International Journal of Public Health

, Volume 62, Issue 2, pp 271–282 | Cite as

Alcohol abuse and other factors associated with risky sexual behaviors among adolescent students from the poorest areas in Costa Rica

  • Diego Rios-ZertucheEmail author
  • Jose Cuchilla
  • Paola Zúñiga-Brenes
  • Bernardo Hernández
  • Patricia Jara
  • Ali H. Mokdad
  • Emma Iriarte
Original Article



We applied the Integrative Model of Behavioral Prediction to analyze factors associated with risky sexual behaviors for adolescent students living in the poorest segments in Costa Rica.


We used data from a school-based knowledge, attitudes, and behaviors survey from the poorest districts of Costa Rica, collected for Salud Mesoamerica Initiative. We analyzed responses of 919 male and female students (12–19 years old) to determine factors associated with sexual intercourse and condom use.


One of every four students reported being sexually active. Students that reported being sexually active were more likely to consume excessive alcohol (OR 3.04 [95 % CI 1.94–4.79]). While 88.0 % [95 % CI 73.5–95.1] of sexually active adolescents said they would use a condom the next time they have sex, only 53.1 % [95 % CI 39.3–66.5] reported condom use the last time. Non-condom-users felt purchasing condoms was uncomfortable (OR 0.34 [95 % CI 0.12–0.93]).


Poor adolescents in Costa Rica begin sexual activities early and undertake behaviors that increase their risk for unwanted pregnancies and sexually transmitted infections. We found the urgent need to address alcohol abuse, and recognize gender differences in youth health programs.


Costa Rica Integrative model Condom use Adolescents Poverty Alcohol abuse 



We would like to thank the team by the University of Costa Rica, directed by Eyleen Alfaro Porras, for conducting in-country data collection, and the Ministries of Health and Education in Costa Rica for their support to complete this study.

Compliance with ethical standards

Conflict of interest

All authors declare that there are no conflicts of interest.


This study was funded by the Bill & Melinda Gates Foundation, the Carlos Slim Foundation, and the Spanish Agency for International Development Cooperation, through the Inter-American Development Bank. The opinions expressed in this publication are those of the authors and do not necessarily reflect the views of the Inter-American Development Bank, its Board of Directors, or the countries they represent.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

38_2016_859_MOESM1_ESM.docx (272 kb)
Supplementary material 1 (DOCX 271 kb)


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Copyright information

© Swiss School of Public Health (SSPH+) 2016

Authors and Affiliations

  1. 1.Salud Mesoamérica Initiative/Inter-American Development BankPanama CityPanama
  2. 2.University of CaliforniaLos AngelesUSA
  3. 3.Institute for Health Metrics and EvaluationUniversity of WashingtonSeattleUSA
  4. 4.Inter-American Development BankSantiagoChile

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