Bullying Victimization and Sexual Behavior Among Adolescents Aged 12-15 Years From 53 Countries: A Global Perspective

Abstract

Background: Identifying correlates of sexual behavior among young adolescents is critical for preventing adverse outcomes linked to such behavior.

Aim: This study examined the relationship of bullying victimization with sexual intercourse, multiple sexual partners, and non-condom use in adolescents aged 12-15 years across 53 countries.

Methods: Cross-sectional data from 145,342 adolescents aged 12-15 years participating in the Global School-based Student Health Survey 2003-2016 were analyzed. Data on bullying victimization were assessed by the question "During the past 30 days, on how many days were you bullied?"

Outcomes: Data on several sexual behaviors were collected: (i) ever having had intercourse, among those who reported having had intercourse; (ii) multiple (≥2) lifetime sexual partners; and (iii) condom use in last sexual intercourse.

Results: Multivariable logistic regression analyses were used to assess the associations. The overall prevalence of any bullying in the past 30 days and lifetime sexual intercourse were 28.8% and 13.1%, respectively. Compared with those who were not bullied in the past 30 days, those who were bullied for 20-30 days were 2.08 (95% CI = 1.65-2.63), 1.70 (95% CI = 1.10-2.63), and 1.72 (95% CI = 1.12-2.67) times more likely to report sexual intercourse, non-condom use, and multiple sex partners, respectively.

Clinical implications: This study provides further evidence that bullying victimization is a global phenomenon and interventions are required to reduce its prevalence and unwanted consequences.

Strengths & limitations: The main strength was the large sample of young adolescents across 53 countries. However, findings from the present study should be interpreted in light of its limitations. First, the study was cross-sectional in nature and thus the direction of the association cannot be established. Second, the data only included young adolescents who attend school. Third, data were self-reported and thus reporting bias may exist. Fourth, the measure of sexual activity used was not able to distinguish between penetrative and nonpenetrative sex. Fifth, adolescents who are victims of bullying may also be exposed to other types of violence such as child maltreatment and sexual assaults, for which data were not available. Finally, the present data set did not contain data on sexual orientation.

Conclusion: These findings highlight the need for interventions either acting to educate about the potential negative consequences or to prevent risky sexual behavior in young adolescents who experience bullying victimization. Smith L, Grabovac I, Jacob L, et al. Bullying Victimization and Sexual Behavior Among Adolescents Aged 12-15 Years From 53 Countries: A Global Perspective. J Sex Med 2020;17:2148-2155.

Keywords: Adolescents; Bullying; Multi-Country Study; Sexual Behavior; Victimization.