Sexual behavior among Brazilian adolescents, National Adolescent School-based Health Survey (PeNSE 2012)

Oliveira-Campos, Maryane; Nunes, Marília Lavocart; Madeira, Fátima de Carvalho; Santos, Maria Goreth; Bregmann, Silvia Reise; Malta, Deborah Carvalho; Giatti, Luana; Barreto, Sandhi Maria

doi:10.1590/1809-4503201400050010

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Brasil

Revista Brasileira de Epidemiologia

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Sumário

Original Articles • Rev. bras. epidemiol. 17 (suppl 1) • 2014 • https://doi.org/10.1590/1809-4503201400050010 copy

Sexual behavior among Brazilian adolescents, National Adolescent School-based Health Survey (PeNSE 2012)

Authorship SCIMAGO INSTITUTIONS RANKINGS

OBJECTIVE:

This study describes the sexual behavior among students who participated in the National Adolescent School-based Health Survey (PeNSE) 2012 and investigates whether social inequalities, the use of psychoactive substances and the dissemination of information on sexual and reproductive health in school are associated with differences in behavior.

METHODOLOGY:

The response variable was the sexual behavior described in three categories (never had sexual intercourse, had protected sexual intercourse, had unprotected sexual intercourse). The explanatory variables were grouped into socio- demographic characteristics, substance use and information on sexual and reproductive health in school. Variables associated with the conduct and unprotected sex were identified through multinomial logistic regression, using "never had sexual intercourse" as a reference.

RESULTS:

Over nearly a quarter of the adolescents have had sexual intercourse in life, being more frequent among boys. About 25% did not use a condom in the last intercourse. Low maternal education and work increased the chance of risky sexual behavior. Any chance of protected and unprotected sex increased with the number of psychoactive substances used. Among those who don't receive guidance on the prevention of pregnancy in school, the chance to have sexual intercourse increased, with the largest magnitude for unprotected sex (OR = 1.41 and OR = 1.87 ).

CONCLUSION:

The information on preventing pregnancy and STD/AIDS need to be disseminated before the 9^th grade. Social inequalities negatively affect risky sexual behavior. Substance use is strongly associated with unprotected sex. Information on the prevention of pregnancy and STD/AIDS need to be disseminated early.

Adolescents; Survey; Sexual behavior; Schools; Condoms; sexual intercourse

	No	Yes
	Sexual intercourse
	% (95%CI)	With condom*	Without condom*
	% (95%CI)	% (95%CI)	% (95%CI)
Sociodemographic factors
Gender
Male	60.4 (57.9 – 63.0)	31.7 (29.7 – 33.9)	7.9 (7.3 – 8.4)
Female	81.8 (78.4 – 84.7)	13.4 (11.2 – 16.0)	4.8 (4.0 – 5.8)
Age
≤ 12 years old	90.4 (89.3 – 91.4)	7.8 (6.6 – 9.2)	1.8 (1.1 – 3.0)
13 years old	86.8 (84.9 – 88.5)	10.1 (8.6 – 11.8)	3.1 (2.7 – 3.5)
14 years old	77.5 (75.8 – 79.1)	17.5 (16.2 – 18.9)	5.0 (4.5 – 5.5)
15 years old	57.9 (52.0 – 63.5)	33.2 (28.6 – 38.2)	8.9 (7.9 – 10.0)
≥ 16 years old	43.4 (35.9 – 51.1)	43.9 (37.9 – 50.3)	12.8 (11.2 – 14.7)
Race/Color
Caucasian	74.5 (73.3 – 75.7)	20.3 (19.2 – 21.4)	5.2 (5.0 – 5.5)
Black	64.2 (61.8 – 66.5)	27.4 (25.4 – 29.5)	8.4 (7.9 – 9.1)
Brown	72.5 (69.4 – 75.4)	21.3 (18.8 – 24.0)	6.3 (5.5 – 7.1)
Yellow	71.8 (67.9 – 75.4)	21.9 (19.2 – 24.9)	6.3 (5.4 – 7.3)
Indigenous	66.4 (64.0 – 68.7)	25.3 (23.1 – 27.5)	8.4 (7.6 – 9.2)
Maternal school education
Complete college degree	78.6 (75.6 – 81.2)	17.8 (15.9 – 19.7)	3.8 (2.8 – 4.9)
Incomplete college degree	73 (71.2 – 74.8)	21.2 (19.5 – 23.1)	5.8 (5.2 – 6.2)
Incomplete high school	69.8 (67.6 – 71.9)	23.5 (21.9 – 25.1)	6.8 (6.0 – 7.5)
Did not study /incomplete primary school	68.6 (63.5 – 73.3)	24.2 (20.5 – 28.4)	7.2 (6.3 – 8.3)
Does not know how to inform it	73.7 (71.1 – 75.9)	20.5 (18.4 – 22.6)	6.0 (5.4 – 6.6)
Currently working
No	74.6 (72.3 – 76.8)	19.7 (18.0 – 21.6)	5.6 (5.2 – 6.2)
Yes	51.7 (48.6 – 54.8)	38.0 (35.6 – 40.5)	10.2 (9.5 – 11.1)
Region
Southeast	71.4 (70.7 – 72.1)	22.3 (21.7 – 22.9)	6.3 (6.0 – 6.5)
North	62.1 (61.0 – 63.1)	30.1 (28.9 – 31.4)	7.8 (7.3 – 8.2)
Northeast	75.2 (73.2 – 77.1)	19.1 (18.1 – 20.2)	5.7 (4.9 – 6.7)
South	73.0 (72.1 – 73.9)	21.0 (20.2 – 21.8)	6.0 (5.9 – 6.1)
Midwest	68.5 (65.2 – 71.5)	24.8 (22.0 – 27.9)	6.7 (6.5 – 6.9)

