Associations between Unprotected Sex and Individual, Family and Extrafamilial Factors - A cross-sectional study of 17-18 year old Swedish students in upper secondary school

Abstract: Background: A majority of sexually active adolescents in Sweden use contraception during sex, however STIs such as chlamydia has been seen to increase among 15-19 year olds. The overall aim of this study was to look into a wide set of factors that influence sexual risk-taking within individual, family and extrafamilial factors. A special focus was put on the influence of family factors on unprotected sex. Living with both parents has previously shown to be protective for general sexual risk behaviour, although researchers indicate that it is the relationships within the family that matters rather than the family structure. Methods: In this cross-sectional study 17-18 year old Swedish students from Uppsala County were recruited to participate in a health survey. The survey was self-administered and consisted of 108 questions, and the response rate was 69 percent. The sample comprised of 2127 respondents, and a majority went to school in the largest municipality in Uppsala County. Variables were identified with guidance from a multi-system framework and were analysed by using Pearson’s chi-squared test, a model was built and analysed using logistic regression. Results: Non-intact families showed patterns of having more unfavourable characteristics compared with two parent families. The final model showed evidence for family structure, peer drug use, school wellbeing and school working atmosphere being significant predictors for unprotected sex. Adolescents from non-intact families showed higher likelihood to engage in unprotected sex compared with teenagers living in two parent families, while controlling for possible confounders such as parenting factors. Conclusion: This study contributes to the literature of family and environmental factors associated with unprotected sex. The study shows the need for further investigation of school environment for sexual risk behaviour and indicates the need for more complex measurements for family process variables and school environment.