All ETDs from UAB

Advisory Committee Chair

Pauline E Jolly

Advisory Committee Members

Inmaculada Aban

Laura H Bachmann

John E Ehiri

Mirjim C Kempf

Document Type


Date of Award


Degree Name by School

Doctor of Public Health (DrPH) School of Public Health


Individual and family factors have been hypothesized to influence adolescent sexual behavior and depression, but the extent to which this is true for adolescents in Jamaica as a whole and for those in rural areas in particular, has not been well studied. The objective of this dissertation was to identify individual and family factors associated with sexual debut and depression among rural Jamaican adolescents. To elucidate these factors and to provide information to guide future interventions, we analyzed data on 748 adolescents attending public high schools in the rural parish of Hanover, Jamaica. Multivariate logistic regression was used to predict factors associated with sexual experience, early sexual debut, and depression. For girls sexual experience was associated with older age at time of survey [Odds ratio (OR) = 1.54; 95% confidence interval (CI) = 1.29-1.84], hanging out with boyfriends (OR=2.27; 95% CI = 1.37-3.76), and lack of parental monitoring (OR=1.20; 95% CI = 1.07-1.35). Living with both biological parents was protective (OR=0.45; 95% CI = 0.30-0.67). For boys being older at time of survey (OR=1.47; 95% CI = 1.07-2.02) and lack of parental monitoring (OR=1.19; 95% CI = 1.01-1.39) were significant predictors. Early sexual debut for girls was influenced by type of partner at first intercourse (OR=11.95; 95% CI = 2.39-59.69) and liberal attitude towards negative sexual outcomes (OR=1.83; 95% CI = 1.21-2.77). Liberal attitude towards negative sexual outcomes i i (OR=3.11; 95% CI = 1.09-8.93) was a major predictor for boys. Being older at time of interview was protective for both genders. Elevated depressive symptom was associated with perceived lack of maternal affection and support (OR=4.06; 95% CI = 2.61-6.32). Our findings have implications for policy and practice. Education programs that will delay initiation of sexual activity need to start early before adolescents become sexually active. Considering gender differences in some of the factors associated with sexual behavior, prevention programs must adequately address the social and cognitive needs of both sexes. As most homes are female-headed, establishing support systems for the mother to take care of their adolescent children may decrease the odds of depressive symptoms.

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