RESUMEN
BACKGROUND: It is widely agreed upon that gender is a key aspect of sexuality however, questions remain on how gender exactly influences adolescents' sexual health. OBJECTIVE: The aim of this research was to study correlations between gender equality attitudes and sexual behavior, sexual experiences and communication about sex among sexually active and non-sexually active adolescents in 2 Latin American countries. DESIGN: In 2011, a cross-sectional study was carried out among 5,913 adolescents aged 14-18 in 20 secondary schools in Cochabamba (Bolivia) and 6 secondary schools in Cuenca (Ecuador). Models were built using logistic regressions to assess the predictive value of attitudes toward gender equality on adolescents' sexual behavior, on experiences and on communication. RESULTS: The analysis shows that sexually active adolescents who consider gender equality as important report higher current use of contraceptives within the couple. They are more likely to describe their last sexual intercourse as a positive experience and consider it easier to talk with their partner about sexuality than sexually experienced adolescents who are less positively inclined toward gender equality. These correlations remained consistent whether the respondent was a boy or a girl. Non-sexually active adolescents, who consider gender equality to be important, are more likely to think that sexual intercourse is a positive experience. They consider it less necessary to have sexual intercourse to maintain a relationship and find it easier to communicate with their girlfriend or boyfriend than sexually non-active adolescents who consider gender equality to be less important. Comparable results were found for boys and girls. CONCLUSIONS: Our results suggest that gender equality attitudes have a positive impact on adolescents' sexual and reproductive health (SRH) and wellbeing. Further research is necessary to better understand the relationship between gender attitudes and specific SRH outcomes such as unwanted teenage pregnancies and sexual pleasure among adolescents worldwide.
Asunto(s)
Actitud Frente a la Salud , Sexismo/estadística & datos numéricos , Conducta Sexual/psicología , Adolescente , Factores de Edad , Bolivia/epidemiología , Comunicación , Estudios Transversales , Ecuador/epidemiología , Femenino , Humanos , Masculino , Factores Sexuales , Sexismo/psicología , Conducta Sexual/estadística & datos numéricosRESUMEN
BACKGROUND: Adolescents' health is greatly influenced by social determinants, including gender norms. Although research has shown that there is an association between gender attitudes and adolescents' sexual behaviour, few studies have assessed this relationship carefully. The Attitudes toward Women Scale for Adolescents (AWSA) is widely used to assess gender attitudes among adolescents; however, to our knowledge it has not been applied in Latin America. OBJECTIVE: To apply AWSA in Latin America for the first time, to perform a factorial validation of this scale and to assess the relationship of gender attitudes and sexual behaviour in Bolivian and Ecuadorian adolescents. DESIGN: This cross-sectional study was carried out in 2011 among 14-18 year olds in 20 high schools in Cochabamba (Bolivia) and six in Cuenca (Ecuador) as a part of a larger project. Schools were purposively selected. A Spanish version of the 12-item AWSA was employed for this study. The assessed aspects of adolescent sexual behaviour were: reported sexual intercourse, reported positive experience during last sexual intercourse and reported current use of contraception. The psychometric properties of AWSA were investigated, and both explanatory and confirmatory factorial analyses were performed. RESULTS: The number of questionnaires included in the analysis was 3,518 in Bolivia and 2,401 in Ecuador. A factorial analysis of AWSA resulted in three factors: power dimension (PD), equality dimension (ED) and behavioural dimension (BD). ED showed the highest correlates with adolescent sexual behaviour. Higher scores of this dimension were associated with a more positive experience of sexual relationships, a higher current use of modern contraception and greater sexual activity among girls. CONCLUSIONS: This study revealed a three-factorial structure of AWSA and demonstrated that by employing factors, the sensitivity of AWSA increases as compared to using the scale as a whole to assess sexual behaviour. This could have important implications for future research on gender and the sexual experiences of adolescents.