title: A review of risk and protective factors for adolescent sexual and reproductive health in developing countries: an update.
abstract: OBJECTIVE
  To conduct a literature review of studies that examined risk and protective factors related to adolescent sexual and reproductive health in developing countries.
  
  
  METHODS
  A literature search was conducted using multiple databases, including PubMed, PsycINFO, Scopus, JSTOR, and the Interagency Youth Working Group. Review criteria included publications that: were conducted in a low- or middle-income country; had a sample size of at least 100 young people aged 10-24 years, and used multivariate analysis. All studies that were identified were also conducted between 1990 and 2010, a 20-year time frame. The literature search and initial review yielded a total of 244 studies that met the criteria and analyzed risk and protective factors related to the following outcomes: sexual initiation, number of sexual partners, condom use, contraceptive use, pregnancy and early childbearing, human immunodeficiency virus, sexually transmitted infections, and sexual coercion.
  
  
  RESULTS
  Most studies that were conducted on adolescent sexual and reproductive health in developing countries were largely focused in Sub-Saharan African contexts, and primarily examined factors related to sexual initiation and condom use. Most factors that examined an adolescent sexual and reproductive health outcome were also focused on the individual level, although an increasing number of studies within the past 10 years have focused on family-level factors. Few studies examined factors at the community or neighborhood level, which, to date, has largely been ignored in developing country contexts.
  
  
  CONCLUSIONS
  The review not only summarizes what is currently known in terms of risk and protective factors that relate to adolescent sexual and reproductive health in developing countries, but also highlights the gaps. Implications for future research are discussed.
authors.affiliation: Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. Electronic address: bnicoter@jhsph.edu.
authors.forename: Kristin
authors.initials: K
authors.lastname: Mmari
authors.forename: Simran
authors.initials: S
authors.lastname: Sabherwal
mesh_terms: D000293:Adolescent; D002648:Child; D003068:Coercion; D003075:Coitus; D017280:Condoms / Q000706:statistics & numerical data; D003268:Contraception Behavior / Q000639:trends; D003431:Cross-Cultural Comparison; D003906:Developing Countries; D005260:Female; D015658:HIV Infections / Q000453:epidemiology; D006306:Health Surveys; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000706:statistics & numerical data; D060728:Reproductive Health / Q000639:trends*; D012307:Risk Factors; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000453:epidemiology; D012959:Socioeconomic Factors; D014600:Utilization Review; D055815:Young Adult
keywords: Adolescent sexual and reproductive health; Developing countries; Risk and protective factors