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Published in: BMC Public Health 1/2010

Open Access 01-12-2010 | Research article

Role of risk and protective factors in risky sexual behavior among high school students in Cambodia

Authors: Siyan Yi, Krishna C Poudel, Junko Yasuoka, Paula H Palmer, Songky Yi, Masamine Jimba

Published in: BMC Public Health | Issue 1/2010

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Abstract

Background

In many developing countries, adolescents have become increasingly prone to engage in habitual risky sexual behavior such as early sexual initiation and unprotected sex. The objective of this study was to identify the operation of risk and protective factors in individual, family, peer, school, and community domains in predicting risky sexual behavior among male and female adolescents in Cambodia.

Methods

From October 2007 to January 2008, we collected data from 1,049 students aged 14 to 20 years. Risky sexual behavior was measured using a scale consisting of four items: sexual intercourse during the past three months, number of sex partners during the past three months, age at first experience of sexual intercourse, and use of condom in last sexual intercourse. The risk factors examined included substance use, depression, peer delinquency, family violence, and community violence. Studied protective factors included family support function, frequency of family dinner, and school attachment.

Results

Of the 1,049 students surveyed, 12.7% reported sexual intercourse during the past three months. Out of those sexually active students, 34.6% reported having two or more sex partners over the same period, and 52.6% did not use a condom during their last sexual intercourse. After controlling for other covariates, a higher likelihood of risky sexual behavior remained significantly associated among male participants with higher levels of substance use, higher levels of peer delinquency, and higher family income. In contrast, risky sexual behavior did not retain its associations with any of the measured protective factors among male participants. Among female participants, a higher likelihood of risky sexual behavior remained significantly associated with higher levels of substance use, higher levels of community-violence witnessing, and lower levels of family support.

