The risk and protective factors for risky sexual behaviors among school-aged adolescents in Indonesia

Abstract

Background: Indonesia's 65 million young people aged 10-24 comprise 28% of its total population. Studies revealed that adolescents who engage in early sexual activity are prone to sexually transmitted diseases, unwanted pregnancy, and unsafe abortion. This study examined the prevalence and associated factors of risky sexual behaviors among Indonesian secondary school adolescents using the 2015 Indonesia Global School-based Student Health Survey (GSHS). Methods: A total of 11,142 students filled the self-administered questionnaire. Risky sexual behaviors measured included 1) ever had sexual intercourse, 2) multiple partners, 3) condom use. The determinant factors were sociodemographic characteristics, mental health-related factors, interpersonal variables, socioeconomic, and parental understanding. A multivariate logistic regression model was used to estimate the adjusted odds ratio and 95% CI. Results: The prevalence of ever had sex was 5.3%; 1.2% of students had sexual intercourse with multiple partners; The prevalence of condom use was 34%. Results from the multivariate logistic regression indicated that ever-had sex had the strongest association with suicide ideation (aOR= 4.636; 95% CI = 4.542-4.732) and significantly lower among respondents who have a parental understanding (aOR = 0.318; 95% CI = 0.310-0.326). Having sex with multiple partners had the highest correlation with smoking behavior (aOR= 9.967; 95% CI = 9.816-10.12), significantly lower among respondents who have a parental understanding (aOR=0.644; 95% CI = 0.632-0.656). Having parental understanding had the strongest correlation with condom use (aOR= 6.597; 95% CI = 6.291-6.918), while loneliness had the lowest relation. (aOR= 0.706; 95% CI = 0.669-0.745). Conclusions: Adolescent sexual reproductive health programs should employ a holistic approach involving mental health promotion and tobacco control programs. It is also essential to engage parents in any adolescent sexual reproductive health program. Key messages: Risky sexual behaviors have a strong correlation with mental health. It is essential to engage parents in any adolescent sexual reproductive health program.