Sexual Risk Behavior: a Multi-System Model of Risk and Protective Factors in South African Adolescents

Abstract

Adolescent sexual risk behavior has typically been studied within singular, isolated systems. Using a multi-system approach, this study examined a combination of individual, proximal, and distal factors in relation to sexual risk behavior among adolescents. A large cross-sectional sample of 2561 adolescent (Mage = 14.92, SDage = 1.70) males (n = 1282) and females in Grades 8 (n = 1225) and 10 completed a range of self-report measures. Hierarchical ordinal logistic regression results supported a multi-system perspective of adolescent sexual risk behavior. Although individual and peer levels were identified as the primary contributors to the final model, a range of factors at varying levels of proximity to the individual were associated with sexual risk behavior. Specifically, being male, black, attaining increased age, greater alcohol use (individual level), parent risk behavior (family/home level), and peer risk behavior, feeling more pressure from peers to have sex (peer level), and lower social cohesion (community level) were associated with increased sexual risk behavior. These findings suggest multiple individual, proximal, and distal factors are salient to understanding sexual risk behavior among adolescents. Implications of the findings for interventions targeting the prevention of adolescent sexual risk behavior are discussed.

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Fig. 1

Notes

  1. 1.

    All South African public schools are classified into one of five quintiles based on socioeconomic indicators of the communities that surround each school (Murray 2016).

  2. 2.

    Block 1 (Individual), Block 2 (Individual + Family/home), Block 3 (Individual + Family/home + Peer), Block 4 (Individual + Family/home + Peer + School), Block 5 (Individual + Family/home + Peer + School + Community).

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Correspondence to Kaymarlin Govender.

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All procedures involving participants in this study were performed 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. Study approval was granted by the University of KwaZulu-Natal Human and Social Science Research Ethics Committee and the Provincial Department of Basic Education, KwaZulu-Natal.

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Govender, K., Cowden, R.G., Asante, K.O. et al. Sexual Risk Behavior: a Multi-System Model of Risk and Protective Factors in South African Adolescents. Prev Sci 20, 1054–1065 (2019). https://doi.org/10.1007/s11121-019-01015-3

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Keywords

  • Adolescents
  • Ecological
  • Multi-system
  • Protective factors
  • Risk factors
  • Sexual risk behavior
  • Youth