Social vulnerabilities and sexual initiation of 10- to 14-year-old pupils in the city of Rio de Janeiro, Brazil

Costa, Simoni Furtado da; Moraes, Claudia Leite de; Taquette, Stella Regina; Marques, Emanuele Souza

doi:10.1590/1413-81232022277.20892021EN

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FREE THEMES • Ciênc. saúde coletiva 27 (7) • July 2022 • https://doi.org/10.1590/1413-81232022277.20892021EN copy

Social vulnerabilities and sexual initiation of 10- to 14-year-old pupils in the city of Rio de Janeiro, Brazil

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

This study aimed to estimate the prevalence of sexual initiation of pupils aged 10 to 14 who attended the second year of public and private high school in the IX Administrative Region of the city of Rio de Janeiro, Brazil and to identify the most vulnerable subgroups. The sample consisted of 694 pupils who were selected through cluster-based and stratified sampling by considering school type (public or private) and course type (daytime or evening). Information was collected by means of a structured self-administered questionnaire. The chi-square test (χ2) and 95% confidence intervals were used to assess the heterogeneity of proportions among subgroups. The prevalence of the event was 18.4%; it was higher in boys, in subgroups of greater social vulnerability, among those who hooked up/dated up to 14 years of age, in victims of sexual violence in affective-sexual relationships and in pupils showing health risk behaviors. The high rate of sexual initiation in early adolescence, especially in more vulnerable groups, shows that the situation must be understood and addressed by means of intersectoral public policies that take into account a social context of multiple needs rather than reproductive health alone.

Key words:
Sexual behavior; Sexual and reproductive health; Sexual violence; Adolescent

		Total n=694			Gender						p- value
		Total n=694			Male n=320 (46.7%)			Female n=374 (53.3%)
		n	%	95%CI	n	%	95%CI	n	%	95%CI
Demographic and socioeconomic features
Age
	15 to 16	272	48.5	40.8-56.3	113	44.1	35.5-53.0	159	52.3	44.2-60.2	0.12
	17 to 18	364	46.4	39.3-53.7	172	49.6	41.9-57.3	192	43.7	35.9-51.7
	19 to 24	50	5.1	3.6-7.2	28	6.3	3.7-10.5	22	4.0	2.2-7.2
Race/Skin color
	White	325	53.2	45.6-60.5	142	49.6	41.2-58.0	183	56.3	47.4-64.7	0.15
	Black/Brown	365	46.8	39.5-54.4	176	50.4	42.0-58.7	189	43.7	35.3-52.6
Current religion
	Yes	474	65.3	59.0-71.1	200	59.9	51.3-68.0	274	70.0	63.4-75.9	0.01
	No	217	34.7	28.9-41.0	119	40.1	32.0-48.7	98	30.0	24.1-36.6
Mother's educational level
	Illiterate/Elementary Education I (E.E. I) incomplete	40	5.0	3.5-7.2	17	5.3	2.8-9.7	23	4.7	2.9-7.5	0.26
	E.E. I completed/ E.E. II incomplete	142	17.4	14.0-21.2	62	15.2	11.1-20.4	80	19.2	14.1-25.8
	E.E. II completed/E.M. incomplete	238	32.5	26.2-39.5	110	30.7	22.6-40.0	128	34.2	28.1-40.8
	High School completed/Higher Education incomplete	77	13.5	11.2-16.2	39	16.9	12.7-22.1	38	10.6	7.3-15.0
	High School completed	162	31.6	24.7-39.4	76	31.9	24.4-40.6	86	31.3	23.5-40.3
Economic class (CCEB)
	A	90	17.2	13.4-21.9	47	19.2	14.1-25.7	43	15.5	11.1-21.4	0.16
	B	324	54.8	51.1-58.4	150	56.5	50.5-62.4	174	53.3	47.6-58.8
	C	209	26.6	22.4-31.2	89	23.5	19.0-28.6	120	29.2	23.5-35.6
	D and E	14	1.4	0.8-2.5	4	0.8	0.3-2.3	10	2.0	0.9-4.2
Family context and maternal teenage pregnancy background
Parents
	Mother and father are alive	600	88.3	85.8-90.4	279	88.3	84.0-91.6	321	88.2	83.8-91.6	0.98
	Only one parent is alive	94	11.7	9.6-14.2	41	11.7	8.4-16.0	53	11.8	8.4-16.2
Father is alive
	Yes	621	91.0	88.6-92.9	285	89.8	85.5-92.9	336	92.1	88.4-94.6	0.38
	Does not know/Does not know him	72	9.0	7.0-11.3	35	10.2	7.1-14.5	37	7.9	5.3-11.6
Living conditions
	Lives with his/her father and mother	301	44.4	40.9-47.9	139	43.3	37.0-50.0	162	45.3	38.8-51.9	0.82
	Lives either with his/her father or his/her mother	229	34.8	31.7-38.0	105	34.8	30.1-39.7	124	34.8	30.2-39.8
	Lives with his/her mother/father and stepfather/stepmother	112	15.0	12.8-17.6	54	16.3	12.3-21.3	58	13.9	10.8-17.8
	Lives with other people	48	5.8	4.2-7.8	21	5.6	3.9-8.0	27	6.0	3.9-9.1
Age at which his/her mother gave birth
	10 to 19	100	13.5	10.7-17.0	47	14.9	10.5-20.7	53	12.4	9.1-16.6	0.61
	20 to 34	463	70.3	62.4-77.1	205	68.6	58.7-77.0	258	71.8	63.9-78.5
	35 or older	84	16.2	10.0-25.1	42	16.5	10.4-25.3	42	15.8	9.1-26.1
School features
School type
	Public	387	36.9	32.0-42.1	175	35.4	30.0-41.2	212	38.2	30.0-47.2	0.59
	Private	307	63.1	57.9-68.0	145	64.6	58.8-70.0	162	61.8	52.8-70.0
Course type
	Daytime course	585	90.4	88.2-92.2	261	89.0	84.9-92.1	324	91.7	88.4-94.1	0.29
	Evening course	109	9.6	7.8-11.8	59	11.0	7.9-15.1	50	8.3	5.9-11.6

