Predictors and Outcomes of Adolescents’ Sexual and Reproductive Health : An Ecological Approach

Experiences with sexual behaviors and intimate relationships typically start during adolescence. These experiences are a normative and integrated part of overall development, yet they may have consequences for adolescents’ sexual and reproductive health (SRH) and psychological wellbeing. Worldwide, estimates of the World Health Organization indicate that about 333 million sexually transmitted infections occur yearly, of which a considerable part affects adolescents aged 15–19 years. In addition, globally, about 17 million teenage girls younger than 20 years give birth every year. SRH problems among adolescents are a challenge for most countries, and are not restricted to low- and middle-income countries (LMIC). Understanding the factors that affect adolescents’ SRH behaviors and outcomes is a fundamental step towards the improvement of adolescents’ SRH.
In the current thesis, we applied a holistic approach to understanding adolescent sexuality (ecological systems theory). The studies presented in this thesis investigate adolescents’ SRH behaviors and outcomes and various predictors thereof. Specifically, the SRH behaviors and outcomes included: adolescents’ experiences with early sexual behaviors, timing of first sexual intercourse, number of sexual partners, condom use, contraceptive use, and teen pregnancy.
The predictors were classified into:
1) individual factors (e.g., gender, ethnic background, depression);
2) social factors (e.g., mother– and father–adolescent relationship quality, parental monitoring, in-school sexuality education).
The studies described in this thesis illustrate the relevance of factors from diverse levels, from individual to social. Overall, our findings support that various stakeholders (e.g., parents, health professionals, and schools), and adolescents themselves, can contribute to a positive sexual development.