Beyond sexual desire and curiosity: sexuality among senior high school students in Papua and West Papua Provinces (Indonesia) and implications for HIV prevention

When it comes to sexuality and norms, young Indonesians are becoming more open. Concern about this is related to the rapid increase in HIV prevalence in Indonesia, especially in Papua and West Papua Provinces. While much research has been conducted among youth who have left school, little is known about senior high school students' sexuality and sexual practices in these provinces. Using qualitative and quantitative data, we explore perspectives on and experiences of sexuality, contraceptive use, unintended pregnancy and unsafe abortion among 1082 Year 11 students from 16 senior high schools in both provinces. Findings suggest that around 38.3% of students reported having had sexual intercourse and 36.5% of these having had their first sexual encounter before they were 15 years old. Furthermore, contraceptive use among sexually active students was very low. Around 32% of female students who reported having had sexual intercourse also reported having an unintended pregnancy and the majority of them had had unsafe abortions. The paper points to the implications of students' high-risk sexual behaviours for HIV prevention.     

A profile of sexually active male adolescent high school students in Lima, Peru

To document knowledge and attitudes regarding sexuality and sexual practices of male adolescent high school students in Lima, Peru, a self-administered, anonymous survey was completed by 991 male adolescents aged 12-19 as part of a School-Based Sex Education Intervention model. Questions concerned sociodemographic information; family characteristics; personal activities; knowledge and attitudes regarding sexuality; sexual experience; and contraceptive use. Knowledge related to sexuality was limited. Males tended to mainly discuss sexuality with their male peers (49.8%). Attitudes towards sexual activity and condom use were largely positive, although some males expressed ambivalent feelings towards the latter. Of the sample, 43% had ever had sex; age at first sexual intercourse was 13 years. While 88% of the sample would use condoms, 74% also gave reasons for not using them. Sexual activity was related to age, ever having repeated a grade, living with only one parent or in a mixed family, activities such as going to parties, use of alcohol, tobacco, and drugs, and viewing pornographic videos or magazines. Many male adolescents were at risk of causing an unintended pregnancy or acquiring an STD.     

Unintended pregnancy and its risk factors among university students in eastern China

BACKGROUND: The study was conducted to determine the prevalence of unintended pregnancy, induced abortion and contraceptive use, and factors associated with unintended pregnancy among Chinese university students. STUDY DESIGN: A self-administered questionnaire survey with cross-sectional design was administered among students in two universities in Ningbo, China, in November-December 2003. Sociodemographic and behavioral factors associated with unintended pregnancy were identified in both genders using univariate and multivariate analyses. RESULTS: Of sexually active students, 10.6% of male and 11.6% of female students reported their partner or they had a history of pregnancy; 10.0% of male and 11.3% of female students reported their partner or they had a history of induced abortion. The risk factors for unintended pregnancy identified among males by multivariate analysis were older age [odds ratio (OR), 2.12; 95% confidence interval (CI), 1.15-3.88], initiation of sexual activity before high school (OR, 2.45; 95% CI, 1.36-4.44), reported lack of condom use in first sexual activity (OR, 1.71; 95% CI, 1.10-2.64), multiple sexual partners (OR, 1.54; 95% CI, 1.06-2.23), and often used condoms during their lifetime (OR, 1.97; 95% CI, 1.01-3.81). The identified risk factors among females were initiation of sexual activity before high school (OR, 5.12; 95% CI, 1.49-17.68), non-consensual sexual intercourse as first sex (OR, 1.77; 95% CI, 1.08-2.90), multiple partners (OR, 2.75; 95% CI, 1.61-4.71), and sometimes/never (OR, 3.02; 95% CI, 1.16-7.87) or often (OR, 3.92; 95% CI, 1.43-10.73) used condoms during their lifetime. CONCLUSION: The high prevalence of unintended pregnancies and induced abortions in this population indicates a need for better and targeted sex education and family planning services.     

