A cross-sectional study on attitudes toward gender equality, sexual behavior, positive sexual experiences, and communication about sex among sexually active and non-sexually active adolescents in Bolivia and Ecuador

Figures & data

Table 1 Crude and weighted distribution of respondents by social, demographic and sexual outcome variables

	Crude number of cases	Weighted number of cases
Characteristics (predictors and outcome variables)	n (%)	n (%)
All cases	5,913 (100.0)	5,913 (100.0)
Sex
Boys	3,330 (56.3)	2,957 (50.0)
Girls	2,583 (43.7)	2,956 (50.0)
Age (years)
14	1,173 (19,8)	1,183 (20.0)
15	1,451 (24.5)	1,183 (20.0)
16	1,456 (24.6)	1,183 (20.0)
17	1,274 (21.5)	1,182 (20.0)
18	559 (9.5)	1,182 (20.0)
Country
Bolivia	3,514 (59.4)	2,957 (50.0)
Ecuador	2,399 (40.6)	2,956 (50.0)
Living with mother during the last 3 years
Less than last 3 years	1,043 (18.2)	1,034 (18.1)
3 years or more	4,696 (81.8)	4,691 (81.9)
Living with father during the last 3 years
Less than last 3 years	2,273 (39.5)	2,437 (42.4)
3 years or more	3,486 (60.5)	3,315 (57.6)
Quality of living house
Poor	2,069 (35.0)	2,125 (36.0)
Good	3,834 (65.0)	3,779 (64.0)
Importance of religion
Not important	1,487 (26.9)	1,344 (24.3)
Important	4,047 (73.1)	4,186 (75.7)
Factor of gender equality
Low	1,963 (33.2)	1,971 (33.4)
Middle	2,077 (35.1)	2,042 (34.5)
High	1,873 (31.7)	1,900 (32.1)
Had sexual intercourse (penetration)
No	4,518 (76.6)	4,341 (73.6)
Yes	1,379 (23.4)	1,557 (26.4)
Those who had sex	1,379 (100.0)	1,557 (100.0)
Number of sexual partners
1	596 (51.2)	719 (53.6)
2 or more	569 (48.8)	622 (46.4)
Actual use of contraceptives
No	954 (69.2)	1,054 (67.7)
Yes	425 (30.8)	502 (32.3)
Experience of last sexual intercourse
Not positive	518 (39.5)	531 (35.8)
Positive	794 (60.5)	953 (64.2)
Mutual initiative to have sexual intercourse the last time
No	767 (55.6)	798 (51.3)
Yes	612 (44.4)	758 (48.7)
Pressure to have sexual intercourse
No	1,010 (85.6)	1,169 (86.9)
Yes	170 (14.4)	175 (13.1)
Easy communication with partner about sex
No	432 (37.8)	457 (36.3)
Yes	712 (62.2)	802 (63.7)
Those who did not have sex	4,518 (100.0)	4,341 (100.0)
Ideas about sexual intercourse
Not positive	3,336 (76.8)	3,245 (77.5)
Positive	1,005 (23.2)	943 (22.5)
Agreement with necessity to have sexual intercourse to maintain a relationship
Did not agree	3,271 (74.4)	3,205 (75.7)
Agreed or did not know	1,128 (25.6)	1,031 (24.3)
Feeling the pressure to have sexual intercourse
No	2,991 (89.3)	2,884 (89.5)
Yes	359 (10.7)	340 (10.5)
Easy communication with partner about sex
No	985 (69.3)	952 (68.5)
Yes	436 (30.7)	437 (31.5)

Table 2 The distribution of the scores per AWSA item by sex and age

	Distribution of responses to the items of the gender equality subscale^a
	V03		V05		V09		V12
Group of respondents	Disagree	Agree	Disagree	Agree	Disagree	Agree	Disagree	Agree
Boys	770 (26.3%)	2,157 (73.7%)	1,041 (35.3%)	1,904 (64.7%)	260 (8.8%)	2,679 (91.2%)	667 (22.7%)	2,271 (77.3%)
Girls	508 (17.3%)	2,426 (82.7%)	808 (27.6%)	2,120 (72.4%)	127 (4.3%)	2,805 (95.7%)	455 (15.5%)	2,486 (84.5%)
p ^b	<0.001		<0.001		<0.001		<0.001
14–16-year old adolescents	808 (23.0%)	2,707 (77.0%)	1,158 (32.9%)	2,363 (67.1%)	264 (7.5%)	3,259 (92.5%)	610 (17.3%)	2,911 (82.7%)
17–18-year old adolescents	469 (20.0%)	1,876 (80.0%)	692 (29.4%)	1,661 (70.6%)	123 (5.2%)	2,225 (94.8%)	512 (21.7%)	1,846 (78.3%)
p ^b	0.007		0.005		0.001		<0.001

^aResponses ‘Strongly disagree’ and ‘Disagree’ were aggregated to ‘Disagree’ and responses ‘Agree’ and ‘Strongly agree’ were aggregated to ‘Agree’; ^bChi-square test.