	Sexual intercourse
	No	Yes
	% (95%CI)	With condom*	Without condom*
	% (95%CI)	% (95%CI)	% (95%CI)
Use of psychoactive substances
Current use of alcohol
No	79.3 (77.2 – 81.2)	16.2 (14.7 – 17.9)	4.5 (4.1 – 5.0)
Yes	49.9 (46.8 – 53.0)	38.9 (36.4 – 41.5)	11.2 (10.5 – 12.0)
Currently smoking
No	73.8 (71.7 – 75.9)	20.7 (19.0 – 22.5)	5.4 (5.1 – 5.9)
Yes	29.8 (28.0 – 31.6)	48.9 (47.2 – 50.6)	21.3 (19.9 – 22.7)
Curren use of illegal substances
No	74.3 (72.2 – 76.4)	20.4 (18.7 – 22.2)	5.3 (4.9 – 5.7)
Yes	35.5 (33.0 – 38.1)	45.6 (43.1 – 48.0)	18.9 (17.8 – 20.1)
School context characteristics
School managerial domain
Public	69.5 (66.2 – 72.5)	23.8 (21.4 – 26.4)	6.7 (6.1 – 7.4)
Private	82.1 (80.9- 83.3)	13.9 (12.9 – 14.9)	4.0 (3.5 – 4.5)
Information on the orientation about the prevention of pregnancy, AIDS or other STD
Yes	71.6 (69.1 – 73.9)	22.2 (20.3 – 24.2)	6.2 (5.8 – 6.7)
No	58.5 (55.8 – 61.1)	31.6 (29.8 – 33.4)	10.0 (8.9 – 11.0)
Information, in school, about how to get condoms for free
Yes	61.2 (58.3 – 64.0)	28.4 (26.2 – 30.7)	10.3 (9.6 – 11.0)
No	72.7 (70.4 – 74.8)	21.7 (19.9 – 23.6)	5.6 (5.3 – 6.1)

	Sexual intercourse with condom*	Sexual intercourse without condom*
	OR (95%CI)	OR (95%CI)
Sociodemographic factors
Gender
Female	1	1
Male	3.54 (2.84 – 4.40) ^†	2.53 (2.05 – 3.12) ^†
Age
13 years old	1	1
14 years old	1.72 (1.55 – 1.91) ^†	1.60 (1.40 – 1.82) ^†
≥15 years old	4.60 (4.22 – 5.02) ^†	4.10 (3.60 – 4.70) ^†
Race/Color
Caucasian	1	1
Black	1.18 (1.03 – 1.36)	1.46 (1.40 – 1.51) ^†
Brown	0.99 (0.93 – 1.18)	1.11 (0.97 – 1.26)
Yellow	1.08 (0.98 – 1.19)	1.17 (1.08 – 1.29) ^‡
Indigenous	1.27 (1.18 – 1.37) ^†	1.60 (1.41 – 1.81) ^†
Maternal school education
Complete college degree	1	1
Incomplete college degree	1.26 (1.12 – 1.42) ^†	1.63 (1.11 – 2.39) ^‡
Incomplete high school	1.35 (1.10 – 1.65) ^‡	1.93 (1.23 – 3.01) ^†
Did not study /incomplete primary school	1.34 (1.1 – 1.81) ^§	1.92 (1.20 – 3.07) ^‡
Does not know how to inform it	1.18 (0.93 – 1.52)	1.67 (1.14 – 2.46) ^‡
Region
Southeast	1	1
North	1.54 (1.40 – 1.70) ^†	1.42 (1.26 – 1.60) ^†
Northeast	0.76 (0.69 – 0.83) ^†	0.85 (0.72 – 1.00)
South	0.86 (0.81 – 0.90) ^†	0.88 (0.84 – 0.92) ^†
Midwest	1.02 (0.88 – 1.18)	0.97 (0.87 – 1.07)
Currently working
No	1	1
Yes	1.72 (1.64 – 1.80) ^†	1.60 (1.43 – 1.80) ^†
Combined use of psychoactive substances
0 (did not use)	1	1
1	3.34 (3.18 – 3.51) ^†	3.05 (2.83 – 3.28) ^†
2	8.06 (7.54 – 8.61) ^†	10.65 (9.38 – 12.1) ^†
3	18.16 (16.15 – 20.4) ^†	32.65 (28.4 – 37.5) ^†
School factors
School managerial domain
Private	1	1
Public	1.72 (1.49 – 2.00) ^†	1.69 (1.44 – 1.99) ^†
Information on the orientation about the prevention of pregnancy, AIDS or other STD
Yes	1	1
No	1.41 (1.35 – 1.47) ^†	1.87 (1.78 – 1.95) ^†

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[1] Corresponding author: Maryane Oliveira-Campos. Departamento de Vigilância de Doenças e Agravos Não Transmissíveis e Promoção da Saúde, Secretaria de Vigilância em Saúde, Ministério da Saúde. SAF Sul, Trecho 02, Lotes 05 e 06, Edifício Premium, Bloco F, Torre 1, Térreo, Sala 16, CEP: 70070-600, Brasília, DF, Brasil. E-mail: oliveiracampos.maryane@yahoo.com.br