Pregnancy and contraceptive use in a national representative sample of Australian secondary school students

OBJECTIVE: To determine rate of pregnancy and use of contraception in a nationally representative sample of school students. METHODS: Year 10 and 12 students from a representative random sample of schools throughout Australia completed a survey concerning health and sexual behaviour. RESULTS: Thirty-five per cent of students had experienced sexual intercourse. Of these, 6.1% (males 4.1%, females 7.8%) reported they had experienced sex that resulted in pregnancy, and a further 7.5% were unsure. Most sexually active students reported using a condom (65%), and a further 36.8% reported using the pill for contraception the last time they had sex. Relatively few students (17.2%) used a dual contraceptive (female method and condom). CONCLUSIONS: Rates of reported pregnancy among Year 10 and 12 students are relatively high. Although the majority of students used some form of contraception when they had sex, a significant minority practised unprotected and unsafe sex. IMPLICATIONS FOR PUBLIC HEALTH PRACTICE: Sex education concerning pregnancy and sexually transmitted infection risks must be delivered early enough to influence first and early sexual activity.     

通州区大中学生艾滋病知识态度行为调查

目的了解通州区大、中学生艾滋病知识掌握情况及其态度和行为,为学校开展预防艾滋病健康教育提供依据。方法采用整群分层抽样方法,对2237名大、中学生进行艾滋病知识、态度、行为问卷调查。结果对艾滋病的三大传播途径,大中学生的回答正确率均达到86%以上;有25.2%的中学生及36.7%的大学生知道蚊虫叮咬不会传播艾滋病。对艾滋病感染者大中学生选择同情和关怀的居首位,占70%左右;39.5%的中学生及38.4%的大学生认为对艾滋病感染者应严格隔离。2.6%的中学生和8.3%的大学生自我报告有过性行为,性行为报告率男生高于女生（P〈0.01）。结论学校应针对不同年龄、性别学生的特点,制定适宜的健康教育策略,使大中学生对艾滋病有全面正确的认识。     

HIV-Related Knowledge, Beliefs, and Behaviors Among High School Students in the United States: Results from a National Survey

The Secondary School Student Health Risk Survey measured the prevalence of sexual intercourse and illegal drug injection among a national probability sample of U.S. high school students and assessed their HIV-related knowledge and beliefs. Ninety-nine (81%) of the 122 selected schools and 8,098 (83%) of the eligible students participated. Nearly all high school students knew the major modes of HIV transmission. Three percent reported injecting illegal drugs, and 1% reported sharing needles used to inject drugs. In addition, 59% of students reported having sexual intercourse and, of students who reported having sexual intercourse, 40% reported having four or more sexual partners. HIV-related knowledge, beliefs, and behaviors among high school students suggest the need for school-based HIV education programs that help young people acquire the knowledge and skills to adopt and maintain behaviors that reduce risk of HIV infection and other related health problems.     

Substance use and HIV-related sexual behaviors among US high school students: are they related?

OBJECTIVES. This study was undertaken to examine whether use of alcohol, cigarettes, marijuana, cocaine, and other illicit drugs is related to the likelihood of sexual behaviors that increase risk for human immunodeficiency virus (HIV) infection among youth. METHODS. The 1990 national Youth Risk Behavior Survey was used to collect self-reported information about a broad range of health risk behaviors from a representative sample of 11,631 high school students in the United States. RESULTS. Students who reported no substance use were least likely to report having had sexual intercourse, having had four or more sex partners, and not having used a condom at last sexual intercourse. Adjusted for age, sex, and race/ethnicity, odds ratios for each of these sexual risk behaviors were greatest among students who had used marijuana, cocaine, or other illicit drugs. Students who had used only alcohol or cigarettes had smaller but still significant increases in the likelihood of having had sexual intercourse and of having had four or more sex partners. CONCLUSIONS. HIV prevention programs for youth should recognize that substance use may be an important indicator of risk for HIV infection and acquired immunodeficiency syndrome through its association with unsafe sexual behaviors.     