Conclusions

The findings suggest the importance of considering gender-related differences in the effects of risk and protective factors when designing and implementing prevention programs. In interventions for both male and female adolescents, prevention of substance use and risky sexual behavior should be integrated. For boys, efforts should focus on the reduction of peer delinquency, while, for girls, improvement of family support should be emphasized.
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Literature
1.
go back to reference Dixon-Mueller R: Starting young: Sexual initiation and HIV prevention in early adolescence. AIDS Behav. 2009, 13: 100-109. 10.1007/s10461-008-9376-2.CrossRefPubMed Dixon-Mueller R: Starting young: Sexual initiation and HIV prevention in early adolescence. AIDS Behav. 2009, 13: 100-109. 10.1007/s10461-008-9376-2.CrossRefPubMed
2.
go back to reference Jejeebhoy SJ, Shah I, Thapa S, (Eds): Sex without consent: Young people in developing countries. 2005, New York and London: Zed Books Jejeebhoy SJ, Shah I, Thapa S, (Eds): Sex without consent: Young people in developing countries. 2005, New York and London: Zed Books
3.
go back to reference Bankole A, Biddlecom A, Guiella G, Singh W, Zulu E: Sexual behavior, knowledge and information sources of very young adolescents in four Sub-Saharan African countries. Afr J Reproduct Health. 2007, 11: 28-43. 10.2307/25549730.CrossRef Bankole A, Biddlecom A, Guiella G, Singh W, Zulu E: Sexual behavior, knowledge and information sources of very young adolescents in four Sub-Saharan African countries. Afr J Reproduct Health. 2007, 11: 28-43. 10.2307/25549730.CrossRef
4.
go back to reference UNAIDS-Joint United Nations Programme on HIV/AIDS: Epidemiological country profile on HIV and AIDS: Cambodia. Summary Epidemiological Fact Sheets. 2008 UNAIDS-Joint United Nations Programme on HIV/AIDS: Epidemiological country profile on HIV and AIDS: Cambodia. Summary Epidemiological Fact Sheets. 2008
5.
go back to reference Hor B, Detels R, Heng S, Mun P: The role of sex worker clients in transmission of HIV in Cambodia. Int J STD AIDS. 2005, 16: 170-174. 10.1258/0956462053057567.CrossRefPubMed Hor B, Detels R, Heng S, Mun P: The role of sex worker clients in transmission of HIV in Cambodia. Int J STD AIDS. 2005, 16: 170-174. 10.1258/0956462053057567.CrossRefPubMed
6.
go back to reference Douthwaite MR, Sareoun L: Sexual behavior and condom use among unmarried young men in Cambodia. AIDS Care. 2006, 18: 505-513. 10.1080/13548500500221537.CrossRefPubMed Douthwaite MR, Sareoun L: Sexual behavior and condom use among unmarried young men in Cambodia. AIDS Care. 2006, 18: 505-513. 10.1080/13548500500221537.CrossRefPubMed
7.
go back to reference Powis N: Cambodia's youth face disturbing trends of drug use and HIV infection. Asian Harm Reduction Network (AHRN) News. 2004, Double issue 35 & 36, May-December 2004, [http://www.ahrn.net] Powis N: Cambodia's youth face disturbing trends of drug use and HIV infection. Asian Harm Reduction Network (AHRN) News. 2004, Double issue 35 & 36, May-December 2004, [http://​www.​ahrn.​net]
8.
go back to reference Palen LA, Edward AS, Flisher AJ, Caldwell LL, Mpofu E: Substance use and sexual risk behavior among South African eighth grade students. J Adolesc Health. 2006, 39: 761-763. 10.1016/j.jadohealth.2006.04.016.CrossRefPubMed Palen LA, Edward AS, Flisher AJ, Caldwell LL, Mpofu E: Substance use and sexual risk behavior among South African eighth grade students. J Adolesc Health. 2006, 39: 761-763. 10.1016/j.jadohealth.2006.04.016.CrossRefPubMed
9.
go back to reference Carter M, McGee R, Taylor B, Williams S: Health outcomes in adolescence: Associations with family, friends, and school engagement. J Adolesc. 2007, 30: 51-62. 10.1016/j.adolescence.2005.04.002.CrossRefPubMed Carter M, McGee R, Taylor B, Williams S: Health outcomes in adolescence: Associations with family, friends, and school engagement. J Adolesc. 2007, 30: 51-62. 10.1016/j.adolescence.2005.04.002.CrossRefPubMed
