Social Support and Its Effects on Adolescent Sexual Risk Taking: A Look at Vulnerable Populations in Baltimore and Johannesburg.

INTRODUCTION: We seek to understand whether and how much social support affects adolescent sexual risk-taking in disadvantaged urban environments.

METHODS: Secondary analyses were conducted on data from the global Wellbeing of Adolescents (15-19years old) in Vulnerable Environments study. The outcomes of interest were sexual experience, age at sexual debut, number of lifetime sexual partners, and condom use at last sex. Social support scales measuring support at home, at school, and from peers were created, as well as a measure about who raised them. Logistic and linear regressions were used to examine associations between social support and sexual risk-taking after controlling for age, schooling, and family structure.

RESULTS: Higher social support was associated with adolescents taking less sexual risk but it was context- and gender-specific. Boys raised by males had lower odds of having sex (adjusted odds ratios (aORs) from .15 (CI = .05-.42) to .19 (.04-.88)). Baltimore girls raised by grandmothers had lower odds of having sex (aOR .34 (.16-.71)). Female support at home was positively associated with girls in Baltimore (aOR .08 (CI = .04-.17)) and Johannesburg (aOR .17 (CI = .03-.87)) having fewer partners. Baltimore girls raised by fathers (aOR 3.78 (CI = 2.33-6.12)) and Johannesburg boys raised by non-biological/step caregivers (aORs from 3.89 (CI = 1.12-13.44) to 8.85 (CI = 6.02-12.99)) were more likely to use condoms.

CONCLUSION: Young men without male support and young women lacking parental support are at particular risk of sexual risk-taking in disadvantaged communities. Parental support can be affected by other contextual factors. Violence in neighborhoods and at home should be considered.