Sexual Activity and Associated Behavioral Risk Factors--论文代写范文

这些风险因素导致更频繁的发生,从事性行为的可能性就越高。未来的研究应该检查风险因素，并确定影响性启蒙和性行为的模式。性活动中未婚的年轻人正在上升。下面的essay代写范文进行论述。

Abstract 
  This study describes the prevalence of risky sexual activities among Bolivian adolescents within the context of other behavioral factors that contribute to compromised health outcomes, unintended pregnancies, and sexually transmitted infections including HIV/AIDS. Data was collected from 576 adolescents, 13-18 years of age, from six schools in La Paz, Bolivia, using the Youth Risk Behavior Surveillance Survey. Findings indicate that males were more likely than females to report having ever engaged in sex, initiated sexual activity at age 14 or younger, and had two or more sexual partners within the three months prior to the survey. For both sexes, those who initiated sexual activity at an early age were more likely to engage in a variety of risk behaviors, with alcohol as the most significant risk factor. The likelihood of engaging in sexual activity is associated with age, low academic performance, substance abuse, violence, depression, and suicidal tendencies. The more frequent the occurrence of these risk factors, the higher the chances of engaging in sexual activity. Future research should examine efforts to simultaneously reduce multiple risk factors and to determine how adolescents’ views on reproductive issues influence sexual initiation and patterns of sexual behavior over time. 
Key Words: Bolivia, Adolescents, Sexual Activity, Alcohol Use, Substance Abuse

 Introduction 
  Worldwide, sexual activity among young unmarried people is on the rise.1 Individuals 10-24 years of age make up more than a quarter of the world’s population and 86% of whom reside in developing countries.2 Involvement in risky behaviors, including the early transition to sexual activity and unprotected sex, makes this age group particularly vulnerable to sexually transmitted infections including HIV/AIDS, as well as unplanned and unwanted pregnancies, abortions, and the complications of early childbearing.1, 2 The onset of sexual activity varies by world region.3 It occurs earliest in Latin America where 44% to 66% of men and 12% to 44% of women have had sex by age 16.

 Adolescent Sexuality 
  Sexual development is a normal part of adolescence. It involves not only the physical changes characteristic of this period, but also the formation of one’s individuality, perspectives, attitudes, expressions of intimacy, and the defining of experiences within a sexual and romantic framework.4 The actual sexual experience is comprised of a range of sexual expressions with varying degrees of closeness ranging from non-coital activities such as kissing and oral sex to the “first intercourse”. Although adolescents may be involved in diverse sexual activities, the first coital experience is regarded as a major feature in the shift to adulthood.4 The early initiation of sexual activity may expose adolescents to considerable social consequences and risks that can compromise individual health, as well as the health of their partners and the larger population of adolescents. 

  For instance, a younger age at first intercourse (usually 16 or younger), is associated with increases in pregnancy, abortions, complications of early childbirth, unprotected sex, having multiple sexual partners, and the use of alcohol and drugs prior to sexual activity.1, 5-7 In the United States, female adolescents start sex at an average age of 17.4 years old and 16.9 for males. In addition, 8% of the nation’s male adolescents and 6% of its female adolescents reported having had sex before age 14.8 Halpern-Felsher and colleagues also noted that adolescents commonly engage in oral sex. 9 They indicated that between 14% and 50% of adolescents reported having had oral sex prior to their first coital experience, often unaware that sexually transmitted infections can also be transmitted through this route.

 The Early Transition to Sexual Activity and Pregnancy in Bolivia 
  Adolescents make up more than half of the Bolivian population.10 However, by age 19, 27% of female adolescents are already mothers. 11 Bolivia has a birth rate of 81 live births per 1000 15-19-year-old women with an infant mortality rate of 97 per 1000 live births among women younger than 20. The fact that 69% of the country’s total abortions were from 14- 15-year-old mothers further attests to the seriousness of this problem with adolescent pregnancy.11 Teen pregnancies and the early transition to motherhood bring health risks for both mother and child and discourage young mothers from completing their education and obtaining gainful employment.11-13 Such reproductive profile ranks Bolivia among the 50 countries with the highest risk of childbirth and its concomitant complications.14 

  In addition, while many adolescents are aware of HIV/AIDS, most adolescents are not aware of other sexually transmitted infections.12 Lack of reproductive health programs and services, inadequate training of health center staff, and communication of inaccurate health information continue to compound existing reproductive health problems.15-16 Although the reproductive status and sexual activity of Bolivian adolescents have been described elsewhere, few studies have examined multiple risk behaviors-including the use of alcohol, exposure to violence, poor academic performance, and depression-that could accompany the early transition to sexual activity. This study describes the prevalence of risky sexual activities among Bolivian adolescents within the context of other risk behaviors that are known to contribute in later life to serious health and social problems including unintended pregnancies and sexually transmitted infections.

  The findings indicate that Bolivian adolescents who have had sex were also more likely to have engaged in other risky behaviors. Furthermore, adolescents who regularly used alcohol, cigarettes and/or marijuana were more likely to engage in sex than those who reported limited substance use. Other risk factors such as violence, low academic performance, depression and suicidal tendencies also exhibited a dose-response relationship, that is, the more persistent the occurrence of these risks, the higher the likelihood for sexual involvement. Among both males and females, alcohol use was noted to be the strongest risk factor for engaging in sexual activity. Bolivian males were more likely than females to engage in a variety of risky behaviors. For instance, males were more likely to report having ever engaged in sex, having started sexual activity at age 14 or younger, and having had two or more sexual partners within the three months prior to the survey. These findings affirm a strong gender pattern in sexual risktaking activity as described in other studies.

  Likewise, the results are consistent with research on youth risk behaviors conducted in other populations, including the United States. This suggests that patterns of adolescent sexual behavior and risk factors are similar across national boundaries. Limitations of this study include the non-random selection of individual study participants, the crosssectional nature of the survey, and a bias toward male adolescents attending school. In this study, the schools were randomly selected. 

  However, the selection of student participants was based mainly on the discretion of their respective school administrators who were more likely to have male students completed the survey, possibly due to cultural norms or expectations regarding gender participation. In addition, the results represent data gathered at a single point in time and which pertain only to adolescents attending school. A longitudinal study would have allowed an analysis of trends in sexual activity as well as associated risk factors over time. Given the sensitive nature of the subject matter, some individuals may not have responded truthfully about past or current sexual experiences. However, the reliability and validity of the YRBSS as an instrument of self-reported behaviors have been repeatedly evaluated and demonstrated.（essay代写)

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