Prevalence and Correlates of Sexual Intercourse Among Adolescents in Post-Communist Albania

ObjectivesWe aimed to investigate the prevalence and correlates of sexual intercourse among adolescents in post-communist Albania.MethodsThe data used in this study was the Albanian Health Behavior in School-aged Children (HBSC) survey conducted in 2022. The current analysis included 1839 schoolchildren aged 15 years who reported on sexual intercourse (about 55% girls). Data on sociodemographic characteristics, family and peer support, behavioral factors, health complaints, and child maltreatment were also collected. Binary logistic regression was used to assess the association of lifetime sexual intercourse with correlates.ResultsThe prevalence of lifetime sexual intercourse was approximately18%. It was around 34% in boys vs. about 4% in girls. Also, sexual intercourse was more prevalent among: adolescents residing in urban areas, those from more affluent families, adolescents who reported lifetime smoking, alcohol consumption and particularly drunkenness, those without a high family support, adolescents who reported witnessing of family violence and especially those who reported lifetime sexual abuse. In gender-pooled models where all variables were adjusted for each other, positive independent correlates of lifetime sexual intercourse included: being boy (OR = 12.6, 95%CI = 8.4-19.1), family affluence (OR = 1.4, 95%CI = 1.0-2.0), lifetime smoking (OR = 1.9, 95%CI = 1.3-2.7), lifetime drunkenness (OR = 2.3, 95%CI = 1.6-3.3) and lifetime sexual abuse (OR = 8.1, 95%CI = 3.9-16.9). Sexual abuse and smoking were consistent correlates (in both genders), in addition to family affluence and drunkenness (in boys only), and adequate exercise and witnessed family violence (in girls only).ConclusionThere is a significant gender difference in the prevalence and correlates of lifetime sexual intercourse among Albanian adolescents. Targeted interventions should promote healthy behaviors and enhance sexual health education in Albania and similar transitional countries, where youths may face unique challenges in adopting healthy sexual behaviors.