10.
go back to reference Le TN, Kato T: The role of peer and culture inrisky sexual behavior for Cambodian and Lao/Mien adolescents. J Adolesc Health. 2006, 38: 288-296. 10.1016/j.jadohealth.2004.12.005.CrossRefPubMed Le TN, Kato T: The role of peer and culture inrisky sexual behavior for Cambodian and Lao/Mien adolescents. J Adolesc Health. 2006, 38: 288-296. 10.1016/j.jadohealth.2004.12.005.CrossRefPubMed
11.
go back to reference Brown KL, Tolou-Shams M, Lescano C, Houck C, Zeidman J, Pugatch D, Louries KJ, Project Shield Study Group: Depressive symptoms as a predictor of sexual risk among African American adolescents and young adults. J Adolesc Health. 2006, 39: 444.e 1-444.e 8. Brown KL, Tolou-Shams M, Lescano C, Houck C, Zeidman J, Pugatch D, Louries KJ, Project Shield Study Group: Depressive symptoms as a predictor of sexual risk among African American adolescents and young adults. J Adolesc Health. 2006, 39: 444.e 1-444.e 8.
12.
go back to reference Brady SS: Lifetime community violence exposure and health risk behavior among young adults in college. J Adolesc Health. 2006, 39: 610-613. 10.1016/j.jadohealth.2006.03.007.CrossRefPubMed Brady SS: Lifetime community violence exposure and health risk behavior among young adults in college. J Adolesc Health. 2006, 39: 610-613. 10.1016/j.jadohealth.2006.03.007.CrossRefPubMed
13.
go back to reference Wight D, Williamson L, Henderson M: Parental influences on young people's sexual behavior: A longitudinal analysis. J Adolesc. 2006, 29: 473-473. 10.1016/j.adolescence.2005.08.007.CrossRefPubMed Wight D, Williamson L, Henderson M: Parental influences on young people's sexual behavior: A longitudinal analysis. J Adolesc. 2006, 29: 473-473. 10.1016/j.adolescence.2005.08.007.CrossRefPubMed
14.
go back to reference Borawski EA, Ievers-Landis CE, Lovegreen LD, Trapl ES: Parental monitoring, negotiated unsupervised time, and parental trust: The role of parenting practices in adolescent health risk behaviors. J Adolesc Health. 2003, 33: 60-70. 10.1016/S1054-139X(03)00100-9.CrossRefPubMedPubMedCentral Borawski EA, Ievers-Landis CE, Lovegreen LD, Trapl ES: Parental monitoring, negotiated unsupervised time, and parental trust: The role of parenting practices in adolescent health risk behaviors. J Adolesc Health. 2003, 33: 60-70. 10.1016/S1054-139X(03)00100-9.CrossRefPubMedPubMedCentral
15.
go back to reference Fulkerson JA, Story M, Mellin A, Leffert N, Neumark-Sztainer D, French SA: Family dinner meal frequency and adolescent development: Relationship with development assets and high-risk behaviors. J Adolesc Health. 2006, 39: 337-337. 10.1016/j.jadohealth.2005.12.026.CrossRefPubMed Fulkerson JA, Story M, Mellin A, Leffert N, Neumark-Sztainer D, French SA: Family dinner meal frequency and adolescent development: Relationship with development assets and high-risk behaviors. J Adolesc Health. 2006, 39: 337-337. 10.1016/j.jadohealth.2005.12.026.CrossRefPubMed
16.
go back to reference Peres CA, Rutherford G, Borges G, Galano E, Hudes ES, Hearst N: Family structure and adolescent sexual behavior in a poor area of Sao Paulo, Brazil. J Adolesc Health. 2008, 42: 177-183. 10.1016/j.jadohealth.2007.08.007.CrossRefPubMed Peres CA, Rutherford G, Borges G, Galano E, Hudes ES, Hearst N: Family structure and adolescent sexual behavior in a poor area of Sao Paulo, Brazil. J Adolesc Health. 2008, 42: 177-183. 10.1016/j.jadohealth.2007.08.007.CrossRefPubMed
17.
go back to reference Cleveland MJ, Feinberg M, Bontempo DE, Greenberg MT: The role of risk and protective factors in substance use across adolescence. J Adolesc Health. 2008, 43: 157-157. 10.1016/j.jadohealth.2008.01.015.CrossRefPubMedPubMedCentral Cleveland MJ, Feinberg M, Bontempo DE, Greenberg MT: The role of risk and protective factors in substance use across adolescence. J Adolesc Health. 2008, 43: 157-157. 10.1016/j.jadohealth.2008.01.015.CrossRefPubMedPubMedCentral