京津两市中学生青春期发育与性行为比较

目的 了解中学阶段青少年的性发育和性行为发生状况，为开展适宜的生殖健康教育及服务提供建议。方法 采用不记名的自我报告式问卷，于1998-1999年对北京和天津市4所中学的初、高中一、二年级1506名学生进行调查。结果 两地中学生绝大部分均已进入青春发育期，其月经初潮和首次遗精的平均年龄与全国资料相比，基本接近，手淫在两市中学生中均普遍存在。总发生率为33.6%，两地比较，天津高于北京，性别差异主要见于男性，性行为发育率为2.2%，北京高于天津，中学生性行为发生为酒后冲动以及对性经历的好奇和对两性关系纯理想化的观念所致。同时发现中学生性经历存在感染性传播疾病和非意愿怀孕的高危险倾向。结论 应重视青春期性与生殖健康教育，帮助青少年建立对性问题的正确态度，责任感和安全性行为。     

洛阳市中学生艾滋病性行为知识态度调查

目的了解河南省洛阳市中学生艾滋病性行为知识、态度现状，以便更好地开展中学生艾滋病及性行为健康教育活动。方法2004年9至12月采用分层整群随机抽样方法，对洛阳市6个区6所普通中学初中和高中的1980名学生进行了艾滋病性行为知、信、行结构式问卷调查。结果中学生没有接受过预防艾滋病的健康教育的比例为54．5％；艾滋病知识的掌握、传播途径不完全知道的比例为38．3％；不知道日常生活接触不传播艾滋病的比例为28．8％；没有与亲友谈论过艾滋病的比例为76．3％，而且91．2％的学生表示不愿意和AIDS／HIV感染者同班学习。中学生看过描写性行为的书刊、音像制品等的比例为21．7％；赞成婚前性行为的比例为13．4％；中学阶段学生曾发生性行为的比例为1．1％；80．5％的中学生认为艾滋病及性知识健康教育很有必要；18．9％的中学生希望从父母、教师或专家获得有关艾滋病及性的知识。结论中学生艾滋病及性知识缺乏，尽快在中学生中开展艾滋病及性行为健康教育。使之安然度过性困惑期已刻不容缓。     

Differences and similarities in sexual and contraceptive knowledge, attitudes, and behavior among Latino male adolescent students in California, United States and Lima, Peru

To identify the differences and similarities in sexual and contraceptive knowledge, attitudes, and behavior among Latino male adolescent students living in California and Lima. Self-administered, anonymous surveys were completed by Latino male students aged 12-19 participating in California, and by male adolescent students in four high schools in Lima. Both surveys contained similar questions allowing for comparisons regarding sexual activity and contraceptive behavior. The mean age of male students were 16 and 15 years, respectively. More California males reported having engaged in sexual intercourse (69% vs 43%. The sexual debut was 13 years in both samples. More students in California were aware of their risk of pregnancy at first sexual intercourse than in Lima (82% vs 50%). One-third of the California males reported communicating with their partner about sex and contraception to be "easy" as compared to 53% of males in Lima. More students in California reported knowing a place to obtain contraceptives if they need them (85% vs 63%), having ever gotten someone pregnant (29% vs 7%), and having fathered a child (67% vs 16%).     

Family connectedness and sexual risk-taking among urban youth attending alternative high schools

CONTEXT : Youth in alternative high schools engage in risky sexual behavior at higher rates than do their peers in regular schools, placing themselves at an increased risk of sexually transmitted disease and unintended pregnancy. Family connectedness is associated with reduced adolescent sexual risk-taking, although this association has not been tested among alternative school youth.
METHODS : A sample of 976 urban, predominantly minority alternative high school students in Houston, Texas, were surveyed in 2000-2002. Survey data were analyzed using logistic regression to determine whether family connectedness is related to sexual risk-taking .
RESULTS : Overall, 68% of students reported ever having had sex. Of sexually experienced students, 74% reported having had sex in the past three months and 29% reported ever having been involved in a pregnancy. The higher students scored on a scale of perceived family connectedness, the less likely they were to report ever having had sex, recently having had unprotected sex and having been involved in a pregnancy (odds ratio, 0.97 per unit increase for each outcome). Among females, higher perceived family connectedness was associated with reduced odds of ever having had sex or having initiated sex prior to age 13 (0.96 for each); males who perceived higher family connectedness had reduced odds of having been involved in a pregnancy (0.93) .
CONCLUSIONS : Family connectedness may be a protective factor related to sexual risk-taking, even among high-risk youth. Including activities that acknowledge the influence of family relationships and facilitate positive parent-child relationships may increase the efficacy of programs for reducing sexual risk-taking among alternative school youth.     

