Effect of multi-level social risk factors on developmental trajectories of sexual risk behaviors among Bahamian middle-to-late adolescents

Abstract

Background: Few studies have examined how multi-level social factors interact and affect developmental patterns of sexual risk among middle-to-late adolescents who are at risk of experiencing sexual risk behaviors. We examined developmental trajectories of sexual risk behaviors of boys and girls in middle-to-late adolescence and the effects of exposure to three social risk factors (poor parental monitoring, peer risk, and neighborhood risk).

Methods: We followed 2,332 Bahamian adolescents every six months from Grades 10-12. We used group-based trajectory modeling to identify distinct trajectories of sexual risk behaviors for boys and girls.

Results: We identified three trajectories each for boys and girls. Peer risk and neighborhood risk predicted a high sexual-risk trajectory for boys, and peer risk (alone or combined with other risk factors) had the greatest impact on the membership of moderate-to-high-risk trajectory for girls. Parental monitoring had a relatively small effect on adolescents' sexual risk behavior.

Conclusion: Our results underscore the importance of early identification of adolescents with sexual risk behavior and development of targeted prevention interventions to improve adolescent health outcomes.

Keywords: Sexual risk behaviors; adolescents; developmental trajectories; group-based trajectory modeling; middle-to-late adolescence; social risk factors.

Figure 1.

The Sexual Risk Trajectories for Males (a) and Females (b) across 24 Months. Figure 1a shows three distinct sexual risk trajectories for boys, which are low-risk, moderate-risk and increasing, and high-risk trajectories. Figure 2b shows three distinct trajectories for girls, which are no-risk, low-risk and increasing, and moderate-to-high-risk trajectories.

Figure 2.

Probability of Group Membership Based on Experience with Risk Factor Combinations for Males (a) and Females (b). Figure 2 shows the impact of social risk factors on three distinct trajectories for boys and girls. Having high-risk peers, poor parental monitoring, and high-risk neighborhoods had the greatest probability of following the high-risk trajectory for boys and the moderate-to-high-risk trajectory for girls. For boys, those with high-risk peers or neighborhoods or with both risk factors increased the probability of following the high-risk trajectory. For girls, high-risk peers had the highest impact on membership in the moderate-to-high-risk group.