The findings and conclusions in these presentations have not been formally disseminated by the Centers for Disease Control and Prevention and should not be construed to represent any agency determination or policy.

Tuesday, May 9, 2006 - 10:00 AM
13

Multi-level correlates of Adolescent Sexual Behavior and Risk for STD

Kathleen A. Ethier1, Christine J. De Rosa2, Deborah H. Kim2, Abdelmonem Afifi3, and Peter R. Kerndt4. (1) CCEHIP, Centers for Disease Control and Prevention, 1600 Clifton Rd, MS-E28, Atlanta, GA, USA, (2) Health Research Association, 1111 N. Las Palmas Ave, Los Angeles, CA, USA, (3) Department of Biostatistic, University of California at Los Angeles, UCLA School of Public Health, Los Angeles, CA, USA, (4) Sexually Transmitted Disease Program, Los Angeles County Department of Health Services, 2615 S. Grand Ave., Room 500, Los Angeles, CA, USA


Background:
Social-context factors influence adolescent sexual behavior, including parental monitoring and communication, after school supervision, school, neighborhood and community bonds, health care access and utilization. These factors have not been examined in combination or with multiple risk behaviors.

Objective:
To examine the role of parent, school, community and health care factors in adolescent sexual behavior.

Method:
In class surveys completed by 4557 middle school students and 5930 high school students (total n=10, 487) in 26 schools in the Los Angeles Unified School District. Outcome measures: (1) ever having sex; (2) intentions to remain abstinent until marriage; (3) consistent condom use; and (4) multiple lifetime partners. Predictors: parent factors (parental monitoring, family rules, relationship satisfaction, communication, family bond); school factors (after-school supervision, school bond), community factors (community participation) and health care factors (access to a school-based health center, reproductive health care, contact with school nurse). Separate logistic regression analyses examine relationships between these factors and each outcome.

Result:
Sexual initiation was significantly related to all parent factors, after school supervision and contact with school nurse. Abstinence intention was related to four parent factors, school bond, contact with school nurse and community participation. Consistent condom use was related to parental monitoring and communication, school bond, reproductive health care, contact with the school nurse and community participation. Multiple partners was related to parental monitoring and family rules, and access to school-based health center.

Conclusion:
The results suggest that multiple factors work together to influence adolescent sexual behavior. Each social context level is important and none is related to all outcomes.

Implications:
These results suggest that a multi-level approach addressing social context levels in an integrated way could have the greatest impact on adolescent risk behavior. A multi-level approach must address a variety of factors within social context level.

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