Trends in sexual risk behaviors among high school students--United States, 1991-2001

Unprotected sexual intercourse places young persons at risk for human immunodeficiency virus (HIV) infection, other sexually transmitted diseases (STDs), and unintended pregnancy. Responsible sexual behavior among adolescents is one of the 10 leading health indicators of the national health objectives for 2010 (objective 25.11). To examine changes in sexual risk behavior that occurred among high school students in the United States during 1991-2001, CDC analyzed data from six national Youth Risk Behavior surveys (YRBS). This report summarizes the results of the analysis, which indicate that, during 1991-2001, the percentage of U.S. high school students who ever had sexual intercourse and the percentage who had multiple sex partners decreased. Among students who are currently sexually active, the prevalence of condom use increased, although it has leveled off since 1999. However, the percentage of these students who used alcohol or drugs before last sexual intercourse increased. Despite decreases in some sexual risk behaviors, efforts to prevent sexual risk behaviors will need to be intensified to meet the national health objective for responsible sexual behavior.     

北京市大学生避孕知识、态度、行为现况调查

目的 了解北京市在校大学生避孕知识、态度、行为及影响因素.方法 采用定量研究方法,根据知情同意原则选择12 450名未婚大学生进行匿名问卷调查.结果 共回收12 129份有效问卷,其中女生的避孕相关知识知晓率高于男生,差异有统计学意义(P=0.000).赞成未婚同居及性解放的比率男生分别为81.9%和60.2%,女生分别为74.8%和54.3%;74.3%的男生和24.9%的女生有性自慰史,18.4%的男生和10.5%女生承认发生过婚前性行为;在有性行为的学生中,29.4%的男生曾导致性伴意外妊娠,23.1%的女生发生过意外妊娠;在对以上知识的态度和行为中男女生间的差异均有统计学意义(意外妊娠P=0.004,其余P=0.000).在首次性行为中使用避孕措施的男生和女生均为51.3%;没有使用避孕药具的主要原因是性行为没有计划而未备避孕药具,认为使用麻烦、影响情趣及认为偶尔性行为不会导致怀孕.结论 大学生未婚性行为发生率呈日益上升趋势,未婚性行为中避孕药具使用率低,意外妊娠发生率高,亟需在大学生中加强避孕知识的宣传.     

北京市大学生避孕知识、态度、行为现况调查

目的 了解北京市在校大学生避孕知识、态度、行为及影响因素.方法 采用定量研究方法,根据知情同意原则选择12 450名未婚大学生进行匿名问卷调查.结果 共回收12 129份有效问卷,其中女生的避孕相关知识知晓率高于男生,差异有统计学意义(P=0.000).赞成未婚同居及性解放的比率男生分别为81.9%和60.2%,女生分别为74.8%和54.3%;74.3%的男生和24.9%的女生有性自慰史,18.4%的男生和10.5%女生承认发生过婚前性行为;在有性行为的学生中,29.4%的男生曾导致性伴意外妊娠,23.1%的女生发生过意外妊娠;在对以上知识的态度和行为中男女生间的差异均有统计学意义(意外妊娠P=0.004,其余P=0.000).在首次性行为中使用避孕措施的男生和女生均为51.3%;没有使用避孕药具的主要原因是性行为没有计划而未备避孕药具,认为使用麻烦、影响情趣及认为偶尔性行为不会导致怀孕.结论 大学生未婚性行为发生率呈日益上升趋势,未婚性行为中避孕药具使用率低,意外妊娠发生率高,亟需在大学生中加强避孕知识的宣传.     