		Total n=694			Gender						p- value
		Total n=694			Male n=320 (46.7%)			Female n=374 (53.3%)
		n	%	95% CI	n	%	95% CI	n	%	95% CI
Features of sexual initiation and affective-sexual relationship background
Sexual initiation in early adolescence
	Yes, aged<15 years of age	138	18.4	15.5-21.7	85	25.7	21.2-30.6	53	12.2	8.8-16.7	0.00
	No/Occurred≥15 years of age	547	81.6	78.3-84.4	230	74.3	69.3-78.8	317	87.8	83.3-91.2
Has already hooked up/dated
	Yes, aged<15	322	50.8	45.6-56.0	162	56.5	47.3-65.3	160	45.9	41.9-49.9	0.10
	Yes, aged≥15	315	40.5	33.6-47.7	134	36.9	29.2-45.4	181	43.5	36.4-50.9
	No	54	8.7	5.7-13.2	22	6.6	3.6-11.7	32	10.6	5.8-18.6
Has had a same-sex experience
	Yes	110	16.6	13.7-19.9	32	9.7	6.2-14.6	78	22.5	17.0-29.2	0.00
	No	576	83.4	80.1-86.3	281	90.3	85.4-93.7	295	77.5	70.8-83.0
Victimization of sexual violence in affective-sexual relationships
	Yes	230	40.0	35.7-44.5	107	43.3	36.7-50.2	123	37.4	28.6-47.1	0.41
	No	314	60.0	55.5-64.3	138	56.7	49.8-63.3	176	62.6	52.9-71.4
Health risk behaviors in the last 3 months
Use of alcohol
	Yes	471	71.1	66.8-75.1	211	68.8	63.2-73.8	260	731	67.9-77.8	0.16
	No	215	28.9	24.9-33.2	106	31.2	26.2-36.8	109	26.9	22.2-32.1
Use of tobacco
	Yes	147	22.2	18.2-26.8	60	20.8	15.9-26.8	87	23.4	17.2-31.0	0.57
	No	540	77.8	73.2-81.8	257	79.2	73.2-84.1	283	76.6	69.0-82.8
Use of marihuana
	Yes	133	19.7	16.4-23.5	59	21.1	16.1-27.0	74	18.5	13.4-25.1	0.56
	No	554	80.3	76.5-83.6	258	78.9	73.0-83.8	296	81.5	74.9-86.6

