Patterns of Risky Sexual Behaviors Among High-Risk and Gang Involved Youth in El Salvador: The Role of Machismo and Code of the Street As Risk Factors

Background: Adolescent childbearing is a challenge in developing countries, including El Salvador. Compared to adult parents, adolescents and their children are in a disadvantageous status of bio-psycho-social development. Moreover, the impoverished economy and social insurgence in El Salvador exacerbate the problem behaviors for this population. Research indicates that adolescent childbearing is associated with risky sexual behaviors, including early sexual initiation, multiple sexual partners and unprotected sex. Identifying patterns and risk and protective factors of high-risk sexual behavior among marginalized youth is imperative for designing future intervention.

Methods: Analyses were conducted with data from the third wave (2013) of the longitudinal study “High Risk and Gang-Involved Youth in El Salvador”, collected through chain referral sampling from 15 marginalized communities in the San Salvador metropolitan area. Given the interrelatedness of adolescent delinquency, youth’s risky sexual activity may co-exist with violence, substance abuse and other high-risk behaviors, related data was collected from a purposive sample consisting of high-risk and gang involved youth in San Salvador (N=512, 84.5% males; 15.5% females; Mean of age=21.36, SD=5.14).

Results: Two age groups, 13-17, 18-24, were specifically identified to analyze the patterns of high-risk sexual behavior. First, 72.1% of male and 81.8% of female in the younger group (13-17) had a sexual debut age of <14 years, while those 18-24 years indicated that 42.5% of male and 12.5% of female had this early sexual initiation. The younger group participants reported more sexual partners.   Younger female (70%) than male (63%) reported more than one sexual partner in a month, compared to 46.5% of male and 8.0% of female among older youths. Finally, gender differences were observed in the rate of unprotected sex in this sample. More females (80%) than males (36.3%) among the younger youths reported unprotected sexual intercourse compared to the older group where 40.4% of males and 84.5% of females. Logistic regression identified certain protective and risk factors for having multiple sexual partners. For the older group, the endorsement of traditional machismo culture (OR=1.04, p=.004) and street code values (OR=1.07, p=.026), were two risk factors. In contrast, spending time hanging out with friends (OR=.502, p=.037) was a protective factor. However, in terms of the younger group, only the participants’ self-efficacy was identified as a marginal statistically significant protective factor (OR=.38, p=.07).

Implications: This study on risky sexual behaviors among younger and older high-risk youth reveals that the younger age group demonstrated higher risk level compared to the older participants. This finding demonstrates that differences in risky sexual behavior patterns exist between younger and older adolescents in underserved communities, with the early initiators being more vulnerable. Second, gang activities and the endorsement of machismo were identified as risk factors, indicating the need for the inclusion of cultural elements in the design of sexual risk reduction interventions. Finally, the extremely high level of unprotected sexual intercourse among female high-risk youth suggests gender specific interventions are needed for this vulnerable population.