title: Predictors of sexual risk behaviour among adolescents from welfare institutions in Malaysia: a cross sectional study.
abstract: BACKGROUND
  In welfare institutions, it is essential to address the health-related needs of adolescent populations who often engage in sexual activities. This study examines the association between individual and interpersonal factors concerning sexual risk behaviour (SRB) among adolescents in welfare institutions in Malaysia.
  
  
  METHODS
  Data were derived from a cross-sectional study of 1082 adolescents in 22 welfare institutions located across Peninsular Malaysia in 2009. Using supervised self-administered questionnaires, adolescents were asked to assess their self-esteem and to complete questions on pubertal onset, substance use, family structure, family connectedness, parental monitoring, and peer pressure. SRB was measured through scoring of five items: sexual initiation, age of sexual debut, number of sexual partners, condom use, and sex with high-risk partners. Multivariate logistic regression analysis was used to examine the various predictors of sexual risk behaviour.
  
  
  RESULTS
  The study showed that 55.1% (95%CI = 52.0-58.2) of the total sample was observed to practice sexual risk behaviours. Smoking was the strongest predictor of SRB among male adolescents (OR = 10.3, 95%CI = 1.25-83.9). Among females, high family connectedness (OR = 3.13, 95%CI = 1.64-5.95) seemed to predict the behaviour.
  
  
  CONCLUSIONS
  There were clear gender differences in predicting SRB. Thus, a gender-specific sexual and reproductive health intervention for institutionalised adolescents is recommended.
authors.forename: Nik Daliana Nik
authors.initials: ND
authors.lastname: Farid
authors.forename: Sulaiman Che'
authors.initials: SC
authors.lastname: Rus
authors.forename: Maznah
authors.initials: M
authors.lastname: Dahlui
authors.forename: Nabilla
authors.initials: N
authors.lastname: Al-Sadat
authors.forename: Norlaili Abdul
authors.initials: NA
authors.lastname: Aziz
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D002648:Child; D003430:Cross-Sectional Studies; D005195:Family Relations; D005260:Female; D006801:Humans; D016015:Logistic Models; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D015999:Multivariate Analysis; D012307:Risk Factors; D012309:Risk-Taking; D012737:Sex Factors; D012725:Sexual Behavior / Q000523:psychology* / Q000706:statistics & numerical data; D012907:Smoking / Q000453:epidemiology; D012946:Social Welfare; D011795:Surveys and Questionnaires; D055815:Young Adult