		Sexual initiation in early adolescence (10-14 years of age)
		Total n=694				Gender
		Total n=694				Male n=320 (46.7%)				Female n=374 (53.3%)
		n	%	95%CI	p- value	n	%	95%CI	p- value	n	%	95%CI	p- value
Demographic and socioeconomic features
Age
	15 to 16	269	16.2	11.5-22.4	0.29	111	22.4	16.2-30.0	0.26	158	11.9	6.5-20.8	0.90
	17 to 18	361	20.2	16.1-25.0		171	27.8	20.6-36.3		190	12.8	9.6-16.9
	19 to 24	47	24.7	16.2-35.9		26	35.8	23.0-51.1		21	10.1	3.4-26.5
Race/Skin color
	White	324	17.1	12.9-22.3	0.41	141	24.6	17.6-33.3	0.71	183	11.4	6.2-20.0	0.71
	Black/Brown	357	19.8	15.9-24.3		172	26.6	20.6-33.7		185	13.0	9.3-18.0
Current religion
	Yes	468	19.5	15.8-24.0	0.25	198	28.0	22.6-34.0	0.28	270	13.2	9.4-18.3	0.15
	No	214	15.9	11.9-21.0		116	22.2	15.0-31.7		98	8.8	4.9-15.6
Mother's educational level
	>4 years	613	17.7	14.8-21.1	0.01	285	25.2	20.3-30.7	0.08	328	11.2	7.9-15.5
	≤4 years	38	34.5	21.6-50.2		15	51.3	23.3-78.5		23	22.6	10.3-42.5	0.09
Economic class (CCEB)
	A and B	411	18.8	15.7-22.3	0.16	195	26.5	21.4-32.3	0.92	216	11.6	7.5-17.5	0.02
	C	206	18.1	13.4-23.8		88	27.8	18.3-39.8		118	11.4	7.9-16.3
	D and E	13	38.0	17.4-64.1		3	36.6	3.9-89.1		10	38.3	14.8-69.0
Family context features
Parents
	Mother and father are alive	594	17.7	14.7-21.2	0.14	277	25.8	21.4-30.8	0.84	317	10.7	7.3-15.3	0.02
	Only one parent or none is alive	91	24.0	16.3-33.9		38	24.4	13.0-41.0		53	23.8	13.7-37.9
Father is alive
	Yes	615	17.8	14.7-21.4	0.15	283	25.6	21.1-30.6	0.93	332	11.1	7.5-16.3	0.06
	No/Does not know or Does not know him	69	25.7	16.1-38.3		32	26.3	13.7-44.5		37	25.1	12.5-43.9
Living conditions
	Lives with his/her father and mother	296	15.8	11.8-20.8	0.14	137	24.4	17.0-33.6	0.65	159	8.6	5.1-14.3	0.14
	Lives with other people	385	20.5	16.5-25.1		177	26.8	21.3-33.3		208	14.8	9.5-22.4
Age at which his/her mother gave birth
	10 to 19	98	28.2	20.9-36.9	0.09	47	30.6	20.4-43.1	0.33	51	25.7	14.9-40.7	0.01
	20 to 34	459	16.6	13.3-20.4		203	23.5	18.1-30.0		256	11	7.7-15.5
	35 or older	82	20.8	11.8-34.2		40	38.9	15.8-68.4		42	6.4	2.2-17.2
School features
School type
	Public	381	24.5	20.8-29.0	0.00	173	32.8	26.2-40.2	0.02	208	17.8	13.9-22.5	0.04
	Private	304	14.9	11.2-19.5		142	21.6	16.0-28.6		162	8.8	4.5-16.6
Course type
	Daytime course	579	17.0	14.0-20.5	0.00	258	23.9	19.3-29.2	0.03	321	11.2	7.7-16.1	0.03
	Evening course	106	32.3	25.4-40.1		57	40.2	25.8-56.6		49	23.3	13.3-37.5

		Sexual initiation in early adolescence (10-14 years of age)
		Total n=694				Gender
		Total n=694				Male n=320 (46.7%)				Female n=374 (53.3%)
		n	%	95%CI	p- value	n	%	95%CI	p- value	n	%	95%CI	p- value
Affective-sexual relationships
Has already hooked up or dated
	Yes, age<15	320	26.5	21.9-31.8	0.00	161	31.9	25.8-38.7	0.00	159	20.9	15.0-28.3	0.00
	Yes, age≥15	312	11.5	8.6-15.3		132	19.1	13.3-26.5		180	6.0	3.6-10.0
	No	53	3.4	0.8-14.1		22	9.7	2.8-28.6		31	0.0	--
Same-sex sexual experience
	Yes	110	21.0	13.8-30.7	0.53	32	41.6	24.7-60.7	0.06	78	13.5	7.7-22.6	0.68
	No	573	18.0	14.6-22.0		281	24.2	19.3-29.8		292	11.8	8.0-17.1
Sexual violence in affective-sexual relationships in the last 12 months
Victimization in affective-sexual relationships
	Yes	229	29.3	23.2-36.1	0.00	107	40.4	30.6-51.1	0.00	122	18.8	11.7-28.7	0.09
	No	312	14.8	11.2-19.3		137	19.1	13.9-25.7		175	11.6	7.7-17.2
Health risk behaviors in the last three months
Use of alcohol
	Yes	468	21.5	17.6-26.0	0.00	208	31.6	24.9-39.2	0.00	260	13.4	8.9-19.6	0.34
	No	213	11.3	7.9-15.8		106	13.1	9.1-18.3		107	9.5	5.3-16.3
Use of tobacco
	Yes	147	28.9	21.0-38.3	0.00	60	37.2	25.6-50.5	0.02	87	22.4	13.9-34.1	0.01
	No	535	15.5	12.4-19.2		254	22.6	18.7-27.0		281	9.1	5.9-13.8
Use of marihuana
	Yes	133	34.3	26.8-42.6	0.00	59	41.5	30.1-54.0	0.00	74	27.0	19.5-37.6	0.00
	No	549	14.6	11.2-18.7		255	21.4	16.7-27.0		294	8.9	5.8-13.5

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[1] Collaborations

All authors participated effectively in the research and in the elaboration of the manuscript. SF Costa, CL Moraes and SR Taquette participated in study design, data collection and analysis, as well as preparation and final review of the manuscript. ES Marques participated in data analysis, drafting and final review of the manuscript.