18.
go back to reference Bursik RJ, Grasmick HG: The use of contextual analysis in models of criminal behaviors. Delinquency and Crime: Current Theories. Edited by: Hawkins JD. 1996, New York: Cambridge University Press, 236-267. Bursik RJ, Grasmick HG: The use of contextual analysis in models of criminal behaviors. Delinquency and Crime: Current Theories. Edited by: Hawkins JD. 1996, New York: Cambridge University Press, 236-267.
19.
go back to reference Catalano RF, Hawkins JD: The social development model: A theory of antisocial behavior. Delinquency and Crime: Current Theories. Edited by: Hawkins JD. 1996, New York: Cambridge University Press, 149-197. Catalano RF, Hawkins JD: The social development model: A theory of antisocial behavior. Delinquency and Crime: Current Theories. Edited by: Hawkins JD. 1996, New York: Cambridge University Press, 149-197.
20.
go back to reference Catalano RF, Kosterman R, Hawkins JD, Newcomb MD, Abbott RD: Modeling the etiology of adolescents substance use: A test of the social development model. J Drug Issues. 1996, 26: 429-455.CrossRefPubMedPubMedCentral Catalano RF, Kosterman R, Hawkins JD, Newcomb MD, Abbott RD: Modeling the etiology of adolescents substance use: A test of the social development model. J Drug Issues. 1996, 26: 429-455.CrossRefPubMedPubMedCentral
21.
go back to reference Lonczak HS, Huang B, Catalano RF, Hawkins JD, Hill KG, Abbott RD, Ryan JA, Kosterman R: The social predictors of adolescent alcohol misuse: A test of the social development model. J Studies Alcohol. 2001, 62: 179-189.CrossRef Lonczak HS, Huang B, Catalano RF, Hawkins JD, Hill KG, Abbott RD, Ryan JA, Kosterman R: The social predictors of adolescent alcohol misuse: A test of the social development model. J Studies Alcohol. 2001, 62: 179-189.CrossRef
22.
go back to reference Hill KG, Hawkins JD, Catalano RF, Abbott RD, Guo J: Family influences on the risk of daily smoking initiation. J Adolesc Health. 2005, 37: 202-210. 10.1016/j.jadohealth.2004.08.014.CrossRefPubMed Hill KG, Hawkins JD, Catalano RF, Abbott RD, Guo J: Family influences on the risk of daily smoking initiation. J Adolesc Health. 2005, 37: 202-210. 10.1016/j.jadohealth.2004.08.014.CrossRefPubMed
23.
go back to reference Catalano RF, Oxford ML, Harachi TW, Abbott RD, Haggerty KP: A test of the social development model to predict problem behavior during the elementary school period. Crim Behav Ment Health. 1999, 9: 39-56. 10.1002/cbm.290.CrossRef Catalano RF, Oxford ML, Harachi TW, Abbott RD, Haggerty KP: A test of the social development model to predict problem behavior during the elementary school period. Crim Behav Ment Health. 1999, 9: 39-56. 10.1002/cbm.290.CrossRef
25.
go back to reference Woo BS, Chang WC, Fung DSS, Koh JB, Leong JS, Kee CH, Seah CKF: Development and validation of a depression scale for Asian adolescents. J Adolesc. 2004, 27: 677-677. 10.1016/j.adolescence.2003.12.004.CrossRefPubMed Woo BS, Chang WC, Fung DSS, Koh JB, Leong JS, Kee CH, Seah CKF: Development and validation of a depression scale for Asian adolescents. J Adolesc. 2004, 27: 677-677. 10.1016/j.adolescence.2003.12.004.CrossRefPubMed
26.
go back to reference Bensley L, Eenwyk JV, Simmons KW: Childhood family violence history and women's risk for intimate partner violence and poor health. Am J Prev Med. 2003, 25: 38-38. 10.1016/S0749-3797(03)00094-1.CrossRefPubMed Bensley L, Eenwyk JV, Simmons KW: Childhood family violence history and women's risk for intimate partner violence and poor health. Am J Prev Med. 2003, 25: 38-38. 10.1016/S0749-3797(03)00094-1.CrossRefPubMed
27.