北京市大学生避孕知识、态度、行为现况调查

目的 了解北京市在校大学生避孕知识、态度、行为及影响因素.方法 采用定量研究方法,根据知情同意原则选择12 450名未婚大学生进行匿名问卷调查.结果 共回收12 129份有效问卷,其中女生的避孕相关知识知晓率高于男生,差异有统计学意义(P=0.000).赞成未婚同居及性解放的比率男生分别为81.9%和60.2%,女生分别为74.8%和54.3%;74.3%的男生和24.9%的女生有性自慰史,18.4%的男生和10.5%女生承认发生过婚前性行为;在有性行为的学生中,29.4%的男生曾导致性伴意外妊娠,23.1%的女生发生过意外妊娠;在对以上知识的态度和行为中男女生间的差异均有统计学意义(意外妊娠P=0.004,其余P=0.000).在首次性行为中使用避孕措施的男生和女生均为51.3%;没有使用避孕药具的主要原因是性行为没有计划而未备避孕药具,认为使用麻烦、影响情趣及认为偶尔性行为不会导致怀孕.结论 大学生未婚性行为发生率呈日益上升趋势,未婚性行为中避孕药具使用率低,意外妊娠发生率高,亟需在大学生中加强避孕知识的宣传.     

北京市大学生避孕知识、态度、行为现况调查

目的 了解北京市在校大学生避孕知识、态度、行为及影响因素.方法 采用定量研究方法,根据知情同意原则选择12 450名未婚大学生进行匿名问卷调查.结果 共回收12 129份有效问卷,其中女生的避孕相关知识知晓率高于男生,差异有统计学意义(P=0.000).赞成未婚同居及性解放的比率男生分别为81.9%和60.2%,女生分别为74.8%和54.3%;74.3%的男生和24.9%的女生有性自慰史,18.4%的男生和10.5%女生承认发生过婚前性行为;在有性行为的学生中,29.4%的男生曾导致性伴意外妊娠,23.1%的女生发生过意外妊娠;在对以上知识的态度和行为中男女生间的差异均有统计学意义(意外妊娠P=0.004,其余P=0.000).在首次性行为中使用避孕措施的男生和女生均为51.3%;没有使用避孕药具的主要原因是性行为没有计划而未备避孕药具,认为使用麻烦、影响情趣及认为偶尔性行为不会导致怀孕.结论 大学生未婚性行为发生率呈日益上升趋势,未婚性行为中避孕药具使用率低,意外妊娠发生率高,亟需在大学生中加强避孕知识的宣传.     

北京市大学生避孕知识、态度、行为现况调查

目的 了解北京市在校大学生避孕知识、态度、行为及影响因素.方法 采用定量研究方法,根据知情同意原则选择12 450名未婚大学生进行匿名问卷调查.结果 共回收12 129份有效问卷,其中女生的避孕相关知识知晓率高于男生,差异有统计学意义(P=0.000).赞成未婚同居及性解放的比率男生分别为81.9%和60.2%,女生分别为74.8%和54.3%;74.3%的男生和24.9%的女生有性自慰史,18.4%的男生和10.5%女生承认发生过婚前性行为;在有性行为的学生中,29.4%的男生曾导致性伴意外妊娠,23.1%的女生发生过意外妊娠;在对以上知识的态度和行为中男女生间的差异均有统计学意义(意外妊娠P=0.004,其余P=0.000).在首次性行为中使用避孕措施的男生和女生均为51.3%;没有使用避孕药具的主要原因是性行为没有计划而未备避孕药具,认为使用麻烦、影响情趣及认为偶尔性行为不会导致怀孕.结论 大学生未婚性行为发生率呈日益上升趋势,未婚性行为中避孕药具使用率低,意外妊娠发生率高,亟需在大学生中加强避孕知识的宣传.     

