Family structure and adolescent sexual behavior in a poor area of Sao Paulo, Brazil

Purpose: In Brazil, as elsewhere, behavior during adolescence can place young people at risk for serious medical and social problems, including sexually transmitted infections, unintended pregnancy, drugs, crime, and violence. Few studies internationally have examined the influence of family structure on risk behavior among low-income youths. Methods: This cross-sectional study included 296 young people in one of the poorest areas of Sao Paulo who were recruited through a vocational school and completed an anonymous, self-administered questionnaire. We examined associations between family structure and various risk behaviors. Results: Ages ranged from 13-24 years (82%, 15-18); 67% were of Afro-Brazilian ancestry, and 56% were female. Median family monthly income was about US$200. Less than half lived with both parents, and 14% lived with neither parent. Rates of many risk behaviors, including involvement in crime and violence, drug and alcohol use, and sexual risk, were lowest among those living with both parents, higher among those living with one parent, and highest among those living with neither parent. For example, 26% of females living with both parents, 37% with one parent, and 71% with neither parent were sexually active (p =.003). Family structure and a personal or parental history of drug or alcohol problems were significant independent predictors of sexual activity. Conclusions: The presence of both parents is an important protective factor for Brazilian youth vulnerable to multiple risks. Prevention programs should explore ways to support parents to be present and involved in the lives of their adolescent children. (C) 2008 Society for Adolescent Medicine. All rights reserved.