go back to reference Vermeiren R, Schwab-Stone M, Deboutte D, Leckman PE, Ruchkin V: Violence exposure and substance use in adolescents: Findings from three countries. Pediatrics. 2003, 111: 535-535. 10.1542/peds.111.3.535.CrossRefPubMed Vermeiren R, Schwab-Stone M, Deboutte D, Leckman PE, Ruchkin V: Violence exposure and substance use in adolescents: Findings from three countries. Pediatrics. 2003, 111: 535-535. 10.1542/peds.111.3.535.CrossRefPubMed
28.
go back to reference Hu G, Sun Z, Hu M, Xia Q, Yin X, Zheng L, Castillo RC: Brief report: Development of a brief scale to assess family support function among Chinese high school students. J Adolesc. 2007, 30: 879-879. 10.1016/j.adolescence.2007.05.005.CrossRefPubMed Hu G, Sun Z, Hu M, Xia Q, Yin X, Zheng L, Castillo RC: Brief report: Development of a brief scale to assess family support function among Chinese high school students. J Adolesc. 2007, 30: 879-879. 10.1016/j.adolescence.2007.05.005.CrossRefPubMed
29.
go back to reference Henry KL, Slater MD: The contextual effect of school attachment on young adolescents' alcohol use. J School Health. 2007, 77: 67-67. 10.1111/j.1746-1561.2007.00169.x.CrossRefPubMed Henry KL, Slater MD: The contextual effect of school attachment on young adolescents' alcohol use. J School Health. 2007, 77: 67-67. 10.1111/j.1746-1561.2007.00169.x.CrossRefPubMed
30.
go back to reference Tapert SF, Aarons GA, Sedlar GR, Brown SA: Adolescent substance use and sexual risk-taking behavior. J Adolesc Health. 2001, 28: 181-181. 10.1016/S1054-139X(00)00169-5.CrossRefPubMed Tapert SF, Aarons GA, Sedlar GR, Brown SA: Adolescent substance use and sexual risk-taking behavior. J Adolesc Health. 2001, 28: 181-181. 10.1016/S1054-139X(00)00169-5.CrossRefPubMed
31.
go back to reference Mmari K, Blum RW: Risk and protective factors that affect adolescent reproductive health in developing countries: A structured literature review. Global Public Health. 2009, 4: 350-366. 10.1080/17441690701664418.CrossRefPubMed Mmari K, Blum RW: Risk and protective factors that affect adolescent reproductive health in developing countries: A structured literature review. Global Public Health. 2009, 4: 350-366. 10.1080/17441690701664418.CrossRefPubMed
32.
go back to reference Zuckerman M, Eysenck S, Eysenck HJ: Sensation seeking in England and America: Cross-cultural, age, and sex comparisons. J Consult Clin Psych. 1978, 46: 139-149. 10.1037/0022-006X.46.1.139.CrossRef Zuckerman M, Eysenck S, Eysenck HJ: Sensation seeking in England and America: Cross-cultural, age, and sex comparisons. J Consult Clin Psych. 1978, 46: 139-149. 10.1037/0022-006X.46.1.139.CrossRef
33.
go back to reference Bell DC, Trevino RA, Atkinson JS, Carlson JW: Motivations for condom use and nonuse. Clin Lab Science. 2003, 16: 20-20. Bell DC, Trevino RA, Atkinson JS, Carlson JW: Motivations for condom use and nonuse. Clin Lab Science. 2003, 16: 20-20.
34.
go back to reference Whitbeck LB, Hoyt DR, Miller M, Kao MY: Parental support, depressed affect, and sexual experience among adolescents. Youth Soc. 1992, 24: 166-177. 10.1177/0044118X92024002003.CrossRef Whitbeck LB, Hoyt DR, Miller M, Kao MY: Parental support, depressed affect, and sexual experience among adolescents. Youth Soc. 1992, 24: 166-177. 10.1177/0044118X92024002003.CrossRef
35.
go back to reference Brown BB, Dolcini MM, Leventhal A: Transformation in peer relationships of adolescents: implications for health-related behavior. Health Risks and Developmental Transactions During Adolescence. Edited by: Schulenberg J, Maggs J, Hurrelmann K. 1997, New York, Cambridge University Press Brown BB, Dolcini MM, Leventhal A: Transformation in peer relationships of adolescents: implications for health-related behavior. Health Risks and Developmental Transactions During Adolescence. Edited by: Schulenberg J, Maggs J, Hurrelmann K. 1997, New York, Cambridge University Press
36.
