title: Alcohol abuse and other factors associated with risky sexual behaviors among adolescent students from the poorest areas in Costa Rica.
abstract: OBJECTIVE
  We applied the Integrative Model of Behavioral Prediction to analyze factors associated with risky sexual behaviors for adolescent students living in the poorest segments in Costa Rica.
  
  
  METHODS
  We used data from a school-based knowledge, attitudes, and behaviors survey from the poorest districts of Costa Rica, collected for Salud Mesoamerica Initiative. We analyzed responses of 919 male and female students (12-19 years old) to determine factors associated with sexual intercourse and condom use.
  
  
  RESULTS
  One of every four students reported being sexually active. Students that reported being sexually active were more likely to consume excessive alcohol (OR 3.04 [95 % CI 1.94-4.79]). While 88.0 % [95 % CI 73.5-95.1] of sexually active adolescents said they would use a condom the next time they have sex, only 53.1 % [95 % CI 39.3-66.5] reported condom use the last time. Non-condom-users felt purchasing condoms was uncomfortable (OR 0.34 [95 % CI 0.12-0.93]).
  
  
  CONCLUSIONS
  Poor adolescents in Costa Rica begin sexual activities early and undertake behaviors that increase their risk for unwanted pregnancies and sexually transmitted infections. We found the urgent need to address alcohol abuse, and recognize gender differences in youth health programs.
authors: Salud Mesoamérica Initiative/Inter-American Development Bank, Panama City, Panama. diegori@iadb.org.
authors: Diego
authors: http://orcid.org/0000-0003-1853-728X
authors: D
authors: Rios-Zertuche
authors: University of California, Los Angeles, USA.
authors: Jose
authors: J
authors: Cuchilla
authors: Salud Mesoamérica Initiative/Inter-American Development Bank, Panama City, Panama.
authors: Paola
authors: P
authors: Zúñiga-Brenes
authors: Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA.
authors: Bernardo
authors: B
authors: Hernández
authors: Inter-American Development Bank, Santiago, Chile.
authors: Patricia
authors: P
authors: Jara
authors: Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA.
authors: Ali H
authors: AH
authors: Mokdad
authors: Salud Mesoamérica Initiative/Inter-American Development Bank, Panama City, Panama.
authors: Emma
authors: E
authors: Iriarte
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D000437:Alcoholism / Q000453:epidemiology / Q000523:psychology*; D002648:Child; D003075:Coitus / Q000523:psychology; D017280:Condoms / Q000706:statistics & numerical data; D003364:Costa Rica / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008960:Models, Psychological; D011204:Poverty Areas; D012307:Risk Factors; D012309:Risk-Taking; D012725:Sexual Behavior / Q000523:psychology*; D013334:Students / Q000523:psychology* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Adolescents; Alcohol abuse; Condom use; Costa Rica; Integrative model; Poverty