Sexual Health among Youth in Residential Care in Spain: Knowledge, Attitudes and Behaviors

Abstract

Adolescents in the child welfare system often face multiple maladaptive experiences that predispose them to worse sexual health outcomes. This study aims to (1) describe the sexual health of adolescents in Spanish residential care by exploring their sexual knowledge, attitudes toward sexuality, and sexual behaviors and (2) to find out whether there are certain characteristics that make a subgroup particularly vulnerable to engaging in risky sexual behaviors. A total of 346 adolescents recruited from 47 Spanish residential care facilities (34.1% girls, 65.9% boys) aged between 11 and 19 years old completed some self-report instruments. Descriptive analyses and tests to prove gender and age differences were conducted. Their knowledge of sexuality was lower than observed in the general adolescent population, their attitudes more negative, and their tendency to engage in risky sexual behaviors higher. Girls made very infrequent use of condoms, while boys had more sexist attitudes and made habitual use of withdrawal. Although more than 20% of them had experienced sexual exchange activities before the age of 13 until 17, they did not use condoms systematically. The low level of knowledge, the early initiation of sexual exchange activities, and the scarce use of protection methods, together with sexist attitudes, place this group in a situation of great vulnerability, increasing the risk of unwanted pregnancies, sexually transmitted infections, and even teen dating violence.

Adolescents’ Perceptions of Sexuality: A Qualitative Study

“…However, several authors have found that European adolescents had little understanding of STIs, with the exception of HIV [50,51]. This is highlighted by the development of incorrect and negative attitudes regarding sexuality and its different aspects [52].…”

“…Similarly, in the study by Nathan et al [53], 69% of the young people surveyed had recently had unprotected sex, and 41% said they were willing to repeat the experience in the future. Early sexual initiation has been associated with an increased likelihood of having unprotected sex [52]. The participants believed that adolescents engage in unprotected sex due to a lack of knowledge about STIs and the consequences for their health, as well as careless behaviour.…”

“…However, it is known that having sufficient knowledge about STIs does not always guarantee that a person will behave appropriately [57]. Adolescents also engage in unprotected sex due to the age-appropriate willingness to take risks [58] and not thinking about the consequences [52].…”