Determinants of Heterosexual Adolescents Having Sex with Female Sex Workers in SingaporeReport as inadecuate




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Objectives

We assessed the proportion of and socio-ecological factors associated with ever having had sex with female sex workers FSWs among heterosexual adolescents. We also described the characteristics of the adolescents who reported inconsistent condom use with FSWs.

Methods

This is a cross-sectional study response rate: 73% of 300 heterosexually active male adolescents of 16 to 19 years attending a national STI clinic in Singapore between 2009 and 2014. We assessed the ecological factors individual, parental, peer, school and medial influences and sexual risk behaviors using a self-reported questionnaire. Poisson regression was used to obtain the adjusted prevalence ratios aPR and confidence intervals CI.

Results

The proportion of heterosexual male adolescents who had ever had sex with FSWs was 39%. Multivariate analysis showed that significant factors associated with ever having had sex with FSWs were sex initiation before 16 years old aPR 1.79 CI: 1.30–2.46, never had a sexually active girlfriend aPR 1.75 CI 1.28–2.38, reported lower self-esteem score aPR 0.96 CI: 0.93–0.98, higher rebelliousness score aPR 1.03 CI: 1.00–1.07 and more frequent viewing of pornography aPR 1.47 CI: 1.04–2.09. Lifetime inconsistent condom use with FSWs was 30%.

Conclusions

A significant proportion of heterosexual male adolescents attending the public STI clinic had ever had sex with FSWs. A targeted intervention that addresses different levels of influence to this behavior is needed. This is even more so because a considerable proportion of adolescents reported inconsistent condom use with FSWs, who may serve as a bridge of STI transmission to the community. National surveys on adolescent health should include the assessment of frequency of commercial sex visits and condom use with FSWs for long-term monitoring and surveillance.



Author: Junice Y. S. Ng, Mee-Lian Wong

Source: http://plos.srce.hr/



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