partners was also associated with condom non-use; however, contrasting behavior was indicated between sexes. A higher number of sexual partners indicated less use of condoms among girls, while for boys, a higher number of sexual partners indicated higher condom use. Conclusion High condom non-use appears to be associated with lack of health care access and sexual health education, poor sexual practices, substance use, and poor self-perception, indicating areas for health promotion programs.

Prevalence and Factors Associated with Early Sexual Initiation among College Students in Southwest Ethiopia

“…Early initiation of sexual activity affects the sexual and reproductive health of the young population [ 5 , 13 ]. Youths who begin early sexual activity are more likely to have high-risk sex (multiple sexual partners) [ 8 ], and they are less likely to use condoms [ 14 ] which are related to the increased susceptibility to human immunodeficiency virus (HIV) and other sexually transmitted diseases (STDs) transmission, unwanted pregnancy, and its complications [ 5 , 6 , 9 , 11 , 13 , 15 – 19 ]. Worldwide, the high prevalence of teenage pregnancies among in-school adolescent girls in particular is a major concern for majority of parents, guardians, and duty bearers [ 20 – 22 ].…”

Caracterização das práticas sexuais de adolescentes

“…A pesquisadora permaneceu no mesmo ambiente que o adolescente durante a coleta dos dados, para garantir que não houvesse dúvidas pelos participantes sobre o que se estava perguntando. Para a coleta de dados foi utilizado um instrumento desenvolvido e fundamentado nas diretrizes que orientam as boas práticas na realização de estudos observacionais (10) , com base nas experiências profissionais dos autores, e com base em publicações científicas nacionais e internacionais sobre a temática acerca dos fatores de risco (9) , práticas sexuais (11) e hábitos dos adolescentes (5,7,11) , e assim,…”

“…O início precoce da vida sexual (prévio aos 15 anos), está relacionado a comportamentos sexuais de risco, expondo o adolescente a maiores chances de adquirir IST, ter mais parceiros sexuais, fazer uso inconsistente de métodos contraceptivos, engravidar sem desejar e fazer sexo com parcerias de risco. As práticas sexuais desprotegidas acarretam riscos para o adolescente como a aquisição de IST (5) e a gravidez na adolescência que representa um problema de saúde pública multidimensional. Com isso, é necessário compreender a multicausalidade envolvida na saúde sexual dos adolescentes para propor intervenções afinadas à realidade e sensíveis às suas especificidades (6) .…”

“…De acordo com a Pesquisa Nacional de Saúde do Escolar (PeNSE), cerca de 28,0% dos escolares brasileiros do 9º ano do ensino fundamental (média de idade de 14 anos) já tiveram relação sexual (7) . Entre os adolescentes sexualmente ativos, 24,7-30,8% relataram que não utilizaram preservativos em sua última relação sexual (5,7) . No Brasil, o percentual de nascidos de vivos de mães adolescentes é de aproximadamente 17,5%, com distribuição espacial heterogênea no território, sobretudo, em regiões com menores índices de desenvolvimento humano, o que evidencia as severas inequidades regionais do país e a perpetuação de ciclos intergeracionais de pobreza (8) .…”

Dating Applications, Sexual Behaviors, and Attitudes of College Students in Brazil’s Legal Amazon

“…Theme-Filha et al [23] found that, in Brazil, more than 50% of all pregnancies carried to term were unplanned and were associated with younger age, brown and yellow skin color, substance use, and lower education level. Students report not having received pregnancy prevention counseling or sexual health education [24]. Birth control methods reported by women of reproductive age include oral and/or injectable contraceptives, tubal ligation, and male condoms [25][26][27].…”