The sexual and reproductive behavior of American women, 1982-1988

Comparison of 1988 data from the National Survey of Family Growth with 1982 data reveals that the proportion of U.S. women who have had sexual intercourse rose slightly, from 86 percent to 89 percent. Among teenagers, the proportion sexually active rose from 47 percent to 53 percent; most of the change is attributable to increases occurring among white and nonpoor teenagers, thus narrowing racial and income differences. Among women aged 15-44 in 1988 who have ever had intercourse, 67 percent reported that they had had two or more sexual partners in their lifetime. The proportion was highest among women aged 20-34 (about 70 percent), but 58 percent of sexually active teenage women reported having had two or more sexual partners. About 67 percent of women of reproductive age in 1988 were exposed to the risk of unintended pregnancy, up from 63 percent in 1982. Among these women, 35 percent rely on contraceptive sterilization to prevent pregnancy and 55 percent use reversible methods, while 10 percent use no method. Poor women are much more likely than nonpoor women to be using no method of contraception (15 vs. eight percent); among poor teenagers, this proportion reaches 25 percent. The level of contraceptive use at first intercourse among teenage women improved substantially between 1982 and 1988, however, rising from 48 percent to 65 percent. During 1984-1988, almost four in 10 births and almost six in 10 pregnancies among American women were unintended; most of these were mistimed, but 12 percent of births were unwanted ever.(ABSTRACT TRUNCATED AT 250 WORDS)     

Pregnancy Risk among Black,White, and Hispanic Teen Girls in New York City Public Schools

Disparities in teen pregnancy rates are explained by different rates of sexual activity and contraceptive use. Identifying other components of risk such as race/ethnicity and neighborhood can inform strategies for teen pregnancy prevention. Data from the 2005 and 2007 New York City Youth Risk Behavior Surveys were used to model demographic differences in odds of recent sexual activity and birth control use among black, white, and Hispanic public high school girls. Overall pregnancy risk was calculated using pregnancy risk index (PRI) methodology, which estimates probability of pregnancy based on current sexual activity and birth control method at last intercourse. Factors of race/ethnicity, grade level, age, borough, and school neighborhood were assessed. Whites reported lower rates of current sexual activity (23.4%) than blacks (35.4%) or Hispanics (32.7%), and had lower predicted pregnancy risk (PRI = 5.4% vs. 9.0% and 10.5%, respectively). Among sexually active females, hormonal contraception use rates were low in all groups (11.6% among whites, 7.8% among blacks, and 7.5% among Hispanics). Compared to white teens, much of the difference in PRI was attributable to poorer contraceptive use (19% among blacks and 50% among Hispanics). Significant differences in contraceptive use were also observed by school neighborhood after adjusting for age group and race/ethnicity. Interventions to reduce teen pregnancy among diverse populations should include messages promoting delayed sexual activity, condom use and use of highly effective birth control methods. Access to long-acting contraceptive methods must be expanded for all sexually active high school students.     

北京市大学生避孕知识、态度、行为现况调查

目的 了解北京市在校大学生避孕知识、态度、行为及影响因素.方法 采用定量研究方法,根据知情同意原则选择12 450名未婚大学生进行匿名问卷调查.结果 共回收12 129份有效问卷,其中女生的避孕相关知识知晓率高于男生,差异有统计学意义(P=0.000).赞成未婚同居及性解放的比率男生分别为81.9%和60.2%,女生分别为74.8%和54.3%;74.3%的男生和24.9%的女生有性自慰史,18.4%的男生和10.5%女生承认发生过婚前性行为;在有性行为的学生中,29.4%的男生曾导致性伴意外妊娠,23.1%的女生发生过意外妊娠;在对以上知识的态度和行为中男女生间的差异均有统计学意义(意外妊娠P=0.004,其余P=0.000).在首次性行为中使用避孕措施的男生和女生均为51.3%;没有使用避孕药具的主要原因是性行为没有计划而未备避孕药具,认为使用麻烦、影响情趣及认为偶尔性行为不会导致怀孕.结论 大学生未婚性行为发生率呈日益上升趋势,未婚性行为中避孕药具使用率低,意外妊娠发生率高,亟需在大学生中加强避孕知识的宣传.