Table 3 Demographic and social factors predicting different aspects of sexual behavior among sexually active adolescents: odds ratios (ORs) and 95% confidence intervals (CIs) estimated from the multivariate binary logistic regression

	Ever had sexual intercourse		Number of sexual partners		Current use of contraceptives		Positive experience last sexual intercourse		Both have taken initiative to have sexual intercourse the last time		Pressure for sexual intercourse		Easy communication with partner
Predictors	OR	(95% CI)	OR	(95% CI)	OR	(95% CI)	OR	(95% CI)	OR	(95% CI)	OR	(95% CI)	OR	(95% CI)
Age^a	1.85	(1.75; 1.95)***	1.17	(1.06; 1.30)**	1.17	(1.06; 1.29)**	1.20	(1.09; 1.33)***	1.31	(1.20; 1.44)***	0.92	(0.80; 1.06)	1.18	(1.06; 1.31)**
Country^b	1.21	(1.05; 1.39)**	0.98	(0.76; 1.26)	1.33	(1.05; 1.70)*	1.81	(1.42; 2.31)***	1.51	(1.23; 1.94)***	0.68	(0.47; 0.97)*	1.15	(0.88; 1.51)
Sex^c	2.17	(1.89; 2.50)***	3.1	(2.41; 3.98)***	0.88	(0.69 1.18)	0.79	(0.62; 1.02)	0.65	(0.52; 0.82)***	0.85	(0.60; 1.22)	0.77	(0.58; 1.01)
Gender equality^d	0.9	(0.77; 1.07)	1.01	(0.75; 1.36)	1.52	(1.14; 2.03)**	1.13	(0.85; 1.50)	1.27	(0.97; 1.66)	0.89	(0.57; 1.38)	1.06	(0.79; 1.44)
Gender equality^e	0.98	(0.84; 1.16)	1.16	(0.87; 1.55)	1.67	(1.26; 2.21)***	1.71	(1.28; 2.28)***	1.21	(0.93; 1.58)	1.28	(0.85; 1.92)	1.83	(1.34; 2.50)**
Living with mother^f	0.61	(0.51; 0.72)***	0.72	(0.53; 0.97)*	0.83	(0.62; 1.10)	0.88	(0.65; 1.18)	1.10	(0.83; 1.45)	0.42	(0.28; 0.62)***	0.88	(0.64; 1.23)
Living with father^f	0.77	(0.66; 0.89)***	0.95	(0.73; 1.23)	1.15	(0.89; 1.48)	1.44	(1.11; 1.86)**	0.90	(0.70; 1.14)	1.12	(0.76; 1.63)	0.75	(0.57; 0.99)*
Living conditions^g	1.16	(1.01; 1.34)*	1.37	(1.05; 1.78)*	1.13	(0.88: 1.45)	1.34	(1.04; 1.73)*	1.12	(0.88; 1.42)	0.80	(0.55; 1.16)	2.05	(1.56; 2.69)***
Importance of religion^h	0.61	(0.53; 0.72)***	0.6	(0.45; 0.79)***	0.87	(0.67; 1.13)	1.64	(1.27; 2.12)***	1.32	(1.03; 1.69)*	0.69	(0.48; 1.00)*	0.68	(0.51; 0.92)*
p ^i	0.853		0.133		0.098		0.090		0.090		0.058		0.155

^aChange by 1 year; ^bEcuador vs. Bolivia (ref.); ^cboys vs. girls (ref.); ^dmedium vs. low gender equality (ref.); ^ehigh vs. low gender equality (ref.); ^fduring last 3 years, lived together with father/mother all time vs. not all time (ref.); ^ggood vs. poor (ref.); ^hreligion was considered as a value vs. not a value (ref); ⁱHosmer and Lemashow test to evaluate the goodness of fit of the logistic regression model. *p<0.05; **p<0.01; ***p<0.001 (bolded).

Table 4 Demographic and social factors predicting different aspects of sexual behavior among adolescents who haven't had sexual intercourse yet: odds ratios (ORs) and 95% confidence intervals (CIs) estimated from the multivariate binary logistic regression

	Positive ideas about sexual intercourse		Agreement to have sexual intercourse to maintain a relationship		Easy communication with partner about sex		Feeling pressure to have sexual intercourse
Predictors	OR	(95% CI)	OR	(95% CI)	OR	(95% CI)	OR	(95% CI)
Age^a	1.17	(1.10 1.24)***	1.09	(1.03; 1.15)**	1.30	(1.21; 1.40)***	1.20	(1.10; 1.31)***
Country^b	1.57	(1.33; 1.86)***	0.96	(0.82; 1.13)	0.81	(0.66; 1.00)*	0.73	(0.57; 0.93)*
Sex^c	3.75	(3.16; 4.44)***	3.67	(3.11; 4.32)***	1.64	(1.34; 2.02)***	2.22	(1.74; 2.84)***
Gender equality^d	1.30	(1.06; 1.59)*	0.79	(0.65; 0.95)***	1.41	(1.10; 1.81)**	0.94	(0.70; 1.25)
Gender equality^e	1.36	(1.11; 1.66)**	0.60	(0.49; 0.73)***	1.86	(1.44; 2.39)***	0.93	(0.70; 1.24)
Living with mother^f	1.32	(1.03; 1.71)*	1.11	(0.87; 1.41)*	0.89	(0.67; 1.18)	0.87	(0.65; 1.17)
Living with father^f	0.91	(0.77; 1.09)	1.09	(0.92; 1.30)	1.03	(0.83; 1.28)	0.94	(0.66; 1.32)
Living conditions^g	1.59	(1.34; 1.90)***	0.90	(0.77; 1.06)	1.08	(0.87; 1.33)	0.90	(0.69; 1.16)
Importance of religion^h	1.14	(0.93; 1.39)	0.77	(0.64; 0.92)**	1.13	(0.86; 1.44)	0.83	(0.63; 1.10)
p ^i	0.173		0.223		0.716		0.234

^aChange by 1 year; ^bEcuador vs. Bolivia (ref.); ^cboys vs. girls (ref.); ^dmedium vs. low gender equality (ref.); ^ehigh vs. low gender equality (ref.); ^fduring last 3 years, lived together with father/mother all time vs. not all time (ref.); ^ggood vs. poor (ref.); ^hreligion was considered as a value vs. not a value (ref); ⁱHosmer and Lemashow test to evaluate the goodness of fit of the logistic regression model. *p<0.05; **p<0.01; ***p<0.001 (bolded).