JMIR Publications

ABSTRACT

Background:

Healthy sexuality is a key task in adolescent development. Nearly 90% of adolescents live in in low-income and middle-income countries (LMICs), few studies have used a standardised methodology to monito the prevalence and trends of sexual behaviors among adolescents in LMICs.

Objective:

To assess the prevalence of sexual behaviors including ever had sexual intercourse, multiple sexual partners, and condom use, as well as their age and gender differences, and to further evaluate trends in the prevalence of sexual behaviors among adolescents aged 12-15 years in 69 LMICs by using the recent data from the Global School-based Student Health Survey.

Methods:

A total of 14,5277 adolescents aged 12-15 years (44.5% boys) from the 69 LMICs that had done at least one survey, and 80,646 adolescents aged 12-15 years (43.1% boys) from the from 17 LMICs that had done two surveys were included in this study. Complex analysis was used to analyze the sexual-related behaviors of each country in this study. Meta-analysis with random-effects was used to calculate the pooled overall and regional prevalence of sexual-related behaviors.

Results:

The most recent global prevalence of ever had sexual intercourse was 6.9%, and was higher among boys (10.0%) than girls (4.2%), and at age 14-15 years (8.5%) than at age 12-13 years (4.0%); Among adolescents who have ever had sex, the most recent global prevalence of having multiple sexual partners was 6.9%, and was higher among boys (58.0%) than girls (41.4%), and at age 14-15 years (53.5%) than at age 12-13 years (49.7%); Among adolescents who have ever had sex, the most recent global prevalence of condom use was 58.1%, and was higher among girls (59.2%) than boys (57.7%), and at age 14-15 years (59.9%)than at age 12-13 years (51.6%). Between the earliest and latest survey, the overall prevalence of ever had sexual intercourse (3.1% decrease) and condom use (2.0% decrease) showed a downward trend, the overall prevalence of having multiple sexual partners increased by 2.6%.

Conclusions:

Health sexual behaviors are an important component of adolescents’ physical and psychological development. This study found that the prevalence of sexual behaviors in young adolescents varies by country, region, sex, and age group. The overall prevalence of ever had sexual intercourse and condom use decreased over time, but the prevalence of having multiple sexual partners increased over time. This study can provide evidence and important implication for policy-makers to implement target programs that promote and improve the sexual and reproductive health of adolescents.