Preventing HIV transmission in adolescents: an analysis of the Portuguese data from the Health Behaviour School-aged Children study and focus groups

Background: There is recognition of the need to examine psychosocial and ecological determinants contributing to both risk and protective factors related to adolescents' sexual behaviour and HIV/AIDS. Methods: The study utilized mixed quantitative and qualitative methods. Data were collected from the Portuguese sample of the Health Behaviour in School-aged Children (HBSC) 2002. Based on these results, 14 focus group discussions were conducted. Results: A substantial minority of young people continue to engage in high-risk practices. Thus, female gender, older age, reporting easy to talk with father, not getting drunk and not getting involved in fights are significantly associated with protected sexual behaviour (using condom during last sexual intercourse). According to these results, being female and a comprehensive grade student are both related to a significantly more positive attitude towards infected people. It was concluded that these adolescents view sexual behaviour, sexual partners and condom use as elements within a complex script that governs heterosexual interactions. Several themes related to condom used emerged. Despite HIV/AIDS knowledge, young people underestimate their own risk of becoming infected with HIV. The majority of adolescents believe that HIV-infected people experience discrimination and social exclusion. Adolescents' opinions of HIV-infected people were mostly positive. Although most participants knew that HIV cannot be transmitted through social contact, undefined fears concerning the infection exist. Conclusions: These findings have important implications for the implementation of a comprehensive programme on HIV/AIDS education in secondary schools.