go back to reference Clasen DR, Brown BB: The multidimensionality of peer pressure in adolescence. J Youth Adolesc. 1985, 14: 451-451. 10.1007/BF02139520.CrossRefPubMed Clasen DR, Brown BB: The multidimensionality of peer pressure in adolescence. J Youth Adolesc. 1985, 14: 451-451. 10.1007/BF02139520.CrossRefPubMed
37.
go back to reference Kliewer W, Murrelle L: Risk and protective factors for adolescent substance use: Findings from a study in selected Central American countries. J Adolesc Health. 2007, 40: 448-455. 10.1016/j.jadohealth.2006.11.148.CrossRefPubMed Kliewer W, Murrelle L: Risk and protective factors for adolescent substance use: Findings from a study in selected Central American countries. J Adolesc Health. 2007, 40: 448-455. 10.1016/j.jadohealth.2006.11.148.CrossRefPubMed
38.
go back to reference Lazarus RS, Folkman S: Stress, appraisal, and coping. 1984, New York, NY: Springer Lazarus RS, Folkman S: Stress, appraisal, and coping. 1984, New York, NY: Springer
39.
go back to reference Ostaszewski K, Zimmerman MA: The effects of cumulative risks and promotive factors on urban adolescent alcohol and other drug use: A longitudinal study of resiliency. Am J Comm Psych. 2006, 38: 237-249. 10.1007/s10464-006-9076-x.CrossRef Ostaszewski K, Zimmerman MA: The effects of cumulative risks and promotive factors on urban adolescent alcohol and other drug use: A longitudinal study of resiliency. Am J Comm Psych. 2006, 38: 237-249. 10.1007/s10464-006-9076-x.CrossRef
40.
go back to reference Rice F: The adolescent: Development, relationship, and culture. 1999, Boston, MA: Allyn and Bacon Rice F: The adolescent: Development, relationship, and culture. 1999, Boston, MA: Allyn and Bacon
41.
go back to reference Scales PC: Reducing risks and building developmental assets: essential actions for promoting adolescent health. J School Health. 1999, 69: 113-9. 10.1111/j.1746-1561.1999.tb07219.x.CrossRefPubMed Scales PC: Reducing risks and building developmental assets: essential actions for promoting adolescent health. J School Health. 1999, 69: 113-9. 10.1111/j.1746-1561.1999.tb07219.x.CrossRefPubMed
42.
go back to reference O'Donell CR: Culture, peers, and delinquency: Implications for the community-peer model of delinquency. Edited by: O'Donell CR. 2003, Culture, peers, and delinquency. NY: The Haworth Press, Inc O'Donell CR: Culture, peers, and delinquency: Implications for the community-peer model of delinquency. Edited by: O'Donell CR. 2003, Culture, peers, and delinquency. NY: The Haworth Press, Inc
43.
go back to reference Werner NE, Silbereisen RK: Family relation quality and contact with deviant peers as predictors of adolescent problem behaviors: The moderating role of gender. J Adolesc Res. 2003, 18: 454-480. 10.1177/0743558403255063.CrossRef Werner NE, Silbereisen RK: Family relation quality and contact with deviant peers as predictors of adolescent problem behaviors: The moderating role of gender. J Adolesc Res. 2003, 18: 454-480. 10.1177/0743558403255063.CrossRef
44.
go back to reference Thornberry TP, Lizotte AJ, Krohn MD, Farnworth M, Jang SJ: Testing interactional theory: An examination of reciprocal causal relationships among family, school, and delinquency. J Crim Law and Crimino. 1991, 82: 3-35. 10.2307/1143788.CrossRef Thornberry TP, Lizotte AJ, Krohn MD, Farnworth M, Jang SJ: Testing interactional theory: An examination of reciprocal causal relationships among family, school, and delinquency. J Crim Law and Crimino. 1991, 82: 3-35. 10.2307/1143788.CrossRef
Metadata
Title
Role of risk and protective factors in risky sexual behavior among high school students in Cambodia
Authors
Siyan Yi
Krishna C Poudel
Junko Yasuoka
Paula H Palmer
Songky Yi
Masamine Jimba
Publication date
01-12-2010
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2